A nudge intervention to improve hand hygiene compliance in the hospital.

Content Provider	Europe PMC
Author	Elia, Fabrizio Calzavarini, Fabrizio Bianco, Paola Vecchietti, Renata Gabriella Macor, Antonio Franco D’Orazio, Alessia Dragonetti, Antonella D’Alfonso, Alessandra Belletrutti, Laura Floris, Mara Bert, Fabrizio Crupi, Vincenzo Aprà, Franco
Abstract	Hand hygiene among professionals plays a crucial role in preventing healthcare‐associated infections, yet poor compliance in hospital settings remains a lasting reason for concern. Nudge theory is an innovative approach to behavioral change first developed in economics and cognitive psychology, and recently spread and discussed in clinical medicine. To assess a combined nudge intervention (localized dispensers, visual reminders, and gain-framed posters) to promote hand hygiene compliance among hospital personnel. A quasi-experimental study including a pre-intervention phase and a post-intervention phase (9 + 9 consecutive months) with 117 professionals overall from three wards in a 350-bed general city hospital. Hand hygiene compliance was measured using direct observations by trained personnel and measurement of alcohol-based hand-rub consumption. Levels of hand hygiene compliance were low in the pre-intervention phase: 11.44% of hand hygiene opportunities prescribed were fulfilled overall. We observed a statistically significant effect of the nudge intervention with an increase to 18.71% (p < 0.001) in the post-intervention phase. Improvement was observed in all experimental settings (the three hospital wards). A statistical comparison across three subsequent periods of the post-intervention phase revealed no significant decay of the effect. An assessment of the collected data on alcohol-based hand-rub consumption indirectly confirms the main result in all experimental settings. Behavioral outcomes concerning hand hygiene in the hospital are indeed affected by contextual, nudging factors to a significant extent. If properly devised, nudging measures can provide a sustainable contribution to increase hand hygiene compliance in a hospital setting.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9294805&blobtype=pdf
ISSN	18280447
Journal	Internal and Emergency Medicine [Intern Emerg Med]
Volume Number	17
DOI	10.1007/s11739-022-03024-7
PubMed Central reference number	PMC9294805
Issue Number	7
PubMed reference number	35852676
e-ISSN	19709366
Language	English
Publisher	Springer International Publishing
Publisher Date	2022-07-19
Publisher Place	Gewerbestrasse 11, Cham, Ch 6330, Switzerland
Access Restriction	Open
Rights License	This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. © The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI) 2022
Subject Keyword	Hand hygiene Infection prevention Nudge Decision-making
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine Internal Medicine