Page 287 - Encyclopedia of Nursing Research

254 n InSTITUTIonaL ReVIeW BoaRD anD InFoRMeD ConSenT

organization (2009) concludes that “the positively identifying with, and actively par-
inability over two decades to motivate health ticipating in the intervention, but many lack
I care workers compliance with hand cleans- empirical data to support the conclusions
ing suggests that modifying hand hygiene made (Lankford et al., 2003; Larson et al., 2000;
behavior is a complex task.” Pittet, 2000; Whitby et al., 2008).
Despite the lack of empirical evidence, nursing research extending Kanter’s
it is reasonable to suggest that a relation- (1977) theory found that a supportive work
ship may exist between health care work- environment is directly related to work effec-
ers perceptions, their work environment, tiveness, job satisfaction, and organizational
hand hygiene behavior, and infection rates. commitment (Laschinger & Havens, 1997;
To date, variations in infection rates and Laschinger, almost, & Tuer-Hodes, 2003).
health care workers’ hand hygiene practices a supportive work environment is also
in similar type hospitals are unexplained. inversely associated with patient outcomes,
Furthermore, health care workers hand such as mortality (aiken, Clarke, Sloane,
hygiene practices remain persistently low Lake, & Cheney, 2008; aiken & Lake, 1994;
despite national campaigns such as the Say Rafferty et al., 2007), patient falls, medication
No to Infections campaign in Ireland and the errors (Laschinger & Leiter, 2006), patient sat-
Clean Your Hands Campaign in the United isfaction (Donahue, Piazza, Griffin, Dykes, &
Kingdom. a possible explanation may be Fitzpatrick, 2008), length of stay (needleman,
that these campaigns were directed entirely Buerhaus, Mattke, Stewart, & Zelevinsky,
at the individual health care worker without 2002), and improved hemodialysis perfor-
making any attempt to focus on addressing mance (Harwood et al., 2007).
hospital organizational factors that impact Given the continuing level of interest
on health care workers work environment. that exists in improving health care work-
The possible impact that hospital orga- ers’ hand hygiene practices and the lack of
nizational features may have on health care any study, with the exception of Larson et al.
workers’ hand hygiene behavior and resul- (2000), explicitly and empirically investigat-
tant acquisition of HCaIs has merited some ing the association between hand hygiene
discussion (Larson et al., 2000; Pittet, 2000; and hospital organizational characteristics,
Whitby et al., 2008). From a theoretical per- it may be timely to further explore the effect
spective, organizational behavioral theory that hospital organizational characteristics
focuses on the association between participa- and health care workers’ perceptions of a
tion in an organization and achieving orga- supportive work environment have on health
nizational goals (Kanter, 1977). achieving care workers’ hand hygiene behavior and
organizational goals within a hospital setting ultimately rates of HCaIs.
may easily be related to a reduction of HCaIs.
Kanter’s (1977) theory of organizational Sile A. Creedon
behavior concludes that the behavior exhib-
ited by an individual working in an organiza-
tion is shaped by their perceptions of support
within the work environment. It is plausible InstItutIonal revIeW Board
to suggest that health care workers’ percep-
tions of support within the work environment and Informed consent
influences their compliance with guidelines
such as hand hygiene guidelines. There is evi-
dence that interventions overtly supported by In 1974, the Department of Health and Human
hospital organizational features (e.g., hospi- Services required that all research involving
tal management) lead to health care workers human subjects should have an institutional