Peer pressure influences adherence to hand hygiene

Nationally, hand hygiene adherence by healthcare workers remains staggeringly low despite its critical importance in infection control. A study in the October issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA), found that healthcare workers' adherence to hand hygiene is better when other workers are nearby.

"Social network effects, or peer effects, have been associated with smoking, obesity, happiness and worker productivity. As we found, this influence extends to hand hygiene compliance, too," said Philip Polgreen, MD, an author of the study. "Healthcare workers' proximity to their peers had a positive effect on their hand hygiene adherence."

Researchers at the University of Iowa's Carver College of Medicine used a custom-built, badge-based system to estimate hand hygiene compliance and opportunities, as well as the location and proximity of every healthcare worker in the medical intensive care unit of the University of Iowa Hospital and Clinics during a 10-day period for 24-hours a day. Badges were randomly provided at the start of each shift to physicians, nurses and critical care staff. The badges collected information from healthcare workers within proximity and hand hygiene compliance when entering and exiting a patient room. In total, more than 47,000 hand hygiene opportunities were recorded.

The estimated hand hygiene rate was 7 percent higher (28 percent vs 21 percent) when healthcare workers were in close proximity to peers when compared with the rate when healthcare workers were alone. In general, the researchers found that the magnitude of the peer effects increased in the presence of additional healthcare workers, but only up to a point.

The authors note that the results speak to the importance of the social environment in healthcare and have important implications for understanding how human behavior affects the spread of diseases within healthcare settings.

Source: Society for Healthcare Epidemiology of America