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Peers have impact on infection control procedures

September 11, 2014

Professionals in the healthcare sector should realise the importance of working within a team, as well as being able to carry out procedures and practices independently. However, recent research suggests that being in a team can have a significant impact on how employees conduct themselves.

Although it is a common conclusion to assume that working within a team can offer healthcare professionals, especially those that are new or inexperienced, support and direction, research indicates that peers can influence whether or not a person carries out the necessary procedure or protocol.

A study, published in Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA), found that healthcare workers are more likely to wash their hands when surrounded by their peers. This could hold valuable insight for organisations in the sector as it could offer advice for how to get higher adherence in all infection control practices, and answer questions as to why they may not be carried out by employees.

In America, hand hygiene adherence remains fairly low, despite the various campaigns directed at raising awareness in this area, as well as other infection control practices. However, the research found that healthcare workers were far more likely to engage in hand hygiene protocol when other workers are nearby.

This suggests healthcare workers are aware of the appropriate measures to take but are neglecting to do so unless they know a peer is watching them. This could help organisations better tailor training and educational materials towards the dangers of not carrying out infection control practices, rather than detailing what they are.

"Social network effects, or peer effects, have been associated with smoking, obesity, happiness and worker productivity. As we found, this influence extends to hand hygiene compliance, too," said Dr Philip Polgreen, an author of the study. "Healthcare workers' proximity to their peers had a positive effect on their hand hygiene adherence."

Research conducted at the University of Iowa's Carver College of Medicine used a custom-built, badge-based system to estimate hand hygiene compliance and opportunities. As well as this, the method was also able to determine the location of each healthcare worker and the proximity of them to their peers in the medical intensive care unit. Data was taken across a ten-day period and monitored 24 hours a day.

Badges were randomly given to physicians, nurses and critical care staff at the start of each shift, and then collected information from healthcare workers concerning proximity and hand hygiene compliance when entering and leaving a patient room. Across the period, more than 47,000 hand hygiene opportunities were identified.

The findings suggest the hand hygiene rate was seven per cent higher (28 per cent vs 21 per cent) when healthcare workers were in close proximity to peers, compared to when employees were alone. In general, the researchers found that the magnitude of the peer effects increased in the presence of additional healthcare workers, but only up to a point.

According to the authors of the study, the research highlights the importance of social environment in the healthcare sector and could have significant implications for understanding how human behaviour affects the spread of diseases within healthcare settings.

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