Process Evaluation of an Acute-Care Nurse-Centred Hand Hygiene Intervention in US Hospitals

Madeline Sands and Robert Aunger

Evaluation Review, 2024, vol. 48, issue 4, 663-691

Abstract: This paper describes a process evaluation of a ‘wise’ intervention that took place in six acute care units in two medical-surgical teaching hospitals in the United States during 2016–2017. ‘Wise’ interventions are short, inexpensive interventions that depend on triggering specific psychological mechanisms to achieve behaviour change. This study sought to increase the hand hygiene compliance (HHC) rates before entering a patient’s room among nurses. The intervention centred on the use of threat to professional identity to prompt improved HHC. Through questionnaires administered to intervention participants and the implementation facilitator, together with independent observation of intervention delivery, we examined whether the steps in the Theory of Change occurred as expected. We found that aspects of the implementation—including mode of delivery, use of incentives, and how nurses were recruited and complied with the intervention—affected reach and likely effectiveness. While components of the intervention’s mechanisms of impact—such as the element of surprise—were successful, they ultimately did not translate into performance of the target behaviour. Performance was also not affected by use of an implementation intention as repeated performance of HHC over years of being a nurse has likely already established well-ingrained practices. Context did have an effect; the safety culture of the units, the involvement of the Nurse Managers, the level of accountability for HHC in each unit, and the hospitals themselves all influenced levels of engagement. These conclusions should have implications for those interested in the applicability of ‘wise’ interventions and those seeking to improve HHC in hospitals.

Keywords: process evaluation; behaviour centred design; hand hygiene; wise intervention; hospitals; healthcare workers (search for similar items in EconPapers)
Date: 2024
References: Add references at CitEc
Citations:

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0193841X231197253 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:evarev:v:48:y:2024:i:4:p:663-691

DOI: 10.1177/0193841X231197253

Access Statistics for this article

More articles in Evaluation Review
Bibliographic data for series maintained by SAGE Publications ().