Journal List > Perspect Nurs Sci > v.12(1) > 1060410

TOOLS
Song and Jeong: The Hawthorne Effect on the Adherence to Hand Hygiene
Original Article

Perspectives in Nursing Science 2015;12(1):7-13.

Published online: 19 April 2015

DOI: https://doi.org/10.16952/pns.2015.12.1.7

The Hawthorne Effect on the Adherence to Hand Hygiene

Ju Yeoun Song1, Ihn Sook Jeong2,

1Unit Manager, Infection Control Team, Pusan National University Yangsan Hospital, Yangsan

2Professor, College of Nursing, Pusan National University, Yangsan, Korea

Corresponding author: Jeong, Ihn Sook College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 626-870, Korea. Tel: +82-51-510-8342, Fax: +82-51-510-8308, E-mail: jeongis@pusan.ac.kr

Received 23 December 2014       Revised 18 January 2015       Accepted 19 January 2015

Copyright © 2015 The Research Institute of Nursing Science, Seoul National University

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

This observational study was aimed to determine the influence of the Hawthorne effect on the adherence to hand hygiene (HH) among healthcare workers (HCWs) in South Korea. Methods: HCWs were monitored in 2 periods regarding adherence to HH when there were indications for HH. In first period, HCWs recognized that their behavior of hand hygiene being observed (overt observation), and did not recognize in second period (covert observation). Results: The overall difference in HH rate between two periods was 45.0% point (77.8% vs 32.8%). There were significant differences between profession but in nurse aids. The differences in HH rate between two periods were 46.1% point in nurses, 29.9% point in physicians, 64.0% in radiologists, 62.5% point in laboratory technicians, 36.4% point in physio-therapist, and 1.0% point in nurse aids. The Hawthorne effect on the adherence to HH lasted more than 3 months. Conclusion: The Hawthorne effect markedly influence on the adherence to HH regardless of profession except nurse aids. Therefore, Hawthorne effect can be useful tool to improve and sustain the adherence to HH among HCWs in South Korea.

Keywords: Hand hygiene, Adherence, Hawthorne effect

REFERENCES

1.Allegranzi B., Pittet D. Role of hand hygiene in healthcare-associated infection prevention. J Hosp Infect. 2009 Aug. 73 (4): 305-15.http://dx.doi.org/10.1016/j.jhin.2009.04.019.
crossref
2.World Health Organization. WHO guidelines on hand hygiene in health care: First Global Patient Safety Challenge Clean Care Is Safer Care. Geneva: World Health Organization;2009. Available from:. http://www.ncbi.nlm.nih.gov/books/NBK144013/.
3.Pittet D., Allegranzi B., Sax H., Dharan S., Pessoa-Silva CL., Donaldson L, et al. Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis. 2006. 6(10):641–52. http://dx.doi.org/10.1016/S1473-3099(06)70600-4.
crossref
4.Cromer AL., Latham SC., Bryant KG., Hutsell S., Gansauer L., Bendyk HA, et al. Monitoring and feedback of hand hygiene compliance and the impact on facility-acquired methicillin-resistant Staphylococcus aureus. Am J Infect Control. 2008. 36:672–7. http://dx.doi.org/10.1016/j.ajic.2007.12.006.
crossref
5.Ward MA., Schweizer ML., Polgreen PM., Gupta K., Reisinger HS., Perencevich EN. Automated and electronically assisted hand hygiene monitoring systems: a systematic review. Am J Infect Control. 2014. 42:472–8. http://dx.doi.org/10.1016/j.ajic.2014.01.002.
crossref
6.Kohli E., Ptak J., Smith R., Taylor E., Talbot EA., Kirkland KB. Variability in the Hawthorne effect with regard to hand hygiene performance in high- and low-performing inpatient care units. Infect Control Hosp Epidemiol. 2009. 30(3):222–5. http://dx.doi.org/10.1086/595692.
crossref
7.Eckmanns T., Bessert J., Behnke M., Gastmeier P., Ruden H. Compliance with antiseptic hand rub use in intensive care units: the Hawthorne effect. Infect Control Hosp Epidemiol. 2006. 27(9):931–4. http://dx.doi.org/10.1086/507294.
crossref
8.Gilboy N., Howard PK. Compliance with hand hygiene guidelines. Adv Emerg Nurs J. 2008. 30(3):193–200. http://dx.doi.org/10.1097/01.TME.0000334370.14034.fc.
crossref
9.Buchanan D., Huczynski A. Organizational behavior. 3rd ed.London: Prentice Hall;1997.
10.Hwang SM., Lee RH. Personality as types of self perception of others' evaluation: how Koreans perceive personality. Scientific Study of Subjectivity: Q Methodology and Theory. 2010. 20:121–43.
11.Arenas MD., Sánchez-Payá J., Barril G., García-Valdecasas J., Gorriz JL., Soriano A, et al. A multicentric survey of the practice of hand hygiene in haemodialysis units: factors affecting compliance. Nephrol Dial Transplant. 2005. 20(6):1164–71. http://dx.doi.org/10.1093/ndt/gfh759.
crossref
12.Harbarth S., Pittet D., Grady L., Zawacki A., Potter-Bynoe G., Samore MH, et al. Interventional study to evaluate the impact of an alcohol-based hand gel in improving hand hygiene compliance. Pediatr Infect Dis J. 2002. 21(6):489–95.
crossref
13.Feil PH., Grauer JS., Gadbury-Amyot CC., Kula K., McCunniff MD. Intentional use of the Hawthorne effect to improve oral hygiene compliance in orthodontic patients. J Dent Educ. 2002. 66(10):1129–35.
crossref
14.Pittet D., Mourouga P., Perneger TV. Compliance with handwashing in a teaching hospital. Ann Intern Med. 1999. 130(2):126–30. http://dx.doi.org/10.7326/0003-4819-130-2-199901190-00006.
crossref
15.Alsubaie S., Maither A., Alalmaei W., Al-Shammari AD., Tashkan-di M., Somily AM, et al. Determinants of hand hygiene noncompliance in intensive care units. Am J Infect Control. 2013. 41(2):131–5. http://dx.doi.org/10.1016/j.ajic.2012.02.035.
crossref

Figure 1.
Change of adherence to hand hygiene by time elapse.
pns-12-7f1.tif
Table 1.
The Differences of Hand Hygiene Indications by Observation Method and Profession
Professional categories 1st wave (Overt observation) January~May, 2011 2nd wave (Covert observation) March~July. 2012
No. of subjects No. of HH indications Mean No. of HH indications No. of subjects No. of HH indications Mean No. of HH indications
Total 692 2,252 3.3 636 1,487 2.3
Nurses 430 1,413 3.3 398 1,054 2.6
Physicians 47 95 2.0 83 156 1.9
Radiologists 96 404 4.2 28 48 1.7
Laboratory technicians 29 161 5.6 15 53 3.5
Physio-therapists 40 107 2.7 55 95 1.7
Nurse aids 50 72 1.4 57 81 1.4

No.=Number, HH=Hand hygiene.

Table 2.
The Differences of Hand Hygiene Rate by Observation Method and Profession
Professional categories 1st wave (Overt observation) January~May, 2011 2nd wave (Covert observation) March~July. 2012 Difference HH rate (%p) x2 p
No. of HH HH rate (%) (1) No. of HH HH rate (%) (2)
Total 1,751 77.8 487 32.8 45.0 754.87 ＜.001
Nurses 1,140 80.7 365 34.6 46.1 538.13 ＜.001
Physicians 54 56.8 42 26.9 29.9 20.33 ＜.001
Radiologists 326 80.7 8 16.7 64.0 91.17 ＜.001
Laboratory technicians 125 77.6 8 15.1 62.5 66.31 ＜.001
Physio-therapists 84 78.5 40 42.1 36.4 20.48 ＜.001
Nurse aids 22 30.6 24 29.6 1.0 0.02 .901

No.=Number, HH=Hand hygiene, %p=Percent point.

TOOLS
Similar articles