Speaking up about hand hygiene failures: A vignette survey study among healthcare professionals.

Schwappach, David L B (2018). Speaking up about hand hygiene failures: A vignette survey study among healthcare professionals. American journal of infection control, 46(8), pp. 870-875. Elsevier 10.1016/j.ajic.2018.02.026

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BACKGROUND

Speaking up by healthcare professionals (HCPs) is an important resource to reduce risks to patient safety. Due to complex tradeoffs, HCPs are often reluctant to voice their concerns. A survey investigated HCPs' likelihood to speak up.

METHODS

A cross-sectional survey study among HCPs in 5 Swiss hospitals addressed speaking-up behaviors, safety climate, and likelihood to speak up about poor hand hygiene practice described in a vignette. Likelihood to speak up was analyzed using a multilevel regression model.

RESULTS

Of surveyed HCPs (n = 1217), 56% reported that they would speak up to a colleague with poor hand hygiene practice. Nurses as compared to doctors rated the situation as more realistic (5.25 vs 4.32, P < .001), felt more discomfort with speaking up (4.00 vs 3.34, P < .001), and reported a slightly lower likelihood of speaking up (4.41 vs 4.77, P < .001). Clinical function (hierarchy) was strongly associated with speaking-up behavior (P < .001). Higher risk of harm to the patient (P < .001) and higher frequencies of past speaking-up behaviors (P = .006) were positively associated with the likelihood to speak up. Higher frequencies of past withholding voice (P = .013) and higher levels of resignation (P = .008) were both associated with a lower likelihood to speak up.

CONCLUSIONS

Infection control interventions should empower HCPs to speak up about non-adherence with prevention practices by addressing authority gradients and risk perceptions and by focusing on resignation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Schwappach, David

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0196-6553

Publisher:

Elsevier

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

24 Apr 2018 10:09

Last Modified:

23 Oct 2019 08:45

Publisher DOI:

10.1016/j.ajic.2018.02.026

PubMed ID:

29650487

Uncontrolled Keywords:

Communication Hand hygiene Patient safety Speaking up

BORIS DOI:

10.7892/boris.114832

URI:

https://boris.unibe.ch/id/eprint/114832

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