Barriers and levers to hand hygiene practices among Nigerian healthcare workers : a mixed methods research study

Ataiyero, Yetunde Oluremi

Abstract

This research explores the barriers and levers to hand hygiene practices among Nigerian healthcare workers (HCWs). The overall aim was to determine the hand hygiene compliance rate, understand the barriers and levers to hand hygiene practices and validate the barriers and levers to hand hygiene instrument (BALHHI) for Nigerian HCWs. A convergent mixed methods research approach was employed.
In study one, a systematic review of 27 hand hygiene studies from Sub-Saharan African (SSA) countries was conducted. An overall hand hygiene compliance rate among HCWs in SSA was estimated to be 21.1%. The main barriers identified included heavy workload, infrastructural deficit and poorly positioned hand hygiene facilities.
In study two, a ward infrastructure survey and hand hygiene observations of HCWs in surgical wards were conducted using the WHO ward infrastructure survey and modified hand hygiene observation tool, respectively. Hand hygiene resources were found to be insufficient, overall hand hygiene compliance rate was 29.1% and compliance was less than 40% across all professional groups.
In study three, BALHHI was validated through three rounds of psychometric testing – face validity, construct validity and test-retest reliability. This resulted in a 10-item instrument with good psychometric properties.
In study four, a survey of barriers and levers to hand hygiene among surgical HCWs was conducted using BALHHI. Knowledge deficit was the greatest barrier. All three domains of the Theoretical Domains Framework (TDF) and 10 items remaining on the instrument were also considered as barriers to hand hygiene.
In study five, barriers and levers to hand hygiene practices among surgical HCWs were explored using semi-structured interviews. Knowledge deficit was the biggest barrier followed by infrastructural deficit.
This thesis has demonstrated the significance of using a mixed methods research approach and use of theory in research going by the rich findings of this research. Prioritising adequate funding of health systems in SSA countries is critical to enhancing patient safety.

Citation

Ataiyero, Y. O. Barriers and levers to hand hygiene practices among Nigerian healthcare workers : a mixed methods research study. (Thesis). University of Hull. https://hull-repository.worktribe.com/output/4224084

• Thesis Type: Thesis
• Deposit Date: Mar 24, 2022
• Publicly Available Date: Feb 24, 2023
• Keywords: Health & social work
• Public URL: https://hull-repository.worktribe.com/output/4224084
• Additional Information: School of Health and Social Work, The University of Hull
• Award Date: Jul 1, 2020