A Crossover Randomized Controlled Trial of Priming Interventions to Increase Hand Hygiene at Ward Entrances.

BACKGROUND: Research conducted in the United States suggests that two primes (citrus smells and pictures of a person's eyes) can increase hand gel dispenser use on the day they are introduced in hospital. The current study, conducted at a hospital in the United Kingdom, evaluated the effectiveness of these primes, both in isolation and in combination, at the entry way to four separate wards, over a longer duration than the previous work. METHODS: A crossover randomized controlled trial was conducted. Four wards were allocated for 6 weeks of observation to each of four conditions, including "control," "olfactory," "visual," or "both" (i.e., "olfactory" and "visual" combined). It was hypothesized that hand hygiene compliance would be greater in all priming conditions relative to the control condition. The primary outcome was whether people used the gel dispenser when they entered the wards. After the trial, a follow up survey of staff at the same hospital assessed the barriers to, and facilitators of, hand hygiene compliance. The trial data were analyzed using regression techniques and the survey data were analyzed using descriptive statistics. RESULTS: The total number of individuals observed in the trial was 9,811 (female = 61%), with similar numbers across conditions, including "control" N = 2,582, "olfactory" N = 2,700, "visual" N = 2,488, and "both" N = 2,141. None of the priming conditions consistently increased hand hygiene. The lowest percentage compliance was observed in the "both" condition (7.8%), and the highest was observed in the "visual" condition (12.7%). The survey was completed by 97 staff (female = 81%). "Environmental resources" and "social influences" were the greatest barriers to staff cleaning their hands. CONCLUSIONS: Taken together, the current findings suggest that the olfactory and visual priming interventions investigated do not influence hand hygiene consistently. To increase the likelihood of such interventions succeeding, future research should focus on prospectively determined mechanisms of action.

Using environmental engineering to increase hand hygiene compliance: a cross-over study protocol.

INTRODUCTION: Compliance with hand hygiene recommendations in hospital is typically less than 50%. Such low compliance inevitably contributes to hospital-acquired infections that negatively affect patients' well-being and hospitals' finances. The design of the present study is predicated on the assumption that most people who fail to clean their hands are not doing so intentionally, they just forget. The present study will test whether psychological priming can be used to increase the number of people who clean their hands on entering a ward. Here, we present the protocol for this study. METHODS AND ANALYSIS: The study will use a randomised cross-over design. During the study, each of four wards will be observed during four conditions: olfactory prime, visual prime, both primes and neither prime. Each condition will be experienced for 42 days followed by a 7-day washout period (total duration of trial=189 days). We will record the number of people who enter each ward and whether they clean their hands during observation sessions, the amount of cleaning material used from the dispensers each week and the number of hospital-acquired infections that occur in each period. The outcomes will be compared using a regression analysis. Following the initial trail, the most effective priming condition will be rolled out for 3 months in all the wards. ETHICS AND DISSEMINATION: Research ethics approval was obtained from the South Central-Oxford C Research Ethics Committee (16/SC/0554), the Health Regulatory Authority and the sponsor. TRIAL REGISTRATION NUMBER: ISRCTN (15397624); Edge ID 86357.

A psychometric study of information technology risks in the workplace.

As organizations become increasingly reliant on information technology (IT) they are exposed to a growing number of risks. Surprisingly, however, very few studies to date have investigated the psychometric representation of IT risks, and none have been undertaken in the workplace. Accordingly, the present study was designed to map the judgments of a representative group of workplace IT users. Fifty-seven participants evaluated 18 IT risk scenarios by means of 13 bipolar attribute-rating scales. Profile proximities derived from the raw data were submitted to a weighted multidimensional scaling analysis. The results indicated that a six-dimensional solution was required on both statistical and conceptual grounds to represent adequately the participants' judgments. The dimensions reflected the extent to which the various risk scenarios were perceived as: (1) serious or minor in nature; (2) having a high or low probability of occurrence; (3) causing a high or low degree of stress; (4) deliberate or accidental; (5) having an impact on the organization or on individuals; and (6) the product of human or technological causes. The data were also submitted to a series of hierarchical cluster analyses, using a variety of agglomeration techniques. This second approach revealed a robust structure in which the risk scenarios were grouped into two broad categories, based on whether the events depicted would be likely to have a major or minor impact. The major impact category broke down further, into two subcategories, based on whether the scenarios were seen to arise from deliberate causes or through negligence. In conclusion, we consider the implications of our findings for future research, the refinement of IT risk assessment frameworks and tools, and the training of risk management professionals.

Cognition in organizations.

This article reviews major developments from 2000 to early 2007 in the psychological analysis of cognition in organizations. Our review, the first in this series to survey cognitive theory and research spanning the entire field of industrial and organizational psychology, considers theoretical, empirical, and methodological advances across 10 substantive domains of application. Two major traditions, the human factors and organizational traditions, have dominated cognitively oriented research in this field. Our central message is that the technological and human systems underpinning contemporary organizational forms are evolving in ways that demand greater cooperation among researchers across both traditions. Such cooperation is necessary in order to gain theoretical insights of sufficient depth and complexity to refine the explanation and prediction of behavior in organizations and derive psychologically sound solutions to the unprecedented information-processing burdens confronting the twenty-first century workforce.

Intuition: a fundamental bridging construct in the behavioural sciences.

The concept of intuition has, until recently, received scant scholarly attention within and beyond the psychological sciences, despite its potential to unify a number of lines of inquiry. Presently, the literature on intuition is conceptually underdeveloped and dispersed across a range of domains of application, from education, to management, to health. In this article, we clarify and distinguish intuition from related constructs, such as insight, and review a number of theoretical models that attempt to unify cognition and affect. Intuition's place within a broader conceptual framework that distinguishes between two fundamental types of human information processing is explored. We examine recent evidence from the field of social cognitive neuroscience that identifies the potential neural correlates of these separate systems and conclude by identifying a number of theoretical and methodological challenges associated with the valid and reliable assessment of intuition as a basis for future research in this burgeoning field of inquiry.