MethodsIn this study, we define han

Methods
In this study, we define hand hygiene as: any action of hand cleaning that removes visible soil and removes and kills any microorganisms on the hands. We propose to use state of the art approaches from knowledge translation science to, first, identify key factors that act as barriers and enablers to best hand hygiene practice by physicians and then develop and pilot a knowledge translation intervention focused on improving hand hygiene compliance by physicians that is based on the identified barriers and enablers.
The study will be subdivided into three phases to be executed over one year:
Phase 1: identification of barriers and enablers to hand hygiene compliance by physicians. This will include: key informant interviews with physicians and residents; nonparticipant observation of physician/resident hand hygiene behaviours during regular hospital hand hygiene audit sessions; and focus groups with hand hygiene experts (this Phase is equivalent to Phase 0 in MRC framework).
Phase 2: intervention mapping to develop a theorybased knowledge translation intervention to improve physician hand hygiene compliance (this Phase is equivalent to Phase 1 in MRC framework).
Phase 3: implementation and pilot of the knowledge translation intervention (this Phase is equivalent to Phase 2 in MRC framework).