• Am J Infect Control · Oct 2013

    Sociocognitive determinants of observed and self-reported compliance to hand hygiene guidelines in child day care centers.

    • Tizza P Zomer, Vicki Erasmus, Pepijn van Empelen, Caspar Looman, Ed F van Beeck, Aimée Tjon-A-Tsien, Jan Hendrik Richardus, and Hélène A C M Voeten.
    • Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Division of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands. Electronic address: t.zomer@rotterdam.nl.
    • Am J Infect Control. 2013 Oct 1; 41 (10): 862-7.

    BackgroundAlthough hand hygiene (HH) has proven to be an effective measure to prevent infections, HH compliance is generally low. We assessed sociocognitive determinants of caregivers' HH behavior in child day care centers (DCCs) to develop an effective HH intervention.MethodsCaregivers' compliance to HH guidelines was observed. Observed caregivers completed a questionnaire on self-reported HH compliance, sociocognitive determinants, and sociodemographic data. To determine sociocognitive determinants of observed compliance, multilevel logistic regression analyses were performed. Self-reported compliance was analyzed using linear regression.ResultsIn 122 participating DCCs, 350 caregivers and 2,003 HH opportunities were observed. The response rate on the questionnaire was 100%. Overall observed HH compliance was 42% (841/2,003). Overall mean self-reported HH compliance was 8.7 (scale, 0-10). Guideline knowledge (odds ratio [OR], 1.27; 95% confidence interval [CI]: 1.03-1.56) and perceived disease severity (OR, 0.93; 95% CI: 0.87-0.99) were associated with observed compliance. Guideline knowledge (β = 0.31; P < .001), guideline awareness (β = 0.16; P < .001), perceived importance (β = 0.20; P = .004), perceived behavioral control (β = 0.24; P < .001), habit (β = 0.27; P < .001), and children at home (β = 0.30; P = .002) were associated with self-reported compliance.ConclusionWhen developing HH interventions for caregivers in DCCs, improving guideline knowledge should be considered as this was associated with both observed and self-reported HH compliance. Furthermore, increasing guideline awareness, perceived importance, and perceived behavioral control can contribute to better HH, as well as making HH a habitual behavior.Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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