Hand hygiene – social network analysis of peer-identified and management-selected change agents

Autor: Yew Fong Lee, Suraya Amir Husin, Mary-Louise McLaws, Hock Hin Chua, Loke Meng Ong, Didier Pittet, Walter Zingg, See Yin Wong
Jazyk: angličtina
Rok vydání: 2019
Předmět:
020205 medical informatics
Cross Infection/prevention & control
Psychological intervention
Organizational culture
02 engineering and technology
Social Networking
Tertiary Care Centers
Social network analysis
0302 clinical medicine
Promotion (rank)
Hygiene
Surveys and Questionnaires
Health care
0202 electrical engineering
electronic engineering
information engineering
Medicine
Leadership style
Infection Control/statistics & numerical data
Pharmacology (medical)
030212 general & internal medicine
Peer Influence
media_common
ddc:616
Cross Infection
Alcohol-based handrub
Guideline Adherence/statistics & numerical data
Hand Hygiene/statistics & numerical data
Infectious Diseases
Practice Guidelines as Topic
Guideline Adherence
Microbiology (medical)
Health Personnel
media_common.quotation_subject
Multimodal strategy
lcsh:Infectious and parasitic diseases
03 medical and health sciences
Nursing
Behavioural change
Humans
lcsh:RC109-216
Health Personnel/education/psychology/statistics & numerical data
Infection Control
Social network
business.industry
Research
Public Health
Environmental and Occupational Health
Malaysia
Organizational Culture
Social relation
Leadership
business
Hand hygiene
Zdroj: Antimicrobial Resistance and Infection Control, Vol 8, Iss 1, Pp 1-7 (2019)
Antimicrobial Resistance and Infection Control, Vol. 8 (2019) P. 195
Antimicrobial Resistance and Infection Control
ISSN: 2047-2994
Popis: Background Hand hygiene compliance can be improved by strategies fostering collaborative efforts among healthcare workers (HCWs) through change agents. However, there is limited information about how change agents shape the social networks of work teams, and how this relates to organisational culture. The objectives of this study were to describe the influence of peer-identified change agents (PICAs) and management-selected change agents (MSCAs) on hand hygiene, perception of their leadership style by peers, and the role of the organisational culture in the process of hand hygiene promotion. Methods This study, stratified in pre-, during, and post-intervention periods, was conducted between February 2017 and March 2018 in two wards at a tertiary care hospital in Malaysia. Hand hygiene promotion was facilitated either by PICAs (study arm 1) or MSCAs (study arm 2), and the two wards were randomly allocated to one of the two interventions. Outcomes were: 1) perceived leadership styles of PICAs and MSCAs by staff, vocalised during question and answer sessions; 2) the social network connectedness and communication patterns between HCWs and change agents by applying social network analysis; and 3) hand hygiene leadership attributes obtained from HCWs in the post-intervention period by questionnaires. Results Hand hygiene compliance in study arm 1 and study arm 2 improved by from 48% (95% CI: 44–53%) to 66% (63–69%), and from 50% (44–55%) to 65% (60–69%), respectively. There was no significant difference between the two arms. Healthcare workers perceived that PICAs lead by example, while MSCAs applied an authoritarian top-down leadership style. The organisational culture of both wards was hierarchical, with little social interaction, but strong team cohesion. Position and networks of both PICAs and MSCAs were similar and generally weaker compared to the leaders who were nominated by HCWs in the post-intervention period. Healthcare workers on both wards perceived authoritative leadership to be the most desirable attribute for hand hygiene improvement. Conclusion Despite experiencing successful hand hygiene improvement from PICAs, HCWs expressed a preference for the existing top-down leadership structure. This highlights the limits of applying leadership models that are not supported by the local organisational culture.
Databáze: OpenAIRE
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