Download PDF
Krankenhaushygiene up2date 2022; 17(01): 57-79
DOI: 10.1055/a-1194-3049
Präventionsmaßnahmen

Psychologie und Förderung der Händehygiene-Compliance

Neue Perspektiven für den Weg von der Motivation zum Verhalten
Thomas von Lengerke
,
Iris F. Chaberny
› Further Information
Also available at
    Permissions and Reprints All articles of this category

Obwohl die Händehygiene eine hocheffektive infektionspräventive Maßnahme ist, wird sie immer noch nicht überall ausreichend durchgeführt. Wie sich das Verhalten der Mitarbeiter positiv beeinflussen lässt, lesen Sie in diesem Beitrag.
Kernaussagen

  • Händehygiene veranschaulicht das grundsätzliche Dilemma von Prävention: Es ist ihr Erfolg, wenn „nichts passiert“, also etwas so gut (hier: jemand gesund bzw. nicht krank) bleibt, wie es ist.

  • Der „Faktor Mensch“ hat in der Infektionsprävention zentrale Bedeutung und macht psychologische Ansätze im Rahmen multimodaler Ansätze zu deren Förderung notwendig.

  • Beispielsweise auf Basis des Modells „Health Action Process Approach” (HAPA) lassen sich ungesunde bzw. krankmachende Gewohnheiten in Richtung einer gesunden bzw. präventiv wirksamen Verhaltensänderung beeinflussen.

  • Dies wird am ehesten durch zielgruppenorientierte, maßgeschneiderte Interventionen unter Verwendung von Verhaltensveränderungstechniken erreicht.



Publication History

Article published online:
22 February 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Lambe KA, Lydon S, Madden C. et al. Hand hygiene compliance in the ICU: a systematic review. Crit Care Med 2019; 47: 1251-1257 DOI: 10.1097/CCM.0000000000003868.
    CrossrefPubMedGoogle Scholar
  • 2 Carey RN, Connell LE, Johnston M. et al. Behavior change techniques and their mechanisms of action: a synthesis of links described in published intervention literature. Ann Behav Med 2019; 53: 693-707 DOI: 10.1093/abm/kay078.
    CrossrefPubMedGoogle Scholar
  • 3 Connell LE, Carey RN, de Bruin M. et al. Links between behavior change techniques and mechanisms of action: an expert consensus study. Ann Behav Med 2019; 53: 708-720 DOI: 10.1093/abm/kay082.
    CrossrefPubMedGoogle Scholar
  • 4 Johnston M, Carey RN, Connell Bohlen LE. et al. Development of an online tool for linking behavior change techniques and mechanisms of action based on triangulation of findings from literature synthesis and expert consensus. Transl Behav Med 2021; 11: 1049-1065 DOI: 10.1093/tbm/ibaa050.
    CrossrefPubMedGoogle Scholar
  • 5 Lewin K. Principles of topological psychology. New York: McGraw-Hill; 1936
    CrossrefGoogle Scholar
  • 6 Srigley JA, Corace K, Hargadon DP. et al. Applying psychological frameworks of behaviour change to improve healthcare worker hand hygiene: a systematic review. J Hosp Infect 2015; 91: 202-210 DOI: 10.1016/j.jhin.2015.06.019.
    CrossrefPubMedGoogle Scholar
  • 7 Michie S, Atkins L, West R. The behaviour change wheel: a guide to designing interventions. London: Silverback; 2014
    Google Scholar
  • 8 World Health Organization (WHO). WHO guidelines on hand hygiene in health care: first global patient safety challenge clean care is safer care. Geneva: WHO Press; 2009
    Google Scholar
  • 9 (RKI) KfKuIKbRK-I. Händehygiene in Einrichtungen des Gesundheitswesens : Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2016; 59: 1189-1220 DOI: 10.1007/s00103–016–2416–6.
    CrossrefPubMedGoogle Scholar
  • 10 DIN EN 1500: 2017-10.
    Google Scholar
  • 11 WHO. Adherence to long-term therapies: evidence for action. Geneva: WHO; 2003
    Google Scholar
  • 12 Sunkesula VC, Knighton S, Zabarsky TF. et al. Four moments for patient hand hygiene: a patient-centered, provider-facilitated model to improve patient hand hygiene. Infect Control Hosp Epidemiol 2015; 36: 986-989 DOI: 10.1017/ice.2015.78.
    CrossrefPubMedGoogle Scholar
  • 13 Gaube S, Fischer P, Lermer E. Hand(y) hygiene insights: Applying three theoretical models to investigate hospital patients' and visitors' hand hygiene behavior. PloS one 2021; 16: e0245543 DOI: 10.1371/journal.pone.0245543.
    CrossrefPubMedGoogle Scholar
  • 14 Jeanes A, Coen PG, Gould DJ. et al. Validity of hand hygiene compliance measurement by observation: a systematic review. Am J Infect Control 2019; 47: 313-322 DOI: 10.1016/j.ajic.2018.08.004.
    CrossrefPubMedGoogle Scholar
  • 15 Sax H, Allegranzi B, Uckay I. et al. „My five moments for hand hygiene”: a user-centred design approach to understand, train, monitor and report hand hygiene. J Hosp Infect 2007; 67: 9-21 DOI: 10.1016/j.jhin.2007.06.004.
    CrossrefPubMedGoogle Scholar
  • 16 Sax H, Allegranzi B, Chraiti MN. et al. The World Health Organization hand hygiene observation method. Am J Infect Control 2009; 37: 827-834 DOI: 10.1016/j.ajic.2009.07.003.
    CrossrefPubMedGoogle Scholar
  • 17 Diefenbacher S, Siegel A, Keller J. Verfahren zur Erfassung des Händehygieneverhaltens - Eine methodische Betrachtung aus verhaltenswissenschaftlicher Perspektive. Hyg Med 2016; 41: D105-119
    Google Scholar
  • 18 Reichardt C, Bunte-Schonberger K, Behnke M. et al. Krankenhaushygiene – Wo stehen wir im 6. Jahr der „Aktion Saubere Hände“? . AINS 2014; 49: 30-34
    PubMedGoogle Scholar
  • 19 Reichardt C, Koniger D, Bunte-Schonberger K. et al. Three years of national hand hygiene campaign in Germany: what are the key conclusions for clinical practice?. J Hosp Infect 2013; 83 (Suppl. 01) S11-16 DOI: 10.1016/S0195-6701(13)60004-3.
    CrossrefPubMedGoogle Scholar
  • 20 Wetzker W, Bunte-Schonberger K, Walter J. et al. Compliance with hand hygiene: reference data from the national hand hygiene campaign in Germany. J Hosp Infect 2016; 92: 328-331 DOI: 10.1016/j.jhin.2016.01.022.
    CrossrefPubMedGoogle Scholar
  • 21 Kramer TS, Bunte K, Schroder C. et al. No increase in compliance before aseptic procedures in German hospitals. A longitudinal study with data from the national surveillance system over four years. . J Hosp Infect 2020; 106: 71-75 DOI: 10.1016/j.jhin.2020.07.001.
    CrossrefPubMedGoogle Scholar
  • 22 Ott E, Saathoff S, Graf K. et al. The prevalence of nosocomial and community acquired infections in a university hospital: an observational study. Dtsch Arztebl Int 2013; 110: 533-540 DOI: 10.3238/arztebl.2013.0533.
    CrossrefPubMedGoogle Scholar
  • 23 Behnke M, Aghdassi SJ, Hansen S. et al. The prevalence of nosocomial infection and antibiotic use in German hospitals. Dtsch Arztebl Int 2017; 114: 851-857 DOI: 10.3238/arztebl.2017.0851.
    CrossrefPubMedGoogle Scholar
  • 24 Eckmanns T, Rath A, Brauer H. et al. [Compliance with hand hygiene in intensive care units]. Dtsch Med Wochenschr 2001; 126: 745-749 DOI: 10.1055/s-2001-15102.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Erasmus V, Daha TJ, Brug H. et al. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol 2010; 31: 283-294 DOI: 10.1086/650451.
    CrossrefPubMedGoogle Scholar
  • 26 Schwadtke L, Graf K, Lutze B. et al. Compliance der Händedesinfektion auf Intensivstationen. Dtsch Med Wochenschr 2014; 139: 1341-1345 DOI: 10.1055/s-0034-1370143.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 Schwarzer R, Fleig L. Von der Risikowahrnehmung zur Änderung des Gesundheitsverhaltens. Zentralbl Arbeitsmed 2014; 64: 338-341
    CrossrefGoogle Scholar
  • 28 Zhang CQ, Zhang R, Schwarzer R. et al. A meta-analysis of the health action process approach. Health Psychol 2019; 38: 623-637 DOI: 10.1037/hea0000728.
    CrossrefPubMedGoogle Scholar
  • 29 Schwarzer R, Lippke S, Luszczynska A. Mechanisms of health behavior change in persons with chronic illness or disability: the Health Action Process Approach (HAPA). Rehabil Psychol 2011; 56: 161-170 DOI: 10.1037/a0024509.
    CrossrefPubMedGoogle Scholar
  • 30 Aktion Saubere Hände. Händedesinfektion und Compliance: Warum ist eine so einfache Maßnahme so schwierig durchzusetzen?. Aktion Saubere Hände; o.J.; Berlin:
    Google Scholar
  • 31 Lippke S, Renneberg B. Theorien und Modelle des Gesundheitsverhaltens. Renneberg B, Hammelstein P. Gesundheitspsychologie. Berlin: Springer; 2006: 35-60
    CrossrefGoogle Scholar
  • 32 Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 2011; 6: 42 DOI: 10.1186/1748–5908–6-42.
    CrossrefPubMedGoogle Scholar
  • 33 Michie S, Johnston M. Theories and techniques of behaviour change: developing a cumulative science of behaviour change. Health Psychol Rev 2012; 6: 1-6
    CrossrefGoogle Scholar
  • 34 Michie S, Richardson M, Johnston M. et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med 2013; 46: 81-95 DOI: 10.1007/s12160-013-9486-6.
    CrossrefPubMedGoogle Scholar
  • 35 Lutze B. Verhaltenspsychologisch orientierte Infektionsprävention. Welchen Einfluss hat die subjektive Risikowahrnehmung von Ärzten und Pflegekräften auf ihr infektionspräventives Händehygieneverhalten?. Hamburg: Disserta; 2016
    Google Scholar
  • 36 Lutze B, Chaberny IF, Graf K. et al. Intensive care physicians' and nurses' perception that hand hygiene prevents pathogen transmission: belief strength and associations with other cognitive factors. J Health Psychol 2017; 22: 89-100 DOI: 10.1177/1359105315595123.
    CrossrefPubMedGoogle Scholar
  • 37 von Lengerke T, Lutze B, Krauth C. et al. Promoting hand hygiene compliance: PSYGIENE-a cluster-randomized controlled trial of tailored interventions. Dtsch Arztebl Int 2017; 114: 29-36 DOI: 10.3238/arztebl.2017.0029.
    CrossrefPubMedGoogle Scholar
  • 38 von Lengerke T, Ebadi E, Schock B. et al. Impact of psychologically tailored hand hygiene interventions on nosocomial infections with multidrug-resistant organisms: results of the cluster-randomized controlled trial PSYGIENE. Antimicrob Resist Infect Control 2019; 8: 56 DOI: 10.1186/s13756–019–0507–5.
    CrossrefPubMedGoogle Scholar
  • 39 von Lengerke T, Lutze B, Graf K. et al. Psychosocial determinants of self-reported hand hygiene behaviour: a survey comparing physicians and nurses in intensive care units. J Hosp Infect 2015; 91: 59-67 DOI: 10.1016/j.jhin.2015.04.018.
    CrossrefPubMedGoogle Scholar
  • 40 Tomsic I, Ebadi E, Gosse F. et al. Determinants of orthopedic physicians' self-reported compliance with surgical site infection prevention: results of the WACH-trial's pilot survey on COM-B factors in a German university hospital. Antimicrob Resist Infect Control 2021; 10: 67 DOI: 10.1186/s13756–021–00932–9.
    CrossrefPubMedGoogle Scholar
  • 41 Renner B, Gamp M. Krisen- und Risikokommunikation. Präv Gesundheitf 2014; 9: 230-238
    CrossrefGoogle Scholar
  • 42 Zipkin DA, Umscheid CA, Keating NL. et al. Evidence-based risk communication: a systematic review. Ann Intern Med 2014; 161: 270-280 DOI: 10.7326/M14-0295.
    CrossrefPubMedGoogle Scholar
  • 43 McCay L. Emotional motivators might improve hand hygiene among healthcare workers. BMJ 2015; 351: h3968 DOI: 10.1136/bmj.h3968.
    CrossrefPubMedGoogle Scholar
  • 44 Porzig-Drummond R, Stevenson R, Case T. et al. Can the emotion of disgust be harnessed to promote hand hygiene? Experimental and field-based tests. . Soc Sci Med 2009; 68: 1006-1012 DOI: 10.1016/j.socscimed.2009.01.013.
    CrossrefPubMedGoogle Scholar
  • 45 Sassenrath C, Diefenbacher S, Siegel A. et al. A person-oriented approach to hand hygiene behaviour: emotional empathy fosters hand hygiene practice. Psychol Health 2016; 31: 205-227 DOI: 10.1080/08870446.2015.1088945.
    CrossrefPubMedGoogle Scholar
  • 46 Bushuven S, Dietz A, Bushuven S. et al. Interprofessional perceptions and emotional impact of multidrug-resistant organisms: A qualitative study. Am J Infect Control 2019; 47: 876-882 DOI: 10.1016/j.ajic.2019.01.019.
    CrossrefPubMedGoogle Scholar
  • 47 Bushuven S, Dettenkofer M, Dietz A. et al. Interprofessional perceptions of emotional, social, and ethical effects of multidrug-resistant organisms: a qualitative study. PloS one 2021; 16 DOI: 10.1371/journal.pone.0246820.
    CrossrefPubMedGoogle Scholar
  • 48 Luangasanatip N, Hongsuwan M, Limmathurotsakul D. et al. Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. BMJ 2015; 351 DOI: 10.1136/bmj.h3728.
    CrossrefPubMedGoogle Scholar
  • 49 Bandura A. Health promotion from the perspective of social cognitive theory. Psychol Health 1998; 13: 623-649
    CrossrefGoogle Scholar
  • 50 Bandura A. Social cognitive theory: an agentic perspective. Annu Rev Psychol 2001; 52: 1-26 DOI: 10.1146/annurev.psych.52.1.1.
    CrossrefPubMedGoogle Scholar
  • 51 Derksen C, Keller FM, Lippke S. Obstetric Healthcare workers' adherence to hand hygiene recommendations during the COVID-19 pandemic: observations and social-cognitive determinants. Appl Psychol Health Well Being 2020; 12: 1286-1305 DOI: 10.1111/aphw.12240.
    CrossrefPubMedGoogle Scholar
  • 52 Huis A, van Achterberg T, de Bruin M. et al. A systematic review of hand hygiene improvement strategies: a behavioural approach. Implement Sci 2012; 7: 92 DOI: 10.1186/1748–5908–7-92.
    CrossrefPubMedGoogle Scholar
  • 53 Sheeran P, Abraham C. Mediator of moderators: temporal stability of intention and the intention-behavior relation. Personal Social Psychol Bull 2003; 29: 205-215 DOI: 10.1177/0146167202239046.
    CrossrefPubMedGoogle Scholar
  • 54 Lutze B, Chaberny IF, Graf K. et al. Risiko „im Griff“? Ergebnisse des PSYGIENE-Projekts zur Motivationslage bezüglich der eigenen hygienischen Händedesinfektion bei Ärzten und Pflegekräften der Intensivmedizin. Ingensiep HW, Popp W. Hygiene-Aufklärung im Spannungsfeld zwischen Medizin und Gesellschaft. Freiburg i. Br: Karl Alber; 2016: 57-66
    Google Scholar
  • 55 Diefenbacher S, Fliss PM, Tatzel J. et al. A quasi-randomized controlled before-after study using performance feedback and goal setting as elements of hand hygiene promotion. J Hosp Infect 2019; 101: 399-407 DOI: 10.1016/j.jhin.2019.02.001.
    CrossrefPubMedGoogle Scholar
  • 56 Sheeran P, Webb TL. The intention-behavior gap. Soc Pers Psychol Compass 2016; 10: 503-518
    CrossrefGoogle Scholar
  • 57 Gollwitzer PM. Implementation Intentions: strong effects of simple plans. Am Psychol 1999; 54: 493-503
    CrossrefGoogle Scholar
  • 58 Lhakhang P, Lippke S, Knoll N. et al. Evaluating brief motivational and self-regulatory hand hygiene interventions: a cross-over longitudinal design. BMC Public Health 2015; 15: 79 DOI: 10.1186/s12889–015–1453–7.
    CrossrefPubMedGoogle Scholar
  • 59 Zhou G, Jiang T, Knoll N. et al. Improving hand hygiene behaviour among adolescents by a planning intervention. Psychol Health Med 2015; 20: 824-831 DOI: 10.1080/13548506.2015.1024138.
    CrossrefPubMedGoogle Scholar
  • 60 Reyes Fernandez B, Lippke S, Knoll N. et al. Promoting action control and coping planning to improve hand hygiene. BMC Public Health 2015; 15: 964 DOI: 10.1186/s12889-015-2295-z.
    CrossrefPubMedGoogle Scholar
  • 61 Erasmus V, Kuperus MN, Richardus JH. et al. Improving hand hygiene behaviour of nurses using action planning: a pilot study in the intensive care unit and surgical ward. J Hosp Infect 2010; 76: 161-164 DOI: 10.1016/j.jhin.2010.04.024.
    CrossrefPubMedGoogle Scholar
  • 62 Sniehotta FF. Towards a theory of intentional behaviour change: plans, planning, and self-regulation. Brit J Health Psychol 2009; 14: 261-273 DOI: 10.1348/135910708X389042.
    CrossrefPubMedGoogle Scholar
  • 63 Schulz-Stübner S. Vorbildverhalten Leitender Ärzte in Sachen Hygiene - Ergebnisse und Erkenntnisse einer Umfrage. Hyg Med 2012; 37: 408-411
    Google Scholar
  • 64 Kröning B. Führungsverhalten und Händehygiene: Beeinflussen Führungskräfte und Rollenmodelle die Händehygienecompliance bei medizinischem Personal?. Hamburg: Diplomica; 2014
    Google Scholar
  • 65 Alzunitan MA, Edmond MB, Alsuhaibani MA. et al. Positive deviance in infection prevention and control: a systematic literature review. Infect Control Hosp Epidemiol 2020; 1: 1-8 DOI: 10.1017/ice.2020.1256.
    CrossrefPubMedGoogle Scholar
  • 66 Büssing A, Glaser J. Das Tätigkeits- und Arbeitsanalyseverfahrens für das Krankenhaus - Selbstbeobachtungsversion (TAA-KH-S). Göttingen: Hogrefe; 2002
    Google Scholar
  • 67 Huis A, Schoonhoven L, Grol R. et al. Impact of a team and leaders-directed strategy to improve nurses' adherence to hand hygiene guidelines: a cluster randomised trial. Int J Nurs Stud 2013; 50: 464-474 DOI: 10.1016/j.ijnurstu.2012.08.004.
    CrossrefPubMedGoogle Scholar
  • 68 Huis A, Hulscher M, Adang E. et al. Cost-effectiveness of a team and leaders-directed strategy to improve nurses' adherence to hand hygiene guidelines: a cluster randomised trial. Int J Nurs Stud 2013; 50: 518-526 DOI: 10.1016/j.ijnurstu.2012.11.016.
    CrossrefPubMedGoogle Scholar
  • 69 Gaube S, Tsivrikos D, Dollinger D. et al. How a smiley protects health: A pilot intervention to improve hand hygiene in hospitals by activating injunctive norms through emoticons. PloS one 2018; 13 DOI: 10.1371/journal.pone.0197465.
    CrossrefPubMedGoogle Scholar
  • 70 Schwappach DLB. Speaking up about hand hygiene failures: a vignette survey study among healthcare professionals. Am J Infect Control 2018; 46: 870-875 DOI: 10.1016/j.ajic.2018.02.026.
    CrossrefPubMedGoogle Scholar
  • 71 Rall M, Schmid K, Langewand S. et al. Crew Resource Management für die Notaufnahme. Stuttgart: Kohlhammer; 2020
    CrossrefGoogle Scholar
  • 72 Prochaska JO, Redding CA, Evers KE. The transtheoretical model and stages of change. Glanz K, Rimer BK, Viswanath K. Health behavior: theory, research, and practice. San Francisco, CA: Jossey-Bass; 2015: 125-148
    Google Scholar
  • 73 Reyes Fernandez B, Knoll N, Hamilton K. et al. Social-cognitive antecedents of hand washing: Action control bridges the planning-behaviour gap. Psychol Health 2016; 993-1004 DOI: 10.1080/08870446.2016.1174236.
    CrossrefPubMedGoogle Scholar
  • 74 Gaube S, Schneider-Brachert W, Holzmann T. et al. Utilizing behavioral theories to explain hospital visitors' observed hand hygiene behavior. Am J Infect Control 2021; 49: 912-918 DOI: 10.1016/j.ajic.2021.01.003.
    CrossrefPubMedGoogle Scholar
  • 75 Orbell S, Verplanken B. The automatic component of habit in health behavior: habit as cue-contingent automaticity. Health Psychol 2010; 29: 374-383 DOI: 10.1037/a0019596.
    CrossrefPubMedGoogle Scholar
  • 76 Gardner B, Abraham C, Lally P. et al. Towards parsimony in habit measurement: testing the convergent and predictive validity of an automaticity subscale of the Self-Report Habit Index. Int J Behav Nutr Phys Act 2012; 9: 102 DOI: 10.1186/1479–5868–9-102.
    CrossrefPubMedGoogle Scholar
  • 77 Diefenbacher S, Pfattheicher S, Keller J. On the role of habit in self-reported and observed hand hygiene behavior. Appl Psychol Health Well Being 2020; 12: 125-143 DOI: 10.1111/aphw.12176.
    CrossrefPubMedGoogle Scholar
  • 78 Diefenbacher S, Sassenrath C, Siegel A. et al. Implizite Einstellung zur Händehygiene als relevanter Prädiktor von Händehygieneverhalten. Hyg Med 2012; 37: 448-455
    Google Scholar
  • 79 King D, Vlaev I, Everett-Thomas R. et al. „Priming“ hand hygiene compliance in clinical environments. Health Psychol 2016; 35: 96-101 DOI: 10.1037/hea0000239.
    CrossrefPubMedGoogle Scholar
  • 80 Caris MG, Labuschagne HA, Dekker M. et al. Nudging to improve hand hygiene. J Hosp Infect 2018; 98: 352-358 DOI: 10.1016/j.jhin.2017.09.023.
    CrossrefPubMedGoogle Scholar
  • 81 Nicol PW, Watkins RE, Donovan RJ. et al. The power of vivid experience in hand hygiene compliance. J Hosp Infect 2009; 72: 36-42 DOI: 10.1016/j.jhin.2009.01.021.
    CrossrefPubMedGoogle Scholar
  • 82 Houlihan S. Dual-process models of health-related behaviour and cognition: a review of theory. Public Health 2018; 156: 52-59 DOI: 10.1016/j.puhe.2017.11.002.
    CrossrefPubMedGoogle Scholar
  • 83 Kleppe M, Lacroix J, Ham J. et al. A dual-process view on medication adherence: the role of affect. J Health Psychol 2019; 24: 1033-1042 DOI: 10.1177/1359105317690599.
    CrossrefPubMedGoogle Scholar
  • 84 Lambe KA, O'Reilly G, Kelly BD. et al. Dual-process cognitive interventions to enhance diagnostic reasoning: a systematic review. BMJ Qual Saf 2016; 25: 808-820 DOI: 10.1136/bmjqs-2015-004417.
    CrossrefPubMedGoogle Scholar
  • 85 Stahmeyer JT, Lutze B, von Lengerke T. et al. Hand hygiene in intensive care units: a matter of time?. J Hosp Infect 2017; 95: 338-343 DOI: 10.1016/j.jhin.2017.01.011.
    CrossrefPubMedGoogle Scholar
  • 86 Baker R, Camosso-Stefinovic J, Gillies C. et al. Tailored interventions to address determinants of practice. Cochrane Database Syst Sev 2015; DOI: 10.1002/14651858.CD005470.pub3.
    CrossrefPubMedGoogle Scholar
  • 87 von Lengerke T, Schock B, Hartlep I. et al. Promoting compliance with surgical site infection prevention guidelines by psychologically tailored interventions: study protocol of the multi-center parallel-group cluster-randomized controlled „WACH“-trial. Antimicrob Resist Infect Control 2019; 8: 30
    CrossrefPubMedGoogle Scholar
  • 88 von Lengerke T, Hartlep I, Schipper P. et al. SSI-preventive compliance after tailored interventions for infection prevention and control teams: results of the cluster-randomized controlled WACH-trial in six non-university hospitals. Antimicrob Resist Infect Control 2021; 10 (Suppl. 01) 130 (Abstract O30) DOI: 10.1186/s12913-020-4995-z.
    CrossrefPubMedGoogle Scholar
  • 89 Bushuven S, Weidenbusch M, Mohr S. et al. Cognitive bias in professional hand hygiene and feedback: a national online-survey on overconfidence in Germany. Infect Control Hosp Epidemiol 2019; 40: 943-946 DOI: 10.1017/ice.2019.156.
    CrossrefPubMedGoogle Scholar
  • 90 Bushuven S, Juenger J, Moeltner A. et al. Overconfidence in infection control proficiency. Am J Infect Control 2019; 47: 545-550 DOI: 10.1016/j.ajic.2018.10.022.
    CrossrefPubMedGoogle Scholar
  • 91 Stone SP. Time to Implement immediate personalized feedback and individualized action planning for hand hygiene. JAMA Netw Open 2018; 1: e183422 DOI: 10.1001/jamanetworkopen.2018.3422.
    CrossrefPubMedGoogle Scholar
  • 92 Hattie J, Timperley H. The power of feedback. Rev Educ Res 2007; 77: 81-112
    CrossrefGoogle Scholar
  • 93 Clancy C, Delungahawatta T, Dunne CP. Hand-hygiene-related clinical trials reported between 2014 and 2020: a comprehensive systematic review. J Hosp Infect 2021; 111: 6-26 DOI: 10.1016/j.jhin.2021.03.007.
    CrossrefPubMedGoogle Scholar
  • 94 Girou E, Legrand P, Soing-Altrach S. et al. Association between hand hygiene compliance and methicillin-resistant Staphylococcus aureus prevalence in a French rehabilitation hospital. Infect Control Hosp Epidemiol 2006; 27: 1128-1130 DOI: 10.1086/507967.
    CrossrefPubMedGoogle Scholar
  • 95 Ojanpera H, Kanste OI, Syrjala H. Hand-hygiene compliance by hospital staff and incidence of health-care-associated infections, Finland. Bull World Health Organ 2020; 98: 475-483 DOI: 10.2471/BLT.19.247494.
    CrossrefPubMedGoogle Scholar
  • 96 Tomsic I, Heinze NR, Chaberny IF. et al. Implementation interventions in preventing surgical site infections in abdominal surgery: a systematic review. BMC Health Serv Res 2020; 20: 236 DOI: 10.1186/s12913–020–4995-z.
    CrossrefPubMedGoogle Scholar
  • 97 von Lengerke T, Tomsic I, Hartlep I. et al. Hand hygiene compliance during surgical ward rounds after tailored interventions targeting infection prevention and control (IPC) teams and other IPC stakeholders: bivariate crosstabular analyses from the cluster-randomised controlled WACH-trial taking into account the onset of the COVID-19 pandemic. Berlin: DGHM; 2021
    Google Scholar
  • 98 Atkins L, Francis J, Islam R. et al. A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implementation Sci 2017; 12: 77 DOI: 10.1186/s13012–017–0605–9.
    CrossrefPubMedGoogle Scholar
  • 99 Michie S, Carey RN, Johnston M. et al. From theory-inspired to theory-based interventions: a protocol for developing and testing a methodology for linking behaviour change techniques to theoretical mechanisms of action. Ann Behav Med 2018; 52: 501-512 DOI: 10.1007/s12160-016-9816-6.
    CrossrefPubMedGoogle Scholar
  • 100 Michie S, West R, Sheals K. et al. Evaluating the effectiveness of behavior change techniques in health-related behavior: a scoping review of methods used. Transl Behav Med 2018; 8: 212-224 DOI: 10.1093/tbm/ibx019.
    CrossrefPubMedGoogle Scholar
  • 101 Bohlen LC, Michie S, de Bruin M. et al. Do Combinations of behavior change techniques that occur frequently in interventions reflect underlying theory?. Ann Behav Med 2020; 54: 827-842 DOI: 10.1093/abm/kaaa078.
    CrossrefPubMedGoogle Scholar
  • 102 Marques MM, Carey RN, Norris E. et al. Delivering Behaviour change interventions: development of a mode of delivery ontology. Wellcome Open Res 2020; 5: 125 DOI: 10.12688/wellcomeopenres.15906.2.
    CrossrefPubMedGoogle Scholar
  • 103 Michie S, Johnston M, Rothman AJ. et al. In Developing an evidence-based online method of linking behaviour change techniques and theoretical mechanisms of action: a multiple methods study. Southampton (UK) 2021 DOI: 10.3310/hsdr09010.
    CrossrefPubMedGoogle Scholar
  • 104 Schlicht W, Zinsmeister M. Verhalten ändern: Techniken und Werkzeuge. In: Schlicht W, Zinsmeister M, Hrsg. Gesundheitsförderung systematisch planen und effektiv intervenieren. Berlin, Heidelberg: Springer; 2015
    CrossrefGoogle Scholar
  • 105 Moore LD, Robbins G, Quinn J. et al. The impact of COVID-19 pandemic on hand hygiene performance in hospitals. Am J Infect Control 2021; 49: 30-33 DOI: 10.1016/j.ajic.2020.08.021.
    CrossrefPubMedGoogle Scholar
  • 106 Kielar M, Depurbaix R, Agnyziak M. et al. The COVID-19 pandemic as a factor of hospital staff compliance with the rules of hand hygiene: assessment of the usefulness of the „Clean Care is a Safer Care“ program as a tool to enhance compliance with hand hygiene principles in hospitals. J Prev Med Hyg 2021; 62: E25-E32 DOI: 10.15167/2421-4248/jpmh2021.62.1.1603.
    CrossrefPubMedGoogle Scholar
  • 107 Huang F, Armando M, Dufau S. et al. COVID-19 outbreak and healthcare worker behavioural change toward hand hygiene practices. J Hosp Infect 2021; 111: 27-34 DOI: 10.1016/j.jhin.2021.03.004.
    CrossrefPubMedGoogle Scholar
  • 108 Zingg W, Holmes A, Dettenkofer M. et al. Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. The Lancet infectious diseases 2015; 15: 212-224 DOI: 10.1016/S1473-3099(14)70854-0.
    CrossrefPubMedGoogle Scholar
  • 109 Lotfinejad N, Peters A, Tartari E. et al. Hand hygiene in health care: 20 years of ongoing advances and perspectives. The Lancet infectious diseases 2021; 21: E209-221
    CrossrefPubMedGoogle Scholar
  • 110 Bergler R. Psychologie der Hygiene. Darmstadt: Steinkopff; 2009
    CrossrefGoogle Scholar
  • 111 Bergler R. Psychologie der Hygiene. Ingensiep HW, Popp W. Hygiene-Aufklärung im Spannungsfeld zwischen Medizin und Gesellschaft. Freiburg München: Karl Alber; 2016: 33-55
    Google Scholar