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An exploration of consultant doctors' hand hygiene: practice and perspectives

Westbury, J (2012) An exploration of consultant doctors' hand hygiene: practice and perspectives University of Southampton, Faculty of Health Sciences, Doctoral Thesis , 188pp.

Record type: Thesis (Doctoral)


Hand hygiene is considered the cornerstone of infection prevention practice, but previous studies demonstrate one group of healthcare professionals, doctors, have not achieved good levels of compliance in comparison to other staff groups. The aim of the research was to examine consultant doctors? practice and perspectives of hand hygiene, exploring their perceptions as leaders and role models, so as to identify strategies to improve compliance.
The study design was based on naturalistic inquiry, focussing on the social constructions of participants. Nineteen consultant doctors were observed during hospital ward rounds using both a national audit tool to assess hand hygiene compliance and recording of field notes. These same consultants, plus a further two, were interviewed individually to elicit their views. Data from the 21 interviews and field notes were analysed qualitatively using thematic content analysis. Observations demonstrated high levels of hand hygiene compliance for high risk and medium risk activities, with low levels of compliance for low risk activities. Thematic content analysis revealed a strong belief by consultant doctors in the value of hand hygiene. However, a perceived conflict between political and scientific drivers of hand hygiene promotion gave rise to confusion, frustration and a lack of engagement that created barriers to leadership and acting as a role model. Differing guidelines and audit tools that did not address levels of risk compounded the matter. However, consultant doctors offered various recommendations to resolve the issues. Compliance with hand hygiene by consultant doctors is dependant on perceived levels of risk. To promote leadership and role modelling it is critical to engage consultant doctors, understand their views, employ their recommendations and recognise they are motivated by evidence-based rationales for practice rather than political mandates. The findings, conclusion and recommendations of the research study have significant implications for addressing the shortfalls of the hand hygiene agenda in clinical practice and for the engagement of consultant doctors.

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Published date: May 2012
Organisations: University of Southampton, Faculty of Health Sciences


Local EPrints ID: 340447
PURE UUID: 01f3e3cb-abef-49ae-84e9-03f881be4a2f
ORCID for Jacqueline Prieto: ORCID iD

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Date deposited: 13 Aug 2012 14:44
Last modified: 18 Jul 2017 05:44

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Author: J Westbury
Thesis advisor: Miranda Fader
Thesis advisor: Jacqueline Prieto ORCID iD

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