Diffusion of innovations: describing the perceptions of the stages in the innovation-decision process for handwashing and alcohol hand rubs.

A 520-bed community hospital conducted an observational hand washing study and determined that compliance with their hand washing policy was low. As a result, employees were educated on hand washing and the use of alcohol hand rubs for hand antisepsis. Administrators also increased the number of alcohol had rub dispensers on each unit. One year later, a follow-up observational study was conducted which resulted in similar findings. In an attempt to further understand the low compliance to hand washing guidelines, the problem was assessed with the framework of the theory, Diffusion of Innovations. This theory maintains that any idea perceived as new to an individual is termed innovation and the spread of the innovation is termed diffusion. Within this theory is the innovation-decision process of which there are five stages: knowledge, persuasion, decision, implementation, and confirmation. A questionnaire designed to describe the stages of the innovation-decision process for hand washing and alcohol hand rubs was distributed to three units in the hospital. Results showed significantly lower perceptions of adoption for alcohol hand rubs than hand washing. In addition, when comparing units, the acute care unit had significantly lower perceptions of all stages in the innovation-decision process for alcohol hand rubs. All other correlations showed weak relationships with the exception that participants currently enrolled in college had a higher perception of the implementation stage for alcohol hand rubs. The Centers for Disease Control and Prevention supports the use of alcohol hand rubs as one way to achieve had antisepsis. In order to increase the diffusion of this innovation, the knowledge and persuasion stages should be addressed. The aim is to increase healthcare workers’ decision to either utilize this newer innovation of alcohol hand rubs or to increase their traditional hand washing practice.