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Adherence to hand hygiene guidelines – significance of measuring fidelity

Author

Listed:
  • Anne Korhonen
  • Helena Ojanperä
  • Teija Puhto
  • Raija Järvinen
  • Pirjo Kejonen
  • Arja Holopainen

Abstract

Aims and objectives The aim was to evaluate the usability of fidelity measures in compliance evaluation of hand hygiene. Background Adherence to hand hygiene guidelines is important in terms of patient safety. Compliance measures seldom describe how exactly the guidelines are followed. Design and methods A cross‐sectional observation study in a university hospital setting was conducted. Direct observation by trained staff was performed using a standardised observation form supplemented by fidelity criteria. A total of 830 occasions were observed in 13 units. Descriptive statistics (frequency, mean, percentages and range) were used as well as compliance rate by using a standard web‐based tool. In addition, the binomial standard normal deviate test was conducted for comparing different methods used in evaluation of hand hygiene and in comparison between professional groups. Results Measuring fidelity to guidelines was revealed to be useful in uncovering gaps in hand hygiene practices. The main gap related to too short duration of hand rubbing. Thus, although compliance with hand hygiene guidelines measured using a standard web‐based tool was satisfactory, the degree of how exactly the guidelines were followed seemed to be critical. Conclusions Combining the measurement of fidelity to guidelines with the compliance rate is beneficial in revealing inconsistency between optimal and actual hand hygiene behaviour. Relevance to clinical practice Evaluating fidelity measures is useful in terms of revealing the gaps between optimal and actual performance in hand hygiene. Fidelity measures are suitable in different healthcare contexts and easy to measure according to the relevant indicators of fidelity, such as the length of hand rubbing. Knowing the gap facilitates improvements in clinical practice.

Suggested Citation

  • Anne Korhonen & Helena Ojanperä & Teija Puhto & Raija Järvinen & Pirjo Kejonen & Arja Holopainen, 2015. "Adherence to hand hygiene guidelines – significance of measuring fidelity," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(21-22), pages 3197-3205, November.
  • Handle: RePEc:wly:jocnur:v:24:y:2015:i:21-22:p:3197-3205
    DOI: 10.1111/jocn.12969
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    Cited by:

    1. Magdalena Hoffmann & Gerald Sendlhofer & Gudrun Pregartner & Veronika Gombotz & Christa Tax & Renate Zierler & Gernot Brunner, 2019. "Interventions to increase hand hygiene compliance in a tertiary university hospital over a period of 5 years: An iterative process of information, training and feedback," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(5-6), pages 912-919, March.

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