PhD defence M.D. (Manon) van Dijk

Below is a brief summary about the dissertation:

In this thesis, differences and similarities in infection prevention and control (IPC) policies have been investigated. We studied the compliance with IPC policies and measures, on the hospital level, at the nursing ward and in the operating theatre. We also took into account factors that could possibly influence compliance with IPC policies, both positively and negatively. 

One of the studies we conducted on an international level, showed that hospitals with more highly resistant microorganisms, generally have fewer IPC measures implemented. Compliance with IPC policy is also often lower in these hospitals. 

Our regional hand hygiene studies showed that direct observations on hand hygiene compliance cannot be replaced by how nurses and physicians would rate their own hand hygiene compliance (i.e. self-reported compliance). The intrinsic motivation of healthcare workers showed the strongest association with hand hygiene compliance. We were able to improve hand hygiene compliance by an intervention based on friendly competition between hospitals. There is still a lot to gain in the field of IPC in the operating theatre, since we observed a hand hygiene compliance of below 50% among circulating nurses (non-sterile). By using our newly developed protocol, the hand hygiene compliance of specific circulating healthcare workers in the operating theatre (non-sterile), can be measured.

We recommend to focus on pursuing a high compliance with the IPC policy, rather than only implementing as many IPC measures as possible. In addition, we recommend that the focus of new hand hygiene interventions should be on increasing the intrinsic motivation of all healthcare workers and using positive role models. Finally, friendly competition showed to be successful in improving hand hygiene compliance and should therefore be continued.