Brief reportA tool to assess barriers to adherence to hand hygiene guideline
Section snippets
Conceptual underpinnings for the tool
Cabana et al2 reviewed 76 studies that assessed physician barriers to adherence to clinical practice guidelines. On the basis of this review, they identified 7 categories of barriers to guideline adherence related to general knowledge, attitudes, and behaviors (Table 1). The majority of studies examined only a single barrier, and Cabana concluded that intervention programs that fail to consider the variety of barriers to adherence are less likely to succeed. These 7 barriers were used as a
Description of the tool
The tool uses a 6-point Likert scale and has 2 sections. Part 1 includes attitudinal statements about practice guidelines in general (18 statements), and part 2 includes 18 statements specifically regarding the Hand Hygiene Guideline. Part 1 was designed to be used as a general tool with any practice guideline because attitudes regarding guidelines in general may influence one's response to specific guidelines. Possible scores range from 0 to 180, with higher scores indicating fewer perceived
Results
The questionnaire took respondents 5 to 10 minutes to complete. The test-retest reliability coefficient for the 21 health care professionals taking the survey was .86, and the standardized α coefficient in the item analysis was .80. One physician refused to participate in the testing because he said that “guidelines are worthless.”
Discussion
The publication of the Hand Hygiene Guideline provides a unique opportunity to engage staff in efforts to improve practice and adherence to standards. To do this, it would be helpful to understand what staff members perceive as the barriers to implementing practice guidelines in general and the Hand Hygiene Guideline in particular. For example, the fact that one physician refused to participate in the pilot testing because he judged practice guidelines to be unimportant has implications for his
References (4)
- et al.
Guideline for Hand Hygiene in Health-Care Settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force
Am J Infect Control
(2002) - et al.
Why don't physicians follow clinical practice guidelines?: a framework for improvement
JAMA
(1999)
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Hand hygiene: Attitudes and practices of nurses, a comparison between 2007 and 2015
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