Influence of Role Models and Hospital Design on the Hand Hygiene of Health-Care Workers

• Main Authors: Mary G. Lankford, Teresa R. Zembower, William E. Trick, Donna M. Hacek, Gary A. Noskin, Lance R. Peterson
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2003-02-01
• Series: Emerging Infectious Diseases
• Subjects: Handwashing; hand hygiene; sink access; new construction; role model; infection control
• Online Access: https://wwwnc.cdc.gov/eid/article/9/2/02-0249_article

We assessed the effect of medical staff role models and the number of health-care worker sinks on hand-hygiene compliance before and after construction of a new hospital designed for increased access to handwashing sinks. We observed health-care worker hand hygiene in four nursing units that provided similar patient care in both the old and new hospitals: medical and surgical intensive care, hematology/oncology, and solid organ transplant units. Of 721 hand-hygiene opportunities, 304 (42%) were observed in the old hospital and 417 (58%) in the new hospital. Hand-hygiene compliance was significantly better in the old hospital (161/304; 53%) compared to the new hospital (97/417; 23.3%) (p<0.001). Health-care workers in a room with a senior (e.g., higher ranking) medical staff person or peer who did not wash hands were significantly less likely to wash their own hands (odds ratio 0.2; confidence interval 0.1 to 0.5); p<0.001). Our results suggest that health-care worker hand-hygiene compliance is influenced significantly by the behavior of other health-care workers. An increased number of hand-washing sinks, as a sole measure, did not increase hand-hygiene compliance.