| Title |
Identifying heterogeneity in the Hawthorne effect on hand hygiene observation: a cohort study of overtly and covertly observed results
|
|---|---|
| Published in |
BMC Infectious Diseases, August 2018
|
| DOI | 10.1186/s12879-018-3292-5 |
| Pubmed ID | |
| Authors |
Kuan-Sheng Wu, Susan Shin-Jung Lee, Jui-Kuang Chen, Yao-Shen Chen, Hung-Chin Tsai, Yueh-Ju Chen, Yu-Hsiu Huang, Huey-Shyan Lin |
| Abstract |
Observation and feedback are core strategies of hand hygiene (HH) improvement. Direct overt observation is currently the gold standard method. Observation bias, also known as the Hawthorne effect, is a major disadvantage of this method. Our aim was to examine the variation of the Hawthorne effect on HH observation in different healthcare groups and settings. A prospective cohort study was performed in a tertiary teaching hospital during a 15-month period. Up to 38 overt observers (82% nurses) and 93 covert observers (81% medical students) participated in HH observation. The HH events observed overtly were matched for occupation, department, observation time, and location with those observed covertly. The data of matched pairs were then analysed to detect possible Hawthorne effects on different variables. A total of 31,522 HH opportunities were observed (4581 overtly, 26,941 covertly). There were 3047 matched pairs after 1:1 matching of overt and covert observations. The overall HH compliance was higher with overt observation than with covert observation (78% vs. 55%, p < 0.001). The Hawthorne effect was nearly three times larger in nurses (30 percentage points) than in physicians (11 percentage points) and was significantly greater in outpatient clinics (41 percentage points) than in intensive care units (11 percentage points). The magnitude of the Hawthorne effect varied among healthcare worker occupations and observation locations (p values both < 0.001) but not among departments, observation times, or HH indications. Heterogeneity in the Hawthorne effect may influence the interpretation of overt observations and prevent the correct identification of target populations with poor HH compliance. Therefore, directly observed HH compliance may not be an adequate performance indicator for infection control. |
Mendeley readers
The data shown below were compiled from readership statistics for 75 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 75 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 11 | 15% |
| Student > Master | 10 | 13% |
| Student > Bachelor | 8 | 11% |
| Lecturer > Senior Lecturer | 4 | 5% |
| Other | 4 | 5% |
| Other | 13 | 17% |
| Unknown | 25 | 33% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 21% |
| Nursing and Health Professions | 13 | 17% |
| Biochemistry, Genetics and Molecular Biology | 4 | 5% |
| Business, Management and Accounting | 3 | 4% |
| Engineering | 3 | 4% |
| Other | 7 | 9% |
| Unknown | 29 | 39% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 August 2018.
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#20,529,980
of 23,099,576 outputs
Outputs from BMC Infectious Diseases
#6,542
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Outputs of similar age
#288,630
of 330,726 outputs
Outputs of similar age from BMC Infectious Diseases
#126
of 169 outputs
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