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An Innovative Strategy to Increase Patient Hand Hygiene Autonomy of Hospitalized Adults

Knighton, Shanina Camille
http://rave.ohiolink.edu/etdc/view?acc_num=case1489708859944739

Abstract Details

2017, Doctor of Philosophy, Case Western Reserve University, Nursing.
Despite recognition that patients carry pathogens on their hands and demonstrate poor hand hygiene practice, little attention has been given to interventions that increase hand hygiene practices of patients. Studies that have attempted to improve patient hand hygiene practice lack sustainability due to dependability on healthcare staff, however no prior studies have considered ways to improve independent patient hand hygiene practice. One such approach is using a multi-modal education intervention centered around patients that will promote patient self-practice. The purpose of this comparative effectiveness study was to test the effectiveness of two educationally-based approaches to improve patient hand hygiene in older adults hospitalized for elective lower extremity orthopedic or podiatry surgery at a veterans’ hospital. Group 1 (n=41) received an educational video, an educational handout/model (Four Moments for Patient’s Hand Hygiene) and a voice-recorded electronic audio reminder (EAR), which verbally reminded the participant to clean their hands. Group 2 (n=34) received only the educational video and Moments for Patient’s Hand Hygiene “Four Moments” handout. Comparing Post-operative Day (POD) 0 to up to POD 3, and controlling for covariates (Disability of Arm, Shoulder, and Hand [QuickDASH], Hand Grip Strength, Surgical Pain, MRSA in Nares), the questions asked were if participants in the Group 1 had better rates of patient hand hygiene behavior as measured by product consumption and the quantity of colony-forming units on their hands. Using multivariate and univariate analyses, results indicated that the electronic audio reminder was a significant predictor of ABHR consumption, R2 = .39, R2adj. = .34, F (6, 68) = 7.265, p < .001. The average product consumption of ABHR in Group 1 was 29.97 grams (SD 17.13); in comparison to Group 2, 10.88 grams (9.27) (p<0.0001). A subset of participants’ hands were cultured from each group on Day 0 and Day 3, both groups were negative for bacterial growth of both gram-negative and or MRSA pathogens. Implications from this study demonstrate that simple audio technology has the potential to increase patient-centered infection prevention in the acute care settings without increasing healthcare worker burden. Findings can be used to promote healthy behaviors, prevent infection and disease, and improve patient-centered care.
Patricia A Higgins, PhD (Committee Chair)
Mary A Dolansky, PhD (Committee Member)
Camille Warner, PhD (Committee Member)
Curtis Donskey, MD (Committee Member)
147 p.
Behavioral Sciences; Instructional Design; Nursing
Patient hand hygiene self-management; patient-centered infection prevention; electronic audio reminder and patient hand hygiene; independent patient hand hygiene

Recommended Citations

Citations

  • Knighton, S. C. (2017). An Innovative Strategy to Increase Patient Hand Hygiene Autonomy of Hospitalized Adults [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1489708859944739

    APA Style (7th edition)

  • Knighton, Shanina. An Innovative Strategy to Increase Patient Hand Hygiene Autonomy of Hospitalized Adults. 2017. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1489708859944739.

    MLA Style (8th edition)

  • Knighton, Shanina. "An Innovative Strategy to Increase Patient Hand Hygiene Autonomy of Hospitalized Adults." Doctoral dissertation, Case Western Reserve University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=case1489708859944739

    Chicago Manual of Style (17th edition)

case1489708859944739
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© 2017, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.