A nudge intervention to improve hand hygiene compliance in the hospital

F Elia, F Calzavarini, P Bianco, RG Vecchietti… - Internal and Emergency …, 2022 - Springer
F Elia, F Calzavarini, P Bianco, RG Vecchietti, AF Macor, A D'Orazio, A Dragonetti…
Internal and Emergency Medicine, 2022Springer
Hand hygiene among professionals plays a crucial role in preventing healthcare‐associated
infections, yet poor compliance in hospital settings remains a lasting reason for concern.
Nudge theory is an innovative approach to behavioral change first developed in economics
and cognitive psychology, and recently spread and discussed in clinical medicine. To
assess a combined nudge intervention (localized dispensers, visual reminders, and gain-
framed posters) to promote hand hygiene compliance among hospital personnel. A quasi …
Abstract
Hand hygiene among professionals plays a crucial role in preventing healthcare‐associated infections, yet poor compliance in hospital settings remains a lasting reason for concern. Nudge theory is an innovative approach to behavioral change first developed in economics and cognitive psychology, and recently spread and discussed in clinical medicine. To assess a combined nudge intervention (localized dispensers, visual reminders, and gain-framed posters) to promote hand hygiene compliance among hospital personnel. A quasi-experimental study including a pre-intervention phase and a post-intervention phase (9 + 9 consecutive months) with 117 professionals overall from three wards in a 350-bed general city hospital. Hand hygiene compliance was measured using direct observations by trained personnel and measurement of alcohol-based hand-rub consumption. Levels of hand hygiene compliance were low in the pre-intervention phase: 11.44% of hand hygiene opportunities prescribed were fulfilled overall. We observed a statistically significant effect of the nudge intervention with an increase to 18.71% (p < 0.001) in the post-intervention phase. Improvement was observed in all experimental settings (the three hospital wards). A statistical comparison across three subsequent periods of the post-intervention phase revealed no significant decay of the effect. An assessment of the collected data on alcohol-based hand-rub consumption indirectly confirms the main result in all experimental settings. Behavioral outcomes concerning hand hygiene in the hospital are indeed affected by contextual, nudging factors to a significant extent. If properly devised, nudging measures can provide a sustainable contribution to increase hand hygiene compliance in a hospital setting.
Springer
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