workers compliance with hand hygiene guidelines: A metasynthesis
associated infection is a substantial challenge for patient safety resulting in
morbidity and mortality worldwide. Compliance with hand hygiene guidelines
reduces the risk of healthcare associated infection. Evidence suggests that
optimum hand hygiene is not performed by healthcare workers, the reasons for
this need to be identified. There is a
wealth of quantitative studies on hand hygiene performance however a review of
the qualitative literature has not been published. The objective of this review
is to explore the qualitative literature available and synthesise the findings to
establish factors which impact on healthcare workers compliance with hand
Design: A systematic
review of the qualitative literature and metasynthesis of the data identified
in order to gain a new understanding regarding healthcare workers compliance
with hand hygiene guidelines.
core concepts were identified which influence compliance with hand hygiene
guidelines. These were motivational factors and factors related to the
individuals’ perceptions of the work environment. Motivational factors included
social influences, acuity of patient care, self-protection and use of cues.
Perceptions of the work environment included themes related to resources,
knowledge, information and organisational culture.
findings of the metasynthesis reflects the quantitative research. A multimodal
approach to improving hand hygiene compliance is recommended to address those
areas in relation to both healthcare worker motivation and work environment