Systematic qualitative literature review of health care workers' compliance with hand hygiene guidelines

Background:
Acquisition of a HCAI is a substantial risk to patient safety. When HCWs comply with hand hygiene guidelines, it reduces this risk. Despite a growing body of qualitative research in this area, a review of the qualitative literature has not been published.
Methods:
A systematic review of the qualitative literature.
Results:
The results were themed by the factors that HCWs identified as contributing to their compliance with hand hygiene guidelines. Contributing factors were conceptualised using a theoretical background. Two core concepts were identified which influence compliance with hand hygiene guidelines, these were motivational factors and factors related to the individuals’ perceptions of the work environment.
Discussion:
This review of the qualitative literature enabled the researchers to take an inductive approach allowing for all factors affecting the phenomenon of interest to be explored. Two core concepts seem to influence HCWs compliance with hand hygiene guidelines. These are motivational factors and perceptions of the work environment. Motivational factors are grounded in behaviourism and the way in which employees perceive their work environment relates to structural empowerment.
Conclusion:
Noncompliance with hand hygiene guidelines remains a collective challenge that requires researchers to adopt a consistent and standardised approach. Theoretical models should be used intentionally to better explain the complexities of hand hygiene.