Pilot randomised controlled trial to improve hand hygiene through mindful moments

Area of Science:

• Healthcare Improvement
• Clinical Practice
• Mindfulness Interventions

Background:

• Hand hygiene is critical for preventing healthcare-associated infections.
• Physician adherence to hand hygiene protocols remains a challenge in hospital settings.
• Mindfulness interventions show potential for improving clinician performance and patient safety.

Purpose of the Study:

• To assess the efficacy of a brief mindfulness intervention on hand hygiene performance among inpatient physician teams.
• To evaluate the impact of mindful hand hygiene on mindful attention and observable mindfulness behaviors.
• To explore the feasibility and reception of mindfulness training in a clinical environment.

Main Methods:

• A pilot, randomized controlled mixed-methods trial was conducted at an academic medical center.
• Four internal medicine physician teams participated, receiving a facilitated educational discussion on mindful hand hygiene.
• Hand hygiene adherence was the primary outcome, supplemented by mindfulness assessments and qualitative feedback.

Main Results:

• Attending physicians showed a 14.1% increase in hand hygiene adherence with the intervention (P=0.035).
• Residents demonstrated a 24.7% improvement in adherence (P=0.064), while interns increased by 10.0% (P=0.007).
• Mindfulness behaviors increased in the intervention group (3.7% vs 0.9%, P=0.021), but self-reported mindful attention did not significantly change (P=0.865).

Conclusions:

• A brief, education-based mindfulness intervention effectively improved hand hygiene adherence in attending physicians and residents.
• The intervention was well-received and demonstrated feasibility for introducing mindfulness practices in clinical settings.
• Further research into mindfulness training for clinicians to enhance hand hygiene is warranted.