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Utilizing Group-Based Contingencies to Increase Hand Washing in a Large Human Service Setting

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Abstract

Hand washing is the most important preventative measure for the reduction of contagious disease. Although hand washing is easy to perform, non-adherence is a ubiquitous problem. Several studies have demonstrated the effectiveness of multi-component intervention packages to improve hand washing among employees; however, interventions are limited to acute settings, are often implemented for a short period of time, and rarely, if ever, include information on long-term effectiveness. The purpose of the current study was to utilize a behavior analytic approach to determine the stimulus conditions under which hand washing should occur, and to assess and then implement a long-term monitoring system among direct care workers in a large, non-acute inpatient unit. A single-case repeated measures reversal design was used to evaluate the effectiveness of two interventions aimed at improving hand washing adherence. A lottery was found to be effective in increasing hand hygiene for 2-years with 170 staff.

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Acknowledgments

Special thanks to the many data collectors over the years:

Alex Arevalo, Anna Armstrong, Thomas Banz, Mariana Castillo, Monica Lugo, Shari Pincus, Rebecca Stern, Monica Urich

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Authors and Affiliations

  1. Neurobehavioral Unit, Kennedy Krieger Institute, 707 N. Broadway, Baltimore, MD, 21205, USA

    Lynn G. Bowman, Samantha L. Hardesty, Melissa McIvor, Phillip M. Orchowitz, Leaora L. Wagner & Louis P. Hagopian

  2. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Lynn G. Bowman & Louis P. Hagopian

  3. University of Maryland, Baltimore County, Baltimore, MD, USA

    Samantha L. Hardesty & Sigurdur O. Sigurdsson

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  1. Lynn G. Bowman
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  2. Samantha L. Hardesty
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  3. Sigurdur O. Sigurdsson
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  4. Melissa McIvor
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  5. Phillip M. Orchowitz
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  6. Leaora L. Wagner
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  7. Louis P. Hagopian
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Corresponding author

Correspondence to Lynn G. Bowman.

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Conflict of Interest

All authors declare that he/she has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was not necessary as the project served as a quality improvement project for staff employed in the hospital.

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Appendix

Appendix

Staff survey about hand washing practices and social validity of portable sanitizers

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Bowman, L.G., Hardesty, S.L., Sigurdsson, S.O. et al. Utilizing Group-Based Contingencies to Increase Hand Washing in a Large Human Service Setting. Behav Analysis Practice 12, 600–611 (2019). https://doi.org/10.1007/s40617-018-00328-z

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