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

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2024 · —

## 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:** 10782460
- **Project number:** 5I01HX002910-03
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Michael Todd Greene
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2022-02-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10782460

## Citation

> US National Institutes of Health, RePORTER application 10782460, Mindful Hand Hygiene to Reduce Infections Among Veterans While Enhancing ProviderWell-Being (5I01HX002910-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10782460. Licensed CC0.

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