Adapting the WHO hand hygiene 'reminders in the workplace' to improve acceptability for healthcare workers in maternity settings worldwide: a mixed methods study.

Autor:	Dunlop CL; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK catherinedunlop@nhs.net., Kilpatrick C; Department of Integrated Health Services, World Health Organization, Geneva, Switzerland., Jones L; Institute of Applied Health Research, University of Birmingham, Birmingham, UK., Bonet M; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland., Allegranzi B; Department of Integrated Health Services, World Health Organization, Geneva, Switzerland., Brizuela V; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland., Graham W; Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK.; Institute of Education for Medical and Dental Sciences, University of Aberdeen, Aberdeen, UK., Thompson A; Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, Merseyside, UK., Cheshire J; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK., Lissauer D; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.; University of Liverpool, Liverpool, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Sep 17; Vol. 14 (9), pp. e083132. Date of Electronic Publication: 2024 Sep 17.
DOI:	10.1136/bmjopen-2023-083132
Abstrakt:	Introduction: Hand hygiene is key in preventing healthcare-associated infections, but it is challenging in maternity settings due to high patient turnover, frequent emergencies and volume of aseptic procedures. We sought to investigate if adaptions to the WHO hand hygiene reminders could improve their acceptability in maternity settings globally, and use these findings to develop new reminders specific to maternity settings. Methods: Informed by Sekhon et al 's acceptability framework, we conducted an online survey, semi-structured interviews and a focus group examining the three WHO central hand hygiene reminders ('your five moments of hand hygiene', 'how to hand wash' and 'how to hand rub') and their acceptability in maternity settings. A convergent mixed-methods study design was followed. Findings were examined overall and by country income status. A WHO expert working group tested the integrated findings, further refined results and developed recommendations to improve acceptability for use in the global maternity community. Findings were used to inform the development of two novel and acceptable hand hygiene reminders for use in high-income country (HIC) and low- and middle-income country (LMIC) maternity settings. Results: Participation in the survey (n=342), semi-structured interviews (n=12) and focus group (n=7) spanned 51 countries (14 HICs and 37 LMICs). The highest scoring acceptability constructs were clarity of the intervention (intervention coherence), confidence in performance (self-efficacy), and alignment with personal values (ethicality). The lowest performing were perceived difficulty (burden) and how the intervention made the participant feel (affective attitude). Overfamiliarity reduced acceptability in HICs (perceived effectiveness). In LMICs, resource availability was a barrier to implementation (opportunity cost). Two new reminders were developed based on the findings, using inclusive female images, and clinical examples from maternity settings. Conclusion: Following methodologically robust adaptation, two novel and inclusive maternity-specific hand hygiene reminders have been developed for use in both HIC and LMICs. Competing Interests: Competing interests: None declared. (© World Health Organization 2024. Licensee BMJ.)
Databáze:	MEDLINE
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