Survey: Healthcare Professionals Often Hesitate to Express Hand Hygiene Concerns

By on 5:55 AM

The results of a new study published in the American Journal of Infection Control point to a need for stronger efforts toward encouraging healthcare professionals (HCPs) to speak up when observing questionable hand hygiene practices.

More than 1,200 HCPs, specifically nurses and physicians, across five Swiss hospitals participated in a self-administered survey. It covered past speaking-up behaviors, their evaluations of the speaking-up climate in the workplace and their likelihood to speak up about poor hand hygiene practice described in a scenario.

Here are some of the key takeaways:

  • While nearly 86% of respondents reported at least one episode of speaking up due to a safety concern over the previous four weeks, about 61 of respondents also reported at least one episode of withholding their voice during that period despite having safety concerns.
  • 56% of respondents stated they would speak up to a colleague if they witnessed the poor hand hygiene practice described in the scenario, with 43% indicating they would feel uncomfortable with speaking up. 
  • Nurses expressed more discomfort with speaking up and reported a slightly lower likelihood of speaking up than physicians. 
  • Hierarchy was strongly associated with speaking-up behavior. 
  • Higher risk of patient harm and higher frequencies of past speaking-up behaviors were associated positively with likelihood to speak up. Higher frequencies of past withholding voice and higher levels of resignation were associated with a lower likelihood to speak up.
As the study notes, "Infection control interventions should empower HCPs to speak up about non-adherence with prevention practices by addressing authority gradients and risk perceptions and by focusing on resignation."

For more information on hand hygiene and proper practices, access these past Infection Control Consulting Services (ICCS) blogs:

If your organization requires assistance with improving hand hygiene or any other infection prevention and control practice, contact infection control consultant Phenelle Segal, RN, CIC, FAPIC, and her ICCS team of experts.

Phenelle Segal, RN, CIC, FAPIC

Phenelle Segal, RN, CIC, FAPIC, is the founder and president of Infection Control Consulting Services LLC (ICCS). Phenelle has more than 30 years' experience providing customized comprehensive infection control and prevention services to healthcare facilities nationwide. Her services focus on assisting hospitals, ambulatory surgery centers, dental office and oral surgery practices, doctor's offices, nursing homes and other organizations with implementing and maintaining an infection control program that: complies with The Joint Commission, AAAHC, Centers for Medicaid and Medicare Services (CMS) and other regulatory agencies; respond to situations of noncompliance; and improve the processes for reducing risk.