Date of Award

Fall 2015

Project Type


College or School




Program or Major


Degree Name

Master of Science

First Advisor

Pamela P. DiNapoli


Background: Regular hand washing is recognized as the most effective means to combat the spread of infectious illness; however hand washing behavior amongst health care workers (HCW’s) is inconsistent. Furthermore, measurement of hand washing behavior is subject to bias.

Aim: This quality improvement project aimed to remove the Hawthorne effect and improve the behavior of HH at Concord Hospital.

Methods: A quasi-experimental, pre-posttest design was used to evaluate HH rates on a 32 bed med-surge unit at Concord Hospital. Baseline data was collected for 30 days by asking patients if they had seen or heard staff cleaning their hands. Using Lewin’s change theory and the hospitals quality improvement model, data were presented to staff, motivating them to seek out new ways to improve HH on the unit. “Be SEEN and HEARD Being Clean,” was implemented, followed by post intervention data collection.

Results: Sixty-five percent of patients reported seeing or hearing staff perform HH before the intervention, and 93% reported observations of HH after the intervention (p <.001). Staff reported being more aware of personal HH behavior after the intervention.

Conclusion and Implications for the CNL: To our knowledge, this is the first study to modify the behavior of HCW HH in an inpatient setting through incorporating a verbal message. Incorporating an auditory cue may lead to a memory formation and increased ability to recall events at a later date. This multimodal approach to HH; 1) engages the patient, while removing the burden placed on them to question HCW’s behavior, and 2) increases staff awareness of personal HH behavior

Included in

Nursing Commons