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dc.contributor.authorFernandez, Patrick G.
dc.contributor.authorLoftus, Randy W.
dc.contributor.authorDodds, Thomas M.
dc.contributor.authorKoff, Matthew D.
dc.contributor.authorReddy, Sundara
dc.contributor.authorHeard, Stephen O.
dc.contributor.authorBeach, Michael L.
dc.contributor.authorYeager, Mark P.
dc.contributor.authorBrown, Jeremiah R.
dc.date2022-08-11T08:07:58.000
dc.date.accessioned2022-08-23T15:37:37Z
dc.date.available2022-08-23T15:37:37Z
dc.date.issued2015-04-01
dc.date.submitted2016-01-13
dc.identifier.citationAnesth Analg. 2015 Apr;120(4):837-43. doi: 10.1213/ANE.0000000000000408. <a href="http://dx.doi.org/10.1213/ANE.0000000000000408">Link to article on publisher's site</a>
dc.identifier.issn0003-2999 (Linking)
dc.identifier.doi10.1213/ANE.0000000000000408
dc.identifier.pmid25383717
dc.identifier.urihttp://hdl.handle.net/20.500.14038/25757
dc.description.abstractBACKGROUND: Health care worker compliance with hand hygiene guidelines is an important measure for health care-associated infection prevention, yet overall compliance across all health care arenas remains low. A correct answer to 4 of 4 structured questions pertaining to indications for hand decontamination (according to types of contact) has been associated with improved health care provider hand hygiene compliance when compared to those health care providers answering incorrectly for 1 or more questions. A better understanding of knowledge deficits among anesthesia providers may lead to hand hygiene improvement strategies. In this study, our primary aims were to characterize and identify predictors for hand hygiene knowledge deficits among anesthesia providers. METHODS: We modified this previously tested survey instrument to measure anesthesia provider hand hygiene knowledge regarding the 5 moments of hand hygiene across national and multicenter groups. Complete knowledge was defined by correct answers to 5 questions addressing the 5 moments for hand hygiene and received a score of 1. Incomplete knowledge was defined by an incorrect answer to 1 or more of the 5 questions and received a score of 0. We used a multilevel random-effects XTMELOGIT logistic model clustering at the respondent and geographic location for insufficient knowledge and forward/backward stepwise logistic regression analysis to identify predictors for incomplete knowledge. RESULTS: The survey response rates were 55.8% and 18.2% for the multicenter and national survey study groups, respectively. One or more knowledge deficits occurred with 81.6% of survey respondents, with the mean number of correct answers 2.89 (95% confidence interval, 2.78- 2.99). Failure of providers to recognize prior contact with the environment and prior contact with the patient as hand hygiene opportunities contributed to the low mean. Several cognitive factors were associated with a reduced risk of incomplete knowledge including providers responding positively to washing their hands after contact with the environment (odds ratio [OR] 0.23, 0.14-0.37, P < 0.001), disinfecting their environment during patient care (OR 0.54, 0.35-0.82, P = 0.004), believing that they can influence their colleagues (OR 0.43, 0.27-0.68, P < 0.001), and intending to adhere to guidelines (OR 0.56, 0.36-0.86, P = 0.008). These covariates were associated with an area under receiver operator characteristics curve of 0.79 (95% confidence interval, 0.74-0.83). CONCLUSIONS: Anesthesia provider knowledge deficits around to hand hygiene guidelines occur frequently and are often due to failure to recognize opportunities for hand hygiene after prior contact with contaminated patient and environmental reservoirs. Intraoperative hand hygiene improvement programs should address these knowledge deficits. Predictors for incomplete knowledge as identified in this study should be validated in future studies.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=25383717&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1213/ANE.0000000000000408
dc.subjectAdult
dc.subjectAged
dc.subjectAnesthesiology
dc.subjectAttitude of Health Personnel
dc.subjectCluster Analysis
dc.subjectCross Infection
dc.subjectFemale
dc.subjectGeography
dc.subjectHand Disinfection
dc.subject*Hand Hygiene
dc.subject*Health Knowledge, Attitudes, Practice
dc.subjectHealth Personnel
dc.subjectHumans
dc.subjectInfection Control
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectROC Curve
dc.subjectRisk
dc.subjectSocieties, Medical
dc.subjectSurveys and Questionnaires
dc.subjectUnited States
dc.subjectAnesthesiology
dc.titleHand hygiene knowledge and perceptions among anesthesia providers
dc.typeJournal Article
dc.source.journaltitleAnesthesia and analgesia
dc.source.volume120
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/anesthesiology_pubs/172
dc.identifier.contextkey8008785
html.description.abstract<p>BACKGROUND: Health care worker compliance with hand hygiene guidelines is an important measure for health care-associated infection prevention, yet overall compliance across all health care arenas remains low. A correct answer to 4 of 4 structured questions pertaining to indications for hand decontamination (according to types of contact) has been associated with improved health care provider hand hygiene compliance when compared to those health care providers answering incorrectly for 1 or more questions. A better understanding of knowledge deficits among anesthesia providers may lead to hand hygiene improvement strategies. In this study, our primary aims were to characterize and identify predictors for hand hygiene knowledge deficits among anesthesia providers.</p> <p>METHODS: We modified this previously tested survey instrument to measure anesthesia provider hand hygiene knowledge regarding the 5 moments of hand hygiene across national and multicenter groups. Complete knowledge was defined by correct answers to 5 questions addressing the 5 moments for hand hygiene and received a score of 1. Incomplete knowledge was defined by an incorrect answer to 1 or more of the 5 questions and received a score of 0. We used a multilevel random-effects XTMELOGIT logistic model clustering at the respondent and geographic location for insufficient knowledge and forward/backward stepwise logistic regression analysis to identify predictors for incomplete knowledge.</p> <p>RESULTS: The survey response rates were 55.8% and 18.2% for the multicenter and national survey study groups, respectively. One or more knowledge deficits occurred with 81.6% of survey respondents, with the mean number of correct answers 2.89 (95% confidence interval, 2.78- 2.99). Failure of providers to recognize prior contact with the environment and prior contact with the patient as hand hygiene opportunities contributed to the low mean. Several cognitive factors were associated with a reduced risk of incomplete knowledge including providers responding positively to washing their hands after contact with the environment (odds ratio [OR] 0.23, 0.14-0.37, P < 0.001), disinfecting their environment during patient care (OR 0.54, 0.35-0.82, P = 0.004), believing that they can influence their colleagues (OR 0.43, 0.27-0.68, P < 0.001), and intending to adhere to guidelines (OR 0.56, 0.36-0.86, P = 0.008). These covariates were associated with an area under receiver operator characteristics curve of 0.79 (95% confidence interval, 0.74-0.83).</p> <p>CONCLUSIONS: Anesthesia provider knowledge deficits around to hand hygiene guidelines occur frequently and are often due to failure to recognize opportunities for hand hygiene after prior contact with contaminated patient and environmental reservoirs. Intraoperative hand hygiene improvement programs should address these knowledge deficits. Predictors for incomplete knowledge as identified in this study should be validated in future studies.</p>
dc.identifier.submissionpathanesthesiology_pubs/172
dc.contributor.departmentDepartment of Anesthesiology
dc.source.pages837-43


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