Mindful Hand Hygiene to Reduce Infections Among Veterans While Enhancing ProviderWell-Being

NIH RePORTER · VA · I01 · · view on reporter.nih.gov ↗

Abstract

Background: More and more providers face cumulative stress and burdens arising from increasing regulations, administrative and clerical duties, clinical workloads, malpractice lawsuits, and less time with patients. As a result, stress, fatigue, psychological distress, depression, burnout, and career dissatisfaction among providers are prevalent. In addition to impacting providers directly, poor well-being can negatively impact healthcare organizations and reduce quality of care, patient safety and patient satisfaction. Additionally, provider burnout, stress, and workload have been associated with poorer hand hygiene adherence, which can increase the risk of healthcare-associated infection (HAI). Hand hygiene is a key element of preventing HAI, yet maintaining healthcare provider adherence to this basic practice remains challenging. Achieving optimal hand hygiene adherence requires minimizing cognitive biases, such as perceived low odds of spreading infections by not properly performing hand hygiene. Unfortunately, cognitive bias is a known barrier to clinician decision-making. Mindfulness is an approach that can help clinicians shed preconceived biases through nonjudgmental awareness and more broadly facilitate improvements in patient safety. Significance: A hand hygiene-based mindfulness intervention targeted at Veterans Health Administration (VHA) providers could improve hand hygiene practices and thereby enhance patient outcomes. Additionally, incorporating brief mindfulness practices during moments of hand hygiene has the potential to directly improve provider well-being. Innovation and Impact: While targeted interventions and bundled approaches to improve hand hygiene adherence and reduce HAI have been implemented, interventions incorporating introspective techniques, such as mindfulness, are limited. In a recent single-site pilot study, team members of this proposed study found that a brief mindfulness intervention improved hand hygiene and mindful attention among physicians. The proposed study will expand on this pilot work by more broadly testing the hand hygiene-based mindfulness intervention with both physicians and nurses, and by including a specific focus on provider well-being. The goal is to optimize provider hand hygiene adherence, improve provider well-being and enhance the quality and safety of care delivered to Veterans. Specific Aims: We have three specific aims: 1) To evaluate the effectiveness of a hand hygiene-based mindfulness intervention on provider hand hygiene adherence, duration, and perceptions. 2) To evaluate the effectiveness of a hand hygiene-based mindfulness intervention on measures of provider mindfulness and well-being. 3) To identify the barriers, facilitators, and perceptions of a hand hygiene-based mindfulness intervention in the hospital. Methodology: We will conduct a randomized controlled mixed-methods trial at 2 diverse VHA hospitals. Physicians and nurses randomized to the intervention arm will receive ...

Key facts

NIH application ID
10308157
Project number
1I01HX002910-01A2
Recipient
VETERANS HEALTH ADMINISTRATION
Principal Investigator
Michael Todd Greene
Activity code
I01
Funding institute
VA
Fiscal year
2022
Award amount
Award type
1
Project period
2022-02-01 → 2025-01-31