Effects of Health Literacy Programme on Intensive Care Unit Visitors’ Hand Hygiene Behaviour
Keywords:
health literacy programme, health literacy, hand hygiene behaviour, visitors, intensive care unitAbstract
Objective: To examine how effectively a health literacy programme could improve intensive care unit visitors’ hand hygiene behaviour
Design: Two-group quasi-experimental research with a pretest and a posttest
Methodology: The participants, aged between 18 and 59, were 76 visitors to patients in an intensive care unit. The participants were equally assigned to a control group, which received standard care, and an experimental group, which received a health literacy programme. The programme was administered for two days, both to each individual and to the entire group, and was evaluated using the health literacy assessment
tool and the hand hygiene behaviour observation form. The data were analysed using descriptive statistics, chi-square statistics, the Wilcoxon signed-rank test, and the Mann-Whitney U test.
Results: According to the findings, the experimental group’s mean health literacy score was significantly higher than the control group’s (p < .05). The experimental group also earned significantly higher mean scores on frequency and correctness of hand washing than did the control group (p < .05).
Recommendations: It is recommended that the health literacy programme be used to remind visitors to intensive care units to consistently maintain hand hygiene behaviour and quality, to prevent the spread of infectious diseases.
Downloads
References
Banach DB, Bearman GM, Morgan DJ, Munoz-Price LS. Infection control precautions for visitors to healthcare
facilities. Expert Rev Anti Infect Ther 2015;13(9): 1047-50.
Bandura, Albert. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review
; 84(2):191-215.
Barnes L, Morgan J, Harris D, Carling C, Thom A. Preventing the transmission of multidrug- resistant
organisms: modeling the relative importance of hand hygiene and environmental cleaning interventions. Infect
Control Hosp Epidemiol 2014;35(9):1156-62.
Birnbach D, Rosen L, Fitzpatrick M, Arheart K, & Munoz-Price L. An evaluation of hand hygiene in an
intensive care unit: Are visitors a potential vector for pathogens? J Infect Public Health 2015;8(6): 570-74.
Thongchuea B, Khamfu P, Thanomphan S. Effects of hand washing program on knowledge and practice of
prevention and control of multi-drug resistance organisms among nursing personnel, patients, and
care-givers in surgical and orthopedic Department in Nakornping Hospital. Journal of Nurses Association of
Thailand Northern Office 2017;23(2):12-25. (in Thai)
Castro-Sánchez E, Chang P, Vila-CandelR, Escobedo A, Holmes A. Health literacy and infectious diseases:
Why does it matter? Int J Infect Dis 2016;43:103-10.
Chen YC, Chiang LC. Effectiveness of hand-washing teaching programs for families of children in paediatric
intensive care units. JCN 2007;16(6):1173-9.
Country of Los Angeles Public Health. Policy and Guidance for Visitors in Healthcare Settings [Internet]:
Los Angeles; 2018 [cite 2019 Oct 20]. Available from: http://publichealth.lacounty.gov/acd/index.htm.
FitzGerald G, Moore G, Wilson APR. Hand hygiene after touching a patient’s surroundings: the opportunities
most commonly missed. J Hosp Infec 2013;84(1): 27-31.
Griffey et al,. The impact of teach-back on comprehension of discharge instructions and satisfaction among
emergency patients with limited health literacy: A randomized, controlled study. J Commun Health 2015;8(1):10-21.
Haque M, Sartelli M, McKimm J, Bakar MA. Health care-associated infections–an overview. Infect Drug
Resist 2018;11:2321- 8.
Horng LM, Unicomb L, Alam MU, Halder AK, Shoab AK, Ghosh PK, et al. Healthcare worker and family
caregiver hand hygiene in Bangladeshi healthcare facilities: Results from the Bangladesh National hygiene
baseline survey. J Hosp Infec 2016;94(3):286-94.
Jung MY, Kang J. Hand hygiene compliance among visitors at a long- term care hospital in Korea: A covert
observation study. J Korean Acad Nurs 2019;30(1): 99-107.
Mikey K, Picheansathian W, Boonchuang P. Effects of multimodal hand hygiene improvement strategies
on knowledge and practices of hand hygiene among healthcare personnel. Nursing Journal 2016;43(2):
-78. (in Thai)
Kim D, Lee O. Effects of audio-visual stimulation on hand hygiene compliance among family and non-family
visitors of pediatric wards: a quasi- experimental pre-post intervention study. J Pediatr Nurs 2019;46:92-7.
Koo L, Horowitz A, Radice S, Wang M, Kleinman D. Nurse practitioners’ use of communication techniques:
Results of a Maryland oral health literacy survey. PLOS One 2016;11(1):1-15.
Linam WM, Marrero EM, Honeycutt MD, Wisdom CM, Gaspar A, Vijayan V. Focusing on families and visitors
reduces healthcare associated respiratory viral infections in a neonatal intensive care unit. Pediatr Qual Saf 2019;
(6):1-7.
Nizame FA, Nasreen S, Halder AK, Arman S, Winch PJ, Unicomb L, Luby SP. Observed practices and perceived
advantages of different hand cleansing agents in rural Bangladesh: ash, soil, and soap. Am J Trop Med Hyg
;92:1111-6. https://doi.org/10.4269/ ajtmh.14-0378
Nutbeam D. Health literacy as a public health goal: A challenge for contemporary health education and
communication strategies into the 21st century. Health Promot Int 2000;15(3): 259-67.
Srimoragot P, Chadthai Y, Klaewklong N. Effects of the developing hand washing behavior program on
knowledge, attitude and skill among novice monks. J Nurs Sci 2018;36(2):67-77. (in Thai)
Ramos FJ, Fumis RR, Azevedo LC, Schettino G. Intensive care unit visitation policies in Brazil: a multicenter survey. Rev Bras Ter Intensiva 2014; 26(4):339 –46. https://doi.org/10.5935/ 0103507X.20140052
Saharman YR, Fares DA, El-Atmani S, Sedono R, Aditianingsih D, Karuniawati A, et al. A multifaceted
hand hygiene improvement program on the intensive care units of the National Referral Hospital of Indonesia
in Jakarta. Antimicrob Resist Infect Control 2019; 8(1):1-10.
Sorensen K, Brand H. Health literacy lost in translations? Introducing the European health literacy glossary.
Health Promot Int 2013;29(4):634-44.
Thai government gazette of 2020. Statement of the Prime Minister’s Office on declaration of emergency
situation of 2000. 137 Stat. 24:1-2 [Internet]. [cited 2020 Mar 25]. Available from:http://www. ratchakitcha.soc.go.th/DATA/PDF/2563/A/ 024/T_0001.PDF (in Thai)
The Health Education Division, Ministry of Public Health (Thai). An assessment of health knowledge and
health behavior among public health volunteers and working-age people to change health behavior in the
sub-districts to manage quality of life. Nonthaburi: Department of Health Service Support Ministry of
Public Health; 2018. (in Thai)
Intarakamhang U. Health literacy: Measurement and development. Bangkok: Sukhumvitprinting; 2017.
(in Thai)
World Health Organization. A guide to the implementation of the WHO multimodal hand hygiene improvement strategy. Switzerland: WHO Document; 2009.
World Health Organization. Report on the Burden of Endemic Health Care- Associated infection Worldwide.
Switzerland: WHO Document; 2011.
Yang C, Hu J, Tao M, Li Y, Chai Y, Ning Y, et al. Effectiveness of a multifaceted intervention on improving the hand-washing skills and behaviors of migrant workers in Beijing. Glob Health Promot 2017;24(3):32-39.
The Joint Commission. Measuring hand hygiene adherence: overcoming the challenges. U.S.A: Gojo
industry; 2009.
