| Popis: |
BackgroundHand hygiene is known to reduce healthcare-associated infections. However, it remains suboptimal among healthcare providers. In this study, we used the Behaviour Centered Design to explore the facilitators and deterrents of hand hygiene among healthcare providers in the greater Kampala Metropolitan area, Uganda.MethodsA formative qualitative study, enshrined in a cluster randomised trial was conducted in 19 healthcare facilities (HCFs). A total of 19 semi-structured and 18 key informant interviews were used to collect data on hand hygiene status, and facilitators and deterrents of hand hygiene. Data were transcribed verbatim and NVIVO 12.0 software was used to ease the analysis following a thematic framework.ResultsAbout 47.4% of the HCFs had sufficient hand hygiene infrastructure, and 57.9% did not report total compliance to hand hygiene during patient care. Constant reminders such as nudges, and frequency of patient contact and the nature of clinical work were the physical and biological deterrents respectively. Heavy workload in HCFs was the only biological deterrent. Executive brain facilitators included knowledge of workplace health risks and infection prevention and control (IPC) guidelines, and a positive attitude. A negative attitude was the executive brain deterrent to hand hygiene. Recognition and rewards and fear of infections were pointed out as the only motivated brain facilitators. Behavioural setting facilitators included proximity to functional hand hygiene infrastructure, the existence of active IPC committees, good leadership and availability of a budget for hand hygiene supplies. Behavioural setting deterrents included non-functionality and non-proximity to hand hygiene infrastructure and inadequate supplies.Conclusions Compliance to Hand hygiene practice and provisions was reported to be poor. Deterrents to hand hygiene included a heavy workload, negative attitude, inadequate supplies, non-functionality and long-distance to hand washing stations. Facilitators included constant reminders, fear of infections, frequency of patient contact and nature of clinical work, positive attitude, knowledge of IPC guidelines, recognition and reward, good leadership, availability of budgets for hand hygiene supplies, availability and proximity to hand hygiene supplies and infrastructure and active IPC committees. There is a need to remove the barriers and to maintain the facilitators to achieve optimal hand hygiene.ISRCTN Registry with number ISRCTN98148144. The trial was registered on 23/11/2020. |
