Protecting patients from COVID-19

Empathic focus motivates to improve hand hygiene


Good hand hygiene compliance (HHC) not only helps reduce nosocomial infections in general but also reduces the risk of nosocomial COVID-19 infections. However, HHC is often in need of improvement, especially in the "BEFORE" moments of the “5 moments” defined by the World Health Organization WHO [1], which are particularly important for patient protection. Therefore, a recent survey-based study examined how the idea of contracting SARS-CoV-2 (self vs. other) influences HHC of healthcare professionals (HCPs) [2]. The study was published in June 2022 and can be viewed online and downloaded free of charge.

Online experiment allows imagining different scenarios

A total of 68 HCPs from a German municipal hospital agreed to take part in the online survey during the first wave of the pandemic. To participate, they were given access to experimental software that randomly assigned each participant to one of two experimental scenarios. In scenario 1, 31 participants were asked to think about the consequences of contracting SARS-CoV-2 for themselves in terms of their personal health as well as their social and professional situation. In scenario 2, 37 participants were asked to think about the consequences of contracting SARS-CoV-2 for other individuals with whom they were in contact. Both groups were then asked to rate the importance of HHC for each of the "5 moments" and to assess the difficulty of complying with moment-specific HHC in the pandemic situation, as well as to compare the importance of HHC for the different moments using Likert scales [2].

Focusing on others’ health increases hand hygiene readiness in “BEFORE” moments

The analysis of the comparative assessments showed that participants of scenario 2 (focus on others) attached more importance to HHC in “BEFORE” moments than participants of scenario 1 (self-focus) and had a stronger intention to adhere to HHC in the future. Neither occupation (medical vs. nursing) nor work experience, gender, contact with COVID patients or stress level changed the results of the comparative analysis [2].


By focusing on the consequences of COVID-19 for others, the perceived importance of the "5 moments" shifts in favor of the "BEFORE" moments ("BEFORE aseptic activities", "BEFORE patient contact"), which are particularly relevant for patient protection. In addition, the self-reported intention to implement HHC in everyday life, especially in these moments, is increasing. The results indicate that tailored interventions with an empathic focus could improve patient safety in public health in the future.


  1. World Health Organization (2009) WHO guidelines on hand hygiene in health care: First global patient safety challenge. Clean care is safer care. WHO, Geneva. (accessed on August 9, 2022)
  2. Sassenrath C et al. (2022) The impact of activating an empathic focus during COVID19 on healthcare workers motivation for hand hygiene compliance in moments serving the protection of others: a randomized controlled trial study. Z Gesundh Wiss: 1–5.

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