{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:51:33Z","timestamp":1782841893078,"version":"3.54.5"},"reference-count":21,"publisher":"JMIR Publications Inc.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Nursing"],"abstract":"\n Background<\/jats:title>\n Hand hygiene and low-level disinfection of equipment behaviors among hospital staff are some of the leading cost-effective methods to reduce hospital-acquired infections (HAI) among patients.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The aim of this study is to examine hand hygiene and low-level disinfection of equipment practices in a central Texas hospital and to explore pertaining gaps, perceptions, and challenges.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Data were collected using a multipronged mixed methods approach that included the following: (1) observation of hand hygiene and low-level disinfection practices (12 and 8 units during morning and evening shifts, respectively); (2) observation of usability\/placement of hand sanitizer dispensers; (3) semistructured interviews; and (4) a follow-up email survey.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In total, 222 (156 morning shift and 66 evening shift) staff members were observed. Of 526 hand hygiene and 33 low-level disinfection opportunities, compliance was observed 410 (78%) and 17 (51%) times, respectively. Overall, 6 units (50%) had \u22650.80 (favorable) hand hygiene compliance during the morning shift and 2 units (25%) had \u22650.80 hand hygiene compliance during the evening shift. Aggregated low-level disinfection compliance was 0.54 during the morning and 0.33 during the evening. Overall, the odds of noncompliant hand hygiene behavior were 1.4 times higher among staff who worked during night shifts compared to day shifts; however, this relationship was not statistically significant (95% CI 0.86-2.18; P=.18). Noncompliant behavior was most likely among unit B staff during the evening; however, this relationship was not statistically significant (OR 5.3, 95% CI 0.84-32.9; P=.07) All units, except one, had similar hand sanitizer dispenser usability characteristics. In the qualitative part of the study, the following challenges were identified: \u201cshortage of time while seeing patients,\u201d \u201csometimes the staff forgets,\u201d \u201cconcern about drying hands,\u201d \u201cbehavior is difficult or requires reminders,\u201d and \u201cthere may be issues with resources or access to supplies to perform these behaviors.\u201d Staff also stated that \u201ca process that is considered effective is the Stop the Line program,\u201d and that the \u201cbehavior is easy and automatic.\u201d<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Hand hygiene and low-level disinfection compliance is dependent on several personal and nonpersonal factors. Issues such as time constraints, peer pressure, work culture, available resources, and understanding of guidelines could influence staff behavior. The information collected through this study can be used to re-examine similar or related issues at a larger scale.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/18788","type":"journal-article","created":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T23:40:37Z","timestamp":1587253237000},"page":"e18788","source":"Crossref","is-referenced-by-count":2,"title":["Assessing Hand Hygiene and Low-Level Disinfection of Equipment Compliance in an Acute Care Setting: Mixed Methods Approach"],"prefix":"10.2196","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2882-2335","authenticated-orcid":false,"given":"Hammad","family":"Akram","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6121-7199","authenticated-orcid":false,"given":"Alison","family":"Andrews-Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6726-3364","authenticated-orcid":false,"given":"Rachel","family":"Washburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2020,6,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2009.04.019"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2009.08.020"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017108"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3201\/eid2209.151440"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(06)70600-4"},{"key":"ref6","unstructured":"US GovernmentMedicare.gov2019-05-27Hospital Compare, Infectionshttps:\/\/www.medicare.gov\/hospitalcompare\/details.html?msrCd=prnt3grp4&ID=450101&stCd=TX&stName=TEXAS"},{"key":"ref7","unstructured":"Centers for Disease Control and PreventionGuidelines & Guidance Library2019-06-12Infection Controlhttps:\/\/www.cdc.gov\/infectioncontrol\/guidelines\/index.html"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2015.05.013"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1086\/678597"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.2004.011155"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2015.11.012"},{"issue":"9","key":"ref12","first-page":"425","volume":"20","author":"Aziz, AM","year":"2014","journal-title":"British Journal of Healthcare Management"},{"key":"ref13","unstructured":"UNC Health CareClean In, Clean Out2019-06-14http:\/\/news.unchealthcare.org\/empnews\/handhygiene"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2013-002606"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2012.08.004"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.10.021"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1097\/HMR.0b013e3181dde6a5"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.03.005"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005186.pub4"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2013.11.009"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.2196\/11425"}],"container-title":["JMIR Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/nursing.jmir.org\/2020\/1\/e18788","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:24:14Z","timestamp":1782840254000},"score":1,"resource":{"primary":{"URL":"https:\/\/nursing.jmir.org\/2020\/1\/e18788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,5]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2196\/18788","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.18788","asserted-by":"object"}]},"ISSN":["2562-7600"],"issn-type":[{"value":"2562-7600","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,5]]}}}