Qualitative Study of Senior Hospital Managers’

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The importance of hand hygiene should not be underestimated in health care settings. The need to decontaminate patients’ hands via washing has been investigated at the beginning of the 19th century. Labarraque introduced his findings proving that timely washing of hands may decrease the incidence of maternal mortality, for instance. Nowadays, hand hygiene is considered to be one of the most significant subjects concerning the prevention of infections. According to Mathur (2011), “in the wake of the growing burden of health care associated infections, the increasing severity of illness and complexity of treatment, superimposed by multi-drug resistance pathogen infections, heath care practitioners are reversing back to the basics of infection preventions by simple measures like hand hygiene” (p. 611). Numerous researchers have already proved the necessity to meet hand hygiene requirements strictly. In the following paper, the research article devoted to the problem of hand hygiene and infections at hospitals will be analyzed and evaluated.

Research Question

The research article entitled “A qualitative study of senior hospital managers’ views on current and innovative strategies to improve hand hygiene” was written by Elizabeth McInnes, Rosemary Phillips, Sandy Middleton, and Dinah Gould. The article was published in the journal BMC Infectious Diseases. The research question of the study is described by authors as follows: “our aims were to seek senior hospitals’ managers views on current and innovative strategies to improve hand hygiene, whether failure to adhere to hand hygiene best practice should be conceptualized as a health care error and whether hand hygiene strategies would benefit from penalty-based strategies that focus on individual responsibility” (McInnes, Phillips, Middleton, & Gould, 2014, p. 612).

Design of Study

The study design of the survey is qualitative face-to-face interviews. This type of design is one of the most popular when it comes to qualitative studies. Thus, face-to-face communication is often regarded as the most efficient way to receive information directly from the target audience. Several advantages and disadvantages of the chosen design should be taken into consideration. Thus, face-to-face interviews are believed to deliver the most accurate information. For example, interviewees cannot provide false information about evident facts (gender, age). Non-verbal language can be evaluated during this type of communication. During face-to-face intercourse, interviewers can guide participants, ask necessary questions, and choose the best flow of the interview. Finally, one can evaluate one’s emotions and behaviors. For instance, the desire to avoid particular questions or increased feelings may be signs to dig deeper into the problem (Wyse, 2014). However, there are disadvantages of this design as well. The first minus refers to the high cost of conducting face-to-face interviews. Second, depending on the participant’s ability to speak and introduce information, the interviewer may not receive an adequate information. Third, face-to-face communication does not allow to interview a great number of respondents due to the lack of time or resources.

Population of the Study

Hospital executives, managers, and clinical leaders from the hospital in Sydney, Australia were invited for the interview. Snowballing-based purposive sampling was utilized to select participants who could represent dissimilar views about the problem. Only senior participants were invited. A letter of invitation was sent to all potential participants. The research aim and desire to collaborate were described in the letter (McInnes et al., 2014). Researchers gave potential participants one week for contemplations.

Thirteen individuals agreed to conduct an interview. They were representatives of both clinical and non-clinical staff who held leading positions in the hospital. All participants had a professional experience from two to thirty-three years. In my opinion, the number of participants is not adequate. Thirteen interviews are not enough to gather relevant information concerning the problem of the study. Besides, researchers should contact other hospitals. Every hospital has particular organizational culture. That is why it is inefficient to interview employees only of one place as far as they may share the same views.

Data Collection Methods

Interviews were primary sources of data. Audio-taping had been utilized as a data collection method. Discourse analysis had been used for the evaluation of the provided information. The inductive approach was employed as far as relevant findings had to be based on gathered data. There is no information in the article concerning interviewers. The method of coding and thematic analysis was used for the collection of data.


The small number of participants predetermines the primary limitation of the study. Thus, gathered data and personal opinions cannot be used for the generalization of findings. Consequently, further studies should focus on collecting relevant data from large groups of executives. Second, the study examines opinions of senior executives only. It would be useful to investigate the understanding of the significance of hand hygiene in representatives of the rest of the staff. Third, nothing is mentioned about patients (their reactions, preferences of methods of hygiene, desire to improve hand hygiene and meet halfway). Subsequent studies should interview participants as well. The development of online testing can be useful to save time and efforts.


According to the results of the thematic analysis of the audio recordings, senior executives consider that seven aspects are the most significant when it comes to hand hygiene. The first defined theme was “culture change starts with the leaders”. Participants agreed that leaders should become examples to follow to improve hand hygiene in the organization. The second theme was “refresh and renew the message”. Interviewees suggested their opinions that the content of messages devoted to hand hygiene should be presented in an exciting and new manner. The third theme referred to the difficulty of application of the WHO five moments of hand hygiene in practice. The fourth finding concerned the desire of all participants to improve the reporting of results about hand hygiene performance in the hospital. The next two topics included the discussion of patients’ engagement and reconceptualization of compliance. The last theme was devoted to the notion of the usage of penalties (McInnes et al., 2014). These findings provide a relevant answer to the research question of the study.

Summary of the Article

Authors of the article manage to define opinions of senior executives concerning relevant strategies for the improvement of hand hygiene. They have also found out that the need to recognize non-compliance and use penalties is rather controversial. The “no blame culture” does not presuppose the system of punishments. Thus, the emphasis should be on empowerment and engagement. The article provides a basis for further investigations. It is also important to practical nursing. This is predetermined by the fact that gathered data are pieces of advice that can be utilized in practice. Seven identified themes may be regarded as sources for the separate investigation. Still, the current survey is the initial examination that requires further expansion and evaluation of the problem.


Mathur, P. (2011). Hand hygiene: back to the basics of infection control. Indian Journal of Medical Research, 134(5), 611-620.

McInnes, E., Phillips, R., Middleton, S., & Gould, D. (2014). A qualitative study of senior hospital managers’ views on current and innovative strategies to improve hand hygiene. BMC Infectious Diseases, 18(14), 611-622. Web.

Wyse, S. (2014). Advantages and Disadvantages of Face-to-Face Data Collection. Web.

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"Qualitative Study of Senior Hospital Managers’." NursingBird, 23 Apr. 2022, nursingbird.com/qualitative-study-of-senior-hospital-managers/.


NursingBird. (2022) 'Qualitative Study of Senior Hospital Managers’'. 23 April.


NursingBird. 2022. "Qualitative Study of Senior Hospital Managers’." April 23, 2022. https://nursingbird.com/qualitative-study-of-senior-hospital-managers/.

1. NursingBird. "Qualitative Study of Senior Hospital Managers’." April 23, 2022. https://nursingbird.com/qualitative-study-of-senior-hospital-managers/.


NursingBird. "Qualitative Study of Senior Hospital Managers’." April 23, 2022. https://nursingbird.com/qualitative-study-of-senior-hospital-managers/.