Using psychological theory to inform methods to optimize the implementation of a hand hygiene intervention.
Using psychological theory to inform methods to optimize the implementation of a hand hygiene intervention.
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DOI：
10.1186/1748-5908-7-77
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发表时间：
2012-08-28
期刊：
影响因子：
--
通讯作者：
Jaglal SB
中科院分区：
文献类型：
--
作者：
Boscart VM;Fernie GR;Lee JH;Jaglal SB
严格的手部卫生是预防感染传播给患者的最重要因素，但很难做到并保持。对改变工作人员行为所涉及的过程缺乏了解可能导致无法取得成功。本研究的目的是确定护士和管理人员对当前卫生保健实践和实施新的卫生保健电子监测技术的感知障碍和促进因素。我们进行了10个关键信息提供者访谈（3名管理人员和7名护士），以探讨与HH相关的障碍和促进因素以及新技术对结果的影响。半结构化访谈基于Michie等人的理论领域框架，并在干预实施之前进行。数据探索采用归纳定性分析方法。比较管理人员和护士之间的数据。在12个领域中的9个，护士和管理人员的回答不同。管理者认为护士没有足够的知识和技能来执行HH，而护士则自信自己拥有所需的知识和技能。护士关注的是眼前的结果，而管理者则强调该系统的长期效果。护士最关注的是他们的个人安全和家人的安全，作为实施HH的动力来源，而管理人员则确定了专业承诺、激励和目标设定。管理人员表示，员工没有适当的决策流程来判断HH是否必要。他们还强调了团队作为一种社会影响的积极方面，而护士对群体一致性或与他人比较不感兴趣。护士描述了个人反馈和自我监控的重要性，以提高他们的表现，而管理人员报告了不同的观点。本研究强调了使用基于心理学理论的结构化方法为行为改变干预的实施计划提供信息的好处。这项工作是系统地确定影响护士与HH相关行为的因素的重要一步。
Careful hand hygiene (HH) is the single most important factor in preventing the transmission of infections to patients, but compliance is difficult to achieve and maintain. A lack of understanding of the processes involved in changing staff behaviour may contribute to the failure to achieve success. The purpose of this study was to identify nurses’ and administrators’ perceived barriers and facilitators to current HH practices and the implementation of a new electronic monitoring technology for HH. Ten key informant interviews (three administrators and seven nurses) were conducted to explore barriers and facilitators related to HH and the impact of the new technology on outcomes. The semi structured interviews were based on the Theoretical Domains Framework by Michie et al. and conducted prior to intervention implementation. Data were explored using an inductive qualitative analysis approach. Data between administrators and nurses were compared. In 9 of the 12 domains, nurses and administrators differed in their responses. Administrators believed that nurses have insufficient knowledge and skills to perform HH, whereas the nurses were confident they had the required knowledge and skills. Nurses focused on immediate consequences, whereas administrators highlighted long-term outcomes of the system. Nurses concentrated foremost on their personal safety and their families’ safety as a source of motivation to perform HH, whereas administrators identified professional commitment, incentives, and goal setting. Administrators stated that the staff do not have the decision processes in place to judge whether HH is necessary or not. They also highlighted the positive aspects of teams as a social influence, whereas nurses were not interested in group conformity or being compared to others. Nurses described the importance of individual feedback and self-monitoring in order to increase their performance, whereas administrators reported different views. This study highlights the benefits of using a structured approach based on psychological theory to inform an implementation plan for a behavior change intervention. This work is an essential step towards systematically identifying factors affecting nurses’ behaviour associated with HH.
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影响因子：
4.2
作者：
Abraham, Charles;Michie, Susan
通讯作者：
Michie, Susan
DOI：
10.1111/j.1464-0597.2008.00341.x
发表时间：
2008-10-01
影响因子：
7.2
作者：
Michie, Susan;Johnston, Marie;Eccles, Martin
通讯作者：
Eccles, Martin
影响因子：
7.2
作者：
Michie, Susan;Berentson-Shaw, Jessica;Ellis, Simon
通讯作者：
Ellis, Simon
影响因子：
3.2
作者：
Janzen, JA;Silvius, J;Drummond, N
通讯作者：
Drummond, N
影响因子：
4.9
作者：
Rosenthal, VD;Guzman, S;Safdar, N
通讯作者：
Safdar, N