Perceptions of the 5th moment for hand hygiene

Introduction
Hand hygiene is one of the most effective measures in preventing healthcare associated infection. The WHO’s 5 moments for hand hygiene provides guidance on when hand hygiene should be performed. Compliance with the 5 moments is lowest for the 5th moment. The research aim was to evaluate healthcare staff’s perceptions of the WHO hand hygiene moment 5 relative to compliance with this moment.
Methods
A mixed methods study was conducted using focus groups, non-participant observation and survey with focus groups used to inform the design of the questionnaire. The population was healthcare staff observed during three National Hand Hygiene Audits in three Scottish Health Boards. The purposive sample was staff observed who had an opportunity to perform hand hygiene in accordance with the 5th moment. Of the 484 participants observed 410 returned a questionnaire; a response rate of 85%.
Results
Results showed that hand hygiene compliance following the 5th moment was high with 93% of staff performing hand hygiene. Compliance varied with Health Board but not professional group. Staffs’ perception of the 5th moment were positive with over 65% indicating that it was clearly defined, achievable, valuable, encouraged, widely known and not too time consuming. Participants were less positive about the repetitive nature of the 5th moment with 60% indicating that it was repetitive. There was a positive relationship between compliance and the perception that the 5th moment was widely known.
Discussion
Although staff were generally positive about the 5th moment hand hygiene compliance was less than optimum. Lack of understanding of the guidelines may be contributing to staffs’ perception that it is repetitive. Educational programme should focus on how the 5th moment is implemented in practice. This along with greater awareness of the 5th moment for hand hygiene could improve compliance further.