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Mindful Hand Hygiene to Reduce Infections Among Veterans While Enhancing ProviderWell-Being

注意手部卫生，减少退伍军人的感染，同时提高提供者的福祉

基本信息

批准号：
10558454
负责人：
Michael Todd Greene
金额：
--
依托单位：
VETERANS HEALTH ADMINISTRATION
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-02-01 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10558454
关键词：
Address Adherence Adopted Anxiety Area Attention Awareness COVID-19 pandemic Caring Client satisfaction Clinical Cognitive Control Groups Decision Making Education Elements Ensure Environment Evidence based practice Face Fatigue Focus Groups Goals Hand Health Personnel Health system Healthcare Healthcare Systems Hospital Administration Hospitals Human Resources Hygiene Infection Infection prevention Intervention Interview Judgment Malpractice Measures Medical center Mental Depression Methodology Methods Nurses Outcome Patient-Focused Outcomes Patients Perception Personal Satisfaction Physicians Pilot Projects Provider Psyche structure Quality of Care Quality of life Randomized Recommendation Regulation Reporting Risk Safety Site Stress Structure Symptoms Techniques Testing Time United States Department of Veterans Affairs Veterans Veterans Health Administration Work Workload adherence rate anxiety reduction burnout care providers career clinical practice cost disease transmission effectiveness evaluation experience falls future outbreak health care service organization health care settings healthcare-associated infections improved innovation member mindfulness mindfulness intervention multi-component intervention novel patient safety prevent provider adherence psychological distress success tool treatment arm

项目摘要

Background: More and more providers face cumulative stress and burdens arising from increasing regulations, administrative and clerical duties, clinical workloads, malpractice lawsuits, and less time with patients. As a result, stress, fatigue, psychological distress, depression, burnout, and career dissatisfaction among providers are prevalent. In addition to impacting providers directly, poor well-being can negatively impact healthcare organizations and reduce quality of care, patient safety and patient satisfaction. Additionally, provider burnout, stress, and workload have been associated with poorer hand hygiene adherence, which can increase the risk of healthcare-associated infection (HAI). Hand hygiene is a key element of preventing HAI, yet maintaining healthcare provider adherence to this basic practice remains challenging. Achieving optimal hand hygiene adherence requires minimizing cognitive biases, such as perceived low odds of spreading infections by not properly performing hand hygiene. Unfortunately, cognitive bias is a known barrier to clinician decision-making. Mindfulness is an approach that can help clinicians shed preconceived biases through nonjudgmental awareness and more broadly facilitate improvements in patient safety. Significance: A hand hygiene-based mindfulness intervention targeted at Veterans Health Administration (VHA) providers could improve hand hygiene practices and thereby enhance patient outcomes. Additionally, incorporating brief mindfulness practices during moments of hand hygiene has the potential to directly improve provider well-being. Innovation and Impact: While targeted interventions and bundled approaches to improve hand hygiene adherence and reduce HAI have been implemented, interventions incorporating introspective techniques, such as mindfulness, are limited. In a recent single-site pilot study, team members of this proposed study found that a brief mindfulness intervention improved hand hygiene and mindful attention among physicians. The proposed study will expand on this pilot work by more broadly testing the hand hygiene-based mindfulness intervention with both physicians and nurses, and by including a specific focus on provider well-being. The goal is to optimize provider hand hygiene adherence, improve provider well-being and enhance the quality and safety of care delivered to Veterans. Specific Aims: We have three specific aims: 1) To evaluate the effectiveness of a hand hygiene-based mindfulness intervention on provider hand hygiene adherence, duration, and perceptions. 2) To evaluate the effectiveness of a hand hygiene-based mindfulness intervention on measures of provider mindfulness and well-being. 3) To identify the barriers, facilitators, and perceptions of a hand hygiene-based mindfulness intervention in the hospital. Methodology: We will conduct a randomized controlled mixed-methods trial at 2 diverse VHA hospitals. Physicians and nurses randomized to the intervention arm will receive mindfulness education and tools to prompt mindfulness during hand hygiene. Measures of hand hygiene (adherence, duration, and perceptions) and measures of provider mindfulness and well-being will be collected and compared between the intervention and control groups. Next Steps/Implementation: We will work with our proposed partners to review our study findings, modify our intervention as needed, and disseminate our findings through the various partnership channels. At the conclusion of this project, we will have a hand hygiene-based mindfulness intervention package that we can subsequently work to deploy more broadly across VHA hospitals to improve the safety of Veterans and the well-being of those providing their healthcare.

背景：越来越多的医疗服务提供者面临着与日俱增的压力和负担