Background
Interventions to improve hand hygiene compliance
Barriers and enablers to physician hand hygiene compliance
Guiding framework
Methods
Phase 1: Identification of barriers and enablers to physician hand hygiene compliance
Semi-structured interviews with physician and residents
Study population and sampling
Key informant group | Minimum number of interviews to be conducted | ||||
---|---|---|---|---|---|
Medicine | Surgery | Total Interviews | |||
Campus 1
|
Campus 2
|
Campus 1
|
Campus 2
| ||
Residents | 10 | 10 | 20 | ||
Staff Physicians | 5 | 5 | 5 | 5 | 20 |
Total Interviews | 40 |
Data collection
Theoretical Domain | Definition [[44]] |
---|---|
Knowledge | An awareness of the existence of something |
Skills | An ability or proficiency acquired through practice |
Social/Professional Role and Identity | A coherent set of behaviours and displayed personal qualities of an individual in a social or work setting |
Beliefs about capabilities | Acceptance of the truth, reality or validity about an ability, talent or facility that a person can put to constructive use |
Optimism | The confidence that things will happen for the best or that desired goals will be attained |
Beliefs about consequences | Acceptance of the truth, reality or validity about outcomes of a behaviour in a given situation |
Reinforcement | Increasing the probability of a response by arranging a dependent relationship, or contingency, between the response and a given stimulus |
Intentions | A conscious decision to perform a behaviour or a resolve to act in a certain way |
Goals | Mental representations of outcomes or end states that an individual wants to achieve |
Memory, attention and decision processes | The ability to retain information, focus selectively on aspects of the environment and choose between two or more alternatives |
Environmental context and resources | Any circumstance of a person’s situation or environment that discourages or encourages the development of skills and abilities, independence, social competence, and adaptive behaviour |
Social influences | Those interpersonal processes that can cause individuals to change their thoughts, feelings or behaviours |
Emotion | A complex reaction pattern, involving experiential, behavioural and physiological elements, by which the individual attempts to deal with a personally significant matter or event |
Behavioural regulation | Anything aimed at managing or changing objectively observed or measured actions |
Data analysis
Coding interview transcripts
Generating specific beliefs
Identifying relevant theoretical domains
Non-participant observation
Observation of the environmental context of interactions | Observation of the process of the interaction |
---|---|
Who is present during the interaction? | Who speaks to whom and about what? (i.e., the auditor and physician interaction) |
Physical space (use a diagram to depict the set up of space and how people, patients and sinks/alcohol hand rub dispensers are positioned in that space) | How are concerns responded to? |
Describe how patient care is delivered in the setting (i.e., is this a shared room? Are other patients receiving care at the same time?) | Are the physicians receiving feedback from the auditors? |
Location of the auditor in relation to the physician being observed | If feedback is given, how do the physicians respond? |
Describe the length of the interaction | Whenever possible, capture verbatim accounts between individuals present |