Compliance with components of universal precautions guidelines: Using peer feedback program as a cue to action among health care workers in Thailand

• Main Author: Moongtui, Wanchai
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01.01.1999
• Subjects: Behavioral psychology; Behavioral Sciences; Health care; Nursing; Occupational safety; Peer relationships
• ISBN: 9780599229792; 0599229799

Conceptually guided by the Health Beliefs Model (HBM), the purpose of this study was to determine whether there was a difference in the rate of handwashing and glove wearing between health care workers (HCWs) who participated in a Peer Feedback Program (PFP) and those who did not. Secondly, the relationships among the rate of handwashing and glove-wearing and the HBM's variables were determined. Subjects (n = 91) were divided into two groups. One group was randomly assigned to receive the PFP, and the other group received no treatment. To implement the PFP, the investigator educated experimental subjects in the process of peer evaluation and familiarized them with the peer feedback form and its use. Then peer observers rated the occurrence or nonoccurrence of handwashing and glove wearing for their coworkers during the delivery of patient care. Subsequently, the investigator posted on the bulletin board a form providing group peer feedback on compliance behaviors from the previous 3 days' observations. Handwashing and glove wearing rates were assessed by direct observation at 1 month prior to the intervention, during the intervention period, and 1 month after finishing the intervention phase. HBM variables were assessed by using the questionnaire, 2 weeks prior to the baseline observation. Baseline handwashing and glove wearing rates from both control and experimental units ranged from 49.3% to 63.2%. The position of patient care aids was found to be positively correlated with handwashing and glove wearing rates among subjects from one unit, while no relationship was found in other units. Using a stepwise multiple regression, it was found that there was a difference in handwashing and glove wearing rates among HCWs participating in the PFP as compared with those in the control group during the intervention period, with the PFP group showing increased rates. However, there was no statistically significant difference for the scores obtained after the intervention period. In conclusion, the intervention was effective, but there was no retention of effect at 1 month after the intervention period. The major implication was that PFP can be incorporated as a strategy in infection control programs. However, adjunct methods should be sought to promote retention of effect. When the study is replicated, using greater sample sizes and more diverse settings is encouraged.