Key beliefs of hospital nurses’ hand-hygiene behaviour: protecting your peers and needing effective remindersKatherine M. White A B F , Nerina L. Jimmieson C , Nicholas Graves B , Adrian Barnett B , Wendell Cockshaw A B , Phillip Gee D , Katie Page B , Megan Campbell B , Elizabeth Martin B , David Brain B and David Paterson E
A School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia.
B Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Qld 4059, Australia.
C School of Management, Queensland University of Technology, 2 George Street, Brisbane, Qld 4000, Australia.
D School of Psychology, University of Queensland, St Lucia, Qld 4072, Australia.
E The University of Queensland Centre for Clinical Research, Royal Brisbane and Women’s Hospital, Herston, Qld 4029, Australia.
F Corresponding author. Email: email@example.com
Health Promotion Journal of Australia 26(1) 74-78 https://doi.org/10.1071/HE14059
Submitted: 9 November 2014 Accepted: 21 November 2014 Published: 7 April 2015
Issues addressed: Hand hygiene in hospitals is vital to limit the spread of infections. This study aimed to identify key beliefs underlying hospital nurses’ hand-hygiene decisions to consolidate strategies that encourage compliance.
Methods: Informed by a theory of planned behaviour belief framework, nurses from 50 Australian hospitals (n = 797) responded to how likely behavioural beliefs (advantages and disadvantages), normative beliefs (important referents) and control beliefs (barriers) impacted on their hand-hygiene decisions following the introduction of a national ‘5 moments for hand hygiene’ initiative. Two weeks after completing the survey, they reported their hand-hygiene adherence. Stepwise regression analyses identified key beliefs that determined nurses’ hand-hygiene behaviour.
Results: Reducing the chance of infection for co-workers influenced nurses’ hygiene behaviour, with lack of time and forgetfulness identified as barriers.
Conclusions: Future efforts to improve hand hygiene should highlight the potential impact on colleagues and consider strategies to combat time constraints, as well as implementing workplace reminders to prompt greater hand-hygiene compliance.
So what?: Rather than emphasising the health of self and patients in efforts to encourage hand-hygiene practices, a focus on peer protection should be adopted and more effective workplace reminders should be implemented to combat forgetting.
References World Health Organization. WHO guidelines in hand hygiene in health care. Geneva, Switzerland: WHO Press; 2009.
 Hand Hygiene Australia. 5 moments for hand hygiene. 2008. Available from: http://www.hha.org.au/home/5-moments-for-hand-hygiene.aspx [Verified 7 September 2014].
 Grayson ML, Russo PL, Cruickshank M, Bear JL, Gee CA, Hughes CF, et al (2011) Outcomes from the first 2 years of the Australian National Hand Hygiene Initiative. Med J Australia 195, 615–9.
| Outcomes from the first 2 years of the Australian National Hand Hygiene Initiative.CrossRef | 22107015PubMed |
 Australian Institute of Health and Welfare. Health and community services labour force. National health labour force series number 42. Cat. no. HWL 43. Canberra: AIHW; 2009.
 Ajzen I (1991) The theory of planned behavior. Organ Behav Hum Dec 50, 179–211.
| The theory of planned behavior.CrossRef |
 Armitage CJ, Conner M (2001) Efficacy of the theory of planned behaviour: a meta-analytic review. Br J Soc Psychol 40, 471–99.
| Efficacy of the theory of planned behaviour: a meta-analytic review.CrossRef | 1:STN:280:DC%2BD38%2FmvFWguw%3D%3D&md5=35856b13aec04181077175f1e522b638CAS | 11795063PubMed |
 Fishbein M, Von Haeften I, Appleyard J (2001) The role of theory in developing effective interventions: implications from Project SAFER. Psychol Health Med 6, 223–38.
| The role of theory in developing effective interventions: implications from Project SAFER.CrossRef |
 Hardeman W, Johnston M, Johnston DW, Bonetti D, Wareham NJ, Kinmonth AL (2002) Application of the Theory of Planned Behaviour in behaviour change interventions: a systematic review. Psychol Health 17, 123–58.
| Application of the Theory of Planned Behaviour in behaviour change interventions: a systematic review.CrossRef |
 Jang J-H, Wu S, Kirzner D, Moore C, Youssef G, Tong A, et al (2010) Focus group study of hand hygiene practice among healthcare workers in a teaching hospital in Toronto, Canada. Infect Cont Hosp Ep 31, 144–50.
| Focus group study of hand hygiene practice among healthcare workers in a teaching hospital in Toronto, Canada.CrossRef |
 Pessoa-Silva CL, Posfay-Barbe K, Pfister R, Touveneau S, Perneger TV, Pittet D (2005) Attitudes and perceptions toward hand hygiene among healthcare workers caring for critically ill neonates. Infect Cont Hosp Ep 26, 305–11.
| Attitudes and perceptions toward hand hygiene among healthcare workers caring for critically ill neonates.CrossRef |
 Whitby M, McLaws M-L, Ross MW (2006) Why healthcare workers don’t wash their hands: a behavioral explanation. Infect Cont Hosp Ep 27, 484–92.
| Why healthcare workers don’t wash their hands: a behavioral explanation.CrossRef |
 White KM, Jimmieson N, Obst P, Graves N, Barnett A, Cockshaw W, et al (2015) Using a theory of planned behaviour framework to explore hand hygiene beliefs at the ‘5 critical moments’ among Australian hospital-based nurses. BMC Health Serv Res 15, 59
| Using a theory of planned behaviour framework to explore hand hygiene beliefs at the ‘5 critical moments’ among Australian hospital-based nurses.CrossRef |
 von Haeften I, Fishbein M, Kasprzyk D, Montano D (2001) Analyzing data to obtain information to design targeted interventions. Psychol Health Med 6, 151–64.
| Analyzing data to obtain information to design targeted interventions.CrossRef |