Patients’ intention to speak up for health care providers’ hand hygiene in inpatient diabetic foot wound treatment: a cross-sectional survey in diabetes outpatient centres in Lower Saxony, Germany^*

* This manuscript follows the STROBE Statement Guidelines for Reporting of Observational Studies (www.strobe-statement.org).

Abstract

Hand hygiene in wound care by health care providers (HCPs) is a key principle in treating hospitalized patients with diabetic foot infections. This study aimed to estimate the extent to which patients with type-2-diabetes (T2D) intend to speak up for HCPs’ hand hygiene during inpatient foot treatment, test whether this motivation increases given the hospital would invite patients to speak up, and identify associations with socio-demographics, knowledge of hand hygiene requirements, and diabetes-related factors. A questionnaire-survey was conducted in eight diabetes outpatient centres in Lower Saxony/Germany. Intentions to speak up (without and with institutional encouragement) and knowledge about hand hygiene during foot-care were assessed. Analyses of variance were conducted, partly as repeated measures-models with intention-items as within-subject factor. N = 473 patients participated (response = 77.4%). N = 177 (41%) strongly intended to speak up. Institutional encouragement was associated with an increased rate of strong (54% vs. 41%; p < .001) and higher mean intention (M = 3.9 vs. 3.4 with vs. without encouragement [5-point-scales]; F(1, 434) = 41.5, p < .001). In patients without diabetic foot syndrome, this effect was limited to those with at least medium school education (F(2, 292) = 4.4, p = .013) and knowledge on HCPs’ hand hygiene (F(2, 294) = 3.1, p = .047). In conclusion, a majority of T2D-patients in diabetes outpatient centres intend to speak for HCPs’ hand hygiene in inpatient foot treatment, and are receptive to institutional encouragement. However, this presupposes at least medium education and knowledge about hand hygiene, emphasizing that patient empowerment begins with knowledge.

Keywords:

• Patient participation
• patient knowledge
• professional hand hygiene
• type-2-diabetes
• diabetic foot syndrome

Acknowledgements

The Lower Saxon Ministry for Science and Culture was involved in neither the study design, nor the collection, analysis and interpretation of data, nor the writing of the report, nor the decision to submit the article for publication.

Lower Saxon Diabetes Outpatient Centres Study Group Members: Diabetes Kröpcke, Diabetes-Zentrum Hannover-Nord, Integriertes Diabetiker-Zentrum Hannover, Praxisgemeinschaft Hannover-Kleefeld (all Hannover), Die Hausärzte Rethen (Laatzen), Diabetologische Gemeinschaftspraxis Northeim (Northeim), Gemeinschaftspraxis Rehburg-Loccum (Rehburg-Loccum), Diabeteszentrum Uetze (Uetze).

Notes

* This manuscript follows the STROBE Statement Guidelines for Reporting of Observational Studies (www.strobe-statement.org).