For example, the absence of a sink was found to be a major hindrance to hand hygiene in the nursing home setting. ![]() However, it has been pointed out that the application of hospital infection control guidelines to nursing homes is often unrealistic in terms of system differences and different available resources for infection prevention. It was also shown that the incidences of serious infection could be reduced after the introduction of a multifaceted hand hygiene program to improve hand hygiene adherence and compliance in nursing homes. Previous research has pointed to individual knowledge deficits influencing safe hand hygiene practices in nursing homes such as correct duration of hand washing and deficits in hand rub recommendations. The 5 moments of hand hygiene define care situations that should always lead to a hand rub. This term refers to “applying an antiseptic handrub to reduce or inhibit the growth of microorganisms without the need for an exogenous source of water and requiring no rinsing or drying with towels or other devices”. The most effective single measure for infection prevention in various health care settings, including nursing homes is (antiseptic) hand rubbing. In 2015 there were 426.277 cases of infections with multi-resistant bacteria associated with health care registered in Europe. Healthcare-associated infections are a major cause of morbidity and mortality in nursing homes. In addition, nursing managers should be made aware of the impact of their role model function and they should implement this in daily practice. These results suggest that improving hand hygiene should focus on strategies that facilitate the provision of hand disinfectant materials in the immediate work area of nurses. Despite a general awareness of the impact of leadership on staff behaviour, not all nursing managers fully appreciated the impact of their own consistent role modelling regarding hand hygiene behaviours. Hygiene standards and equipment were all generally available but compliance to standards also depended upon availability in the immediate work area and role modelling. Most nurses and nursing managers held the knowledge of effective hand hygiene procedures. We conducted a mixed-methods study surveying 165 nurses and interviewing 27 nursing managers from nursing homes in Germany. We aim to explore these influences of individual and organisational factors of hand hygiene in nursing home staff, with a particular focus on the function of role modelling by nursing managers. Therefore, it may be important to examine individual and organisational factors that foster improvement of these factors in hand hygiene. Studies have shown that increasing knowledge, behaviour and attitudes could enhance hand hygiene compliance in nursing homes. The nursing home setting differs from other healthcare environments in individual and organisational factors such as knowledge, behaviour, and attitude to improve hand hygiene and it is therefore difficult to research the influential factors to improve hand hygiene. Infections with multi-resistant bacteria’s, associated with healthcare, is a known problem. ![]() Effective hand hygiene is one of the most important measures for protecting nursing home residents from nosocomial infections.
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