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Visual triggers ‘increase hand hygiene compliance’

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Using visual triggers that capitalise on the “ick factor” is an effective way to get nurses and other healthcare workers to clean their hands more often, according to US researchers.

Infection control experts at Henry Ford Health System in Detroit used images of bacterial growth designed to motivate hospital staff to comply with hand hygiene guidelines.

“These images put a face to the continuous hand hygiene education that healthcare workers get”

Ashley Gregory

They said they were inspired by UK research that found using emotional motivators in Indian villages was more effective at promoting changes in hand hygiene behaviour than traditional messaging.

The US team developed a book of images containing bacterial cultures of differing types and levels of contamination. They tested the images on hospital units that had low hand hygiene compliance rates.

Over a two-month period, they visited those units 10 times, sampled workers’ hands for bacteria, and then showed them pictures of cultures similar to the contamination on their hands.

Compliance increased by between 11% and 46% in the four units where the study was conducted.

Ashley Gregory, an infection prevention specialist who co-led the project, said: “Hospital staff wanted to wash their hands after looking at the book and picturing similar contamination on their own skin.

“Using this example, other institutions may be able to change behaviour and improve their hand hygiene compliance rates by influencing staff to connect the images of microbial contamination with non-adherence to hand hygiene guidelines,” she said.

Henry Ford Health System

Visual triggers ‘increase hand hygiene compliance’

Source: Henry Ford Hospital

“These images put a face to the continuous hand hygiene education that health care workers get. They stick in your mind. They gross you out,” she added.

The programme also motivated healthcare workers to take ownership of the environmental cleaning of their workspace, said the researchers.

The study will be presented on 11 June at the annual conference of the Association for Professionals in Infection Control and Epidemiology in Charlotte, North Carolina.

“Hand hygiene is one of the most important ways to prevent the spread of infection, and yet it can be one of the most difficult benchmarks to improve,” said the association’s president Susan Dolan, a nurse and hospital epidemiologist at the Children’s Hospital Colorado.

“The visual nature of this approach proved successful for the team at Henry Ford Health System, and it may offer an effective strategy for other healthcare facilities that are looking for ways to change behaviour and improve hand hygiene compliance,” she said.

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Readers' comments (1)

  • michael stone

    An interesting 'spin off' of the 'nudge' approach (by which I mean 'nudge people into doing it, by making the message visible in the workplace).

    Although I can't help but wonder, whether an image of a seriously infected wound on a patient, connected to a lack of hand washing, wouldn't be a stronger 'nudge' than pictures of bacterial cultures ?

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