Motivational interviewing for improvement of hand hygiene compliance
Abstract:
Background: Hospital-acquired infections (HAIs) impose a major global burden, with hand hygiene (HH) a key preventive measure. Sustaining HH compliance often requires behavioral change. Motivational interviewing (MI), a technique fostering self-reflection and improvement, shows promise. This study evaluated MI’s effectiveness in improving HH compliance among healthcare workers (HCW) and its impact on reducing HAI rates.
Methods: This prospective interventional study was conducted from June 2018 to February 2019 in a tertiary hospital MICU involving 29 doctors (8 consultants and 21 residents). Three-month pre-intervention phase recorded baseline HH compliance and HAI rates [central line-associated bloodstream infection (CLABSI), Ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI)]. Intervention included educational and MI sessions plus promotional videos. Post-intervention, HH compliance, readiness to change, and HAI rates were reassessed. Compliance data were evaluated using a multilevel mixed-effects linear regression model, and product use before and after intervention was compared using the Wilcoxon rank-sum test. A p-value<0.05 was considered statistically significant.
Results: Among 650 observed opportunities, HH compliance improved significantly post-intervention (~41% to ~65-70%; p<0.001). Residents improved more than consultants. ABHR and soap use showed no significant change (p=0.521 and p=0.512). VAP and CAUTI rates decreased (p=0.0495), while CLABSI remained unchanged (p=0.184).
Conclusion: Multimodal strategy combining education and MI improved HH compliance among doctors. Its impact on reducing HAIs remains uncertain, warranting further investigation.
Reference:
Arunachala S, Kumar R, Kumar J, Krishna B, Sampath S, Ullah MK, Thomas T, Mahesh PA. Effectiveness of Motivational Interviewing for Improvement of Hand Hygiene Compliance and Reduction of Hospital Acquired Infection in Intensive Care Unit. Am J Infect Control. 2026 Jan 24:S0196-6553(26)00047-7. doi: 10.1016/j.ajic.2026.01.015. Epub ahead of print. PMID: 41587573.