Does the use of a theoretical approach tell us more about hand hygiene behaviour? The barriers and levers to hand hygiene

Despite many strategies employed to improve hand hygiene, compliance remains low at around 50%. Two reasons have been identified for this. First, implementation strategies are rarely tailored according to assessed barriers and levers to best practice. Secondly there is a lack of explicit theoretical basis for the assessment of these barriers and levers to practice. Aim: This paper reports barriers and levers to hand hygiene and an evaluation of the use of theory in assessing barriers and levers to hand hygiene. Identification of barriers and levers occurred through interviews, questionnaires and focus groups. n each case two different question schedules were used, one based on psychological theory and the other with no explicit theoretical underpinning.