Development of Pictograms Depicting the Five Moments of Hands Hygiene for Healthcare Workers: A User-Centered Design Approach

The Health Care-Associated Infections (HCAIs) are a serious health problem, having contributed to high morbidity and mortality rates, as well as an increase in associated costs. Together with a set of good practices, hand hygiene is considered one of the key measures of preventing and controlling the spread of HCAIs. However, compliance with hand hygiene is relatively low. Therefore, there is a well-recognized need for measures that increase compliance rates. This paper describes the development and evaluation of a set of pictograms that illustrate the "Five Moments for Hand Hygiene”. The pictograms depict the key moments where hand hygiene is a mandatory obligation to healthcare workers. In the design and validation of the pictograms, a user-centered design approach was adopted, involving the participation of health care workers through methods such as focus group sessions, the comprehensibility judgment test and the perceived adequacy, effectiveness and preference assessment questionnaire. The gathered results could serve to improve the effectiveness of the present campaigns, which are intended to promote hand hygiene compliance among healthcare workers.