| Abstrakt: |
Background & Objectives: Hand hygiene (HH), a fundamental action which is simple, inexpensive and most effective tool in preventing healthcare-associated infections, is at the core of infection prevention and control (IPC) program, yet hand hygiene compliance (HHC) among health care workers (HCWs) is quite low in healthcare settings and remains a lasting cause of alarm.1,2 Previous studies have shown that a multifaceted approach is critical for HHC improvement, a fact endorsed by World Health Organization.2,3,4,5 In health research, the term 'choice architecture' and related term 'nudging' are broadly applied to a range of intervention types across multiple behavioral contexts, which in recent times, are increasingly being perceived as policy strategies. 6 Nudges are choice-preserving interventions that steer people's behavior in specific directions, while still allowing them to go their own way and thus can be easily implementable, inexpensive measures as hand hygiene interventions.7,8 Multimodal strategies have been recognized as the most effective intervention, affecting three levels: individual, interpersonal, and organizational.9,10,11 These mini-nudges, however, will not displace the traditional tools like training, regulations etc, but instead, will combine with them as potential reinforcers, since behavior can be influenced by altering the microenvironments within which people make choices (choice architecture).12 This in turn, would provide a sustainable contribution towards improving HHC to a significant extent and in turn reduce healthcare-associated infections. Aim: To assess the outcome of multimodal nudge interventions on hand hygiene compliance in healthcare workers Objective: To bring about behavioral change using nudges as interventions and in turn contribute to long-term success of these strategies to improve HHC Methods & Results: A quasi-experimental study was conducted, including a preintervention phase and a post-intervention phase with 226 HCWs overall, from various wards and high-risk areas of our hospital. HHC was measured using both overt and covert observations by trained personnel in pre intervention and post intervention phases. Levels of hand hygiene compliance were low in the pre-intervention phase (40.9 %) with significant improvement seen (68.4 %) in the post intervention phase, the increase after nudging interventions being statistically significant (p<0.05). Interpretation & Conclusion: If properly devised, integrated multimodal interventions based on a multilevel socioecological approach has great potential in bringing about sustained improvement in hand hygiene compliance of healthcare workers. [ABSTRACT FROM AUTHOR] |
