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Chen W, Tseng CL. What are healthcare workers' preferences for hand hygiene interventions? A discrete choice experiment. BMJ Open. 2021;11(11):e052195doi: 10.1136/bmjopen-2021-052195.
Chen, W., & Tseng, C. L. (2021). What are healthcare workers' preferences for hand hygiene interventions? A discrete choice experiment. BMJ open, 11(11), e052195. https://doi.org/10.1136/bmjopen-2021-052195
Chen, Wenlin, and Tseng, Chung-Li. "What are healthcare workers' preferences for hand hygiene interventions? A discrete choice experiment." BMJ open vol. 11,11 (2021): e052195. doi: https://doi.org/10.1136/bmjopen-2021-052195
Chen W, Tseng CL. What are healthcare workers' preferences for hand hygiene interventions? A discrete choice experiment. BMJ Open. 2021 Nov 03;11(11):e052195. doi: 10.1136/bmjopen-2021-052195. PMID: 34732487; PMCID: PMC8572395.
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BMJ Open. 2021 Nov 03;11(11):e052195. doi: 10.1136/bmjopen-2021-052195.

What are healthcare workers' preferences for hand hygiene interventions? A discrete choice experiment.

BMJ open

Wenlin Chen, Chung-Li Tseng

Affiliations

  1. School of Management and Economics, University of Electronic Science and Technology of China, Chengdu, Sichuan, China [email protected].
  2. Business School, University of New South Wales, Sydney, New South Wales, Australia.

PMID: 34732487 PMCID: PMC8572395 DOI: 10.1136/bmjopen-2021-052195

Abstract

OBJECTIVES: To understand the key attributes in designing effective interventions for improving healthcare workers' (HCWs') hand hygiene compliance and HCWs' preference for these attributes.

DESIGN: A discrete choice experiment (DCE) was conducted with five attributes extracted from the framework of Total Quality Management that can be applied in the design of hand hygiene interventions. They were hand hygiene monitoring, open discussion, message framing, resources accessibility and top management involvement. An addition attribute, peer hand hygiene performance, was considered as a contextual factor. Data were analysed by a conditional logit model to evaluate how these attributes impact HCWs' hand hygiene compliance.

SETTING: The DCE was conducted with participants from a university hospital in Taichung.

PARTICIPANTS: HCWs involved in daily patient-care activities (N=387).

RESULTS: To enhance their compliance, HCWs had strong and consistent preferences in having open discussion of hand hygiene problems ([Formula: see text], [Formula: see text]), easy access to hand hygiene resources ([Formula: see text], [Formula: see text]) and top management involvement ([Formula: see text], [Formula: see text]). For hand hygiene monitoring ([Formula: see text], [Formula: see text]), HCWs preferred to be monitored by infection control staff over their department head if their peer hand hygiene performance was low. On the other hand, when the peer performance was high, monitoring by their department head could improve their hand hygiene compliance. Similarly, how educational messages were framed impacted compliance and also depended on the peer hand hygiene performance. When the peer performance was low, HCWs were more likely to increase their compliance in reaction to loss-framed educational messages ([Formula: see text],[Formula: see text]). When the peer performance was high, gain-framed messages that focus on the benefit of compliance were more effective in inducing compliance.

CONCLUSIONS: Each intervention design has its unique impact on HCWs' hand hygiene compliant behaviour. The proposed approach can be used to evaluate HCWs' preference and compliance of an intervention before it is implemented.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: change management; health & safety; quality in health care

Conflict of interest statement

Competing interests: None declared.

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