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Determining a Patient’s Comfort in Inquiring About Healthcare Providers’ Hand-Washing Behavior

Clare, Camille A. MD, MPH*; Afzal, Omara DO*; Knapp, Kenneth PhD; Viola, Deborah PhD

doi: 10.1097/PTS.0b013e31827819d2
Original Articles

Objectives To determine whether a patient’s level of assertiveness and other factors influences her comfort level in asking her provider to wash his or her hands.

Methods In this pilot study, we developed a survey to gather cross-sectional information on a variety of factors that might explain patient willingness to ask her health-care provider to wash his or her hands. Three primary predictor variables are analyzed: (1) patient assertiveness; (2) patient familiarity with her healthcare provider; and (3) whether the patient has observed hand-washing behavior. Fifty patients participated from the Obstetrics and Gynecology Department of Metropolitan Hospital Center.

Results Less assertive patients are much less likely than assertive patients to ask physicians to wash hands (25% versus 68%; Fisher’s exact test P = 0.0427). Among the 3 assertiveness questions included in the survey, the ability to ask physicians questions during visits is most strongly indicative of willingness to ask about hand washing. Familiarity with the names of regular health-care providers has a statistically significant impact on willingness to ask about hand washing. Evidence suggests that observing hand washing behavior affects willingness to ask, but differences are not statistically significant. Results by socioeconomic status such as age, education, income, and race/ethnicity are inconclusive.

Conclusions A patient’s level of assertiveness alone is not sufficient to determine her willingness to inquire about the hand-washing behavior of her provider. A high percentage of patients did not see their provider engaging in adequate hand washing behavior. If patients feel comfortable with their provider to inquire about their care and request hand-washing behavior, health outcomes are affected by reducing the rates of health care–associated infections.

From the *Department of Obstetrics and Gynecology, New York Medical College; and †Department of Health Policy and Management, School of Health Sciences and Practice, New York Medical College, Valhalla, New York.

Correspondence: Camille A. Clare, MD, MPH, Department of Obstetrics and Gynecology, Metropolitan Hospital, 1901 First Avenue, New York, New York 10029 (e-mail:

The authors disclose no conflict of interest.

Source of Funding: There were no sources of funding for this manuscript.

© 2013 by Lippincott Williams & Wilkins