Exploratory Sequential Design

This chapter presents the data from this exploratory sequential study testing the feasibility and acceptability of a resident-focused hand hygiene intervention within a long-term care facility, using a mixed methods design. Characteristics of the qualitative and quantitative samples and data cleaning methods are delineated. The results relevant to each research question are presented. Following the exploratory sequential design, the qualitative findings are discussed first, followed by the quantitative findings.

Qualitative Data Management and Analysis

Researcher Observation in the Setting

The qualitative research question was “What are the issues and concerns identified by staff and residents relevant to implementing a resident-focused hand hygiene intervention in a long-term care facility?” The intervention protocol was refined based on staff and resident feedback, the researcher’s observation, and the qualitative data. Because direct observation is the gold standard to monitor hand hygiene adherence (WHO, 2009),

Residents had varying cognitive and motor deficits. While many residents had arthritic changes, no orthopedic devices interfered with hand hygiene. The availability of the disposable wipes before meals varied based on the delivery method. Some staff offered the wipe as they served the beverage. Others placed the wipe on the table prior to the residents’ arrival. Residents who arrived late were not offered a wipe.

All residents wore a clothing protector, suggesting self-protection from an obvious food stain was a strong motivator for behavior. The clothing protectors, which were folded and lying on the table, became damp when the disposable wipes were placed on top of the clothing protector. The residents were visibly uncomfortable with the damp clothing protector and would touch the other clothing protectors on the table to see if they were also