Patients' beliefs and perceptions of their participation to increase healthcare worker compliance with hand hygiene

Infect Control Hosp Epidemiol. 2009 Sep;30(9):830-9. doi: 10.1086/599118.


Background: Research suggests that patients could improve healthcare workers' compliance with hand hygiene recommendations by reminding them to cleanse their hands.

Objective: To assess patients' perceptions of a patient-participation program to improve healthcare workers' compliance with hand hygiene.

Design: Cross-sectional survey of patient knowledge and perceptions of healthcare-associated infections, hand hygiene, and patient participation, defined as the active involvement of patients in various aspects of their health care.

Setting: Large Swiss teaching hospital.

Results: Of 194 patients who participated, most responded that they would not feel comfortable asking a nurse (148 respondents [76%]) or a physician (150 [77%]) to perform hand hygiene, and 57 (29%) believed that this would help prevent healthcare-associated infections. In contrast, an explicit invitation from a healthcare worker to ask about hand hygiene doubled the intention to ask a nurse (from 34% to 83% of respondents; P < .001) and to ask a physician (from 30% to 78%; P < .001). In multivariate analysis, being nonreligious, having an expansive personality, being concerned about healthcare-associated infections, and believing that patient participation would prevent healthcare-associated infections were associated with the intention to ask a nurse or a physician to perform hand hygiene (P < .05). Being of Jewish, Eastern Orthodox, or Buddhist faith was associated also with increased intention to ask a nurse (P < .05), compared with being of Christian faith.

Conclusions: This study identifies several sociodemographic characteristics associated with the intention to ask nurses and physicians about hand hygiene and underscores the importance of a direct invitation from healthcare workers to increase patient participation and foster patient empowerment. These findings could guide the development of future hand hygiene-promotion strategies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attitude to Health
  • Cross Infection / prevention & control*
  • Cross-Sectional Studies
  • Female
  • Hand Disinfection / standards*
  • Health Knowledge, Attitudes, Practice*
  • Health Personnel / psychology*
  • Humans
  • Hygiene / standards
  • Infectious Disease Transmission, Professional-to-Patient / prevention & control
  • Male
  • Middle Aged
  • Patient Participation*
  • Program Evaluation*
  • Young Adult