Nudging to improve hand hygiene
Nudging to improve hand hygiene
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DOI：
10.1016/j.jhin.2017.09.023
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发表时间：
2018-04-01
影响因子：
6.9
通讯作者：
Vandenbroucke-Grauls, C. M. J. E.
中科院分区：
文献类型：
--
作者：
Caris, M. G.;Labuschagne, H. A.;Vandenbroucke-Grauls, C. M. J. E.
背景：手卫生对于预防医疗相关感染至关重要，但提高依从性具有挑战性。当医护人员很少遇到与医疗保健相关的感染时，他们会认为通过不良的手部卫生引起感染的几率可以忽略不计。诸如此类的认知偏见可能会导致不遵守。轻推，“一个友好的推动，以鼓励所需的行为”，可以提供一个容易实施，廉价的措施，以解决认知偏见，从而支持手部卫生interventions.Aim：为了调查是否行为轻推，显示为海报，可以增加使用酒精为基础的手部擦。方法：我们开发了轻推的基础上，系统回顾先前描述的认知偏见，并测试这些通过横断面调查的目标受众。然后，我们在两个医院病房进行了一项前后对照试验，以评估这些轻推对使用酒精洗手液的影响，使用电子配药器进行测量。结果：根据工作量调整的泊松回归分析显示，在一个病房中，显示在配药器旁边的轻推增加了他们的总体使用[海报1：相对风险：1.6（95%置信区间：1.2-2.2）;海报2：1.7（1.2-2.5）]和两个病房的医生查房期间[海报1：A病房：1.7（1.1-2.6）; B病房：2.2（1.3-3.8）]。使用分配器没有相邻的轻推没有increased.Conclusion：轻推的基础上，在手部卫生中发挥作用的认知偏见，并显示为海报，可以提供一个简单的，廉价的措施，以增加使用酒精为基础的手擦。当应用推动改变行为时，重要的是要为正确的受众确定正确的推动。(C)2017年，卫生保健感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Hand hygiene is paramount to prevent healthcare-associated infections, but improving compliance is challenging. When healthcare workers seldom encounter healthcare-associated infections, they will consider the odds of causing infections through poor hand hygiene negligible. Cognitive biases such as these may induce non-compliance. Nudging, 'a friendly push to encourage desired behaviour', could provide an easily implemented, inexpensive measure to address cognitive biases and thus support hand hygiene interventions.Aim: To investigate whether behavioural nudges, displayed as posters, can increase the use of alcohol-based hand rub.Methods: We developed nudges based on a systematic review of previously described cognitive biases, and tested these through a cross-sectional survey among the target audience. We then conducted a controlled before-after trial on two hospital wards, to assess the effect of these nudges on the use of alcohol-based hand rub, measured with electronic dispensers.Findings: Poisson regression analyses adjusted for workload showed that nudges displayed next to dispensers increased their overall use on one ward [poster 1: relative risk: 1.6 (95% confidence interval: 1.2-2.2); poster 2: 1.7 (1.2-2.5)] and during doctor's rounds on both wards [poster 1: ward A: 1.7 (1.1-2.6); ward B: 2.2 (1.3-3.8)]. Use of dispensers without adjacent nudges did not increase.Conclusion: Nudges based on cognitive biases that play a role in hand hygiene, and displayed as posters, could provide an easy, inexpensive measure to increase use of alcohol-based hand rub. When applying nudges to change behaviour, it is important to identify the right nudge for the right audience. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.