In 2015 there were 426.277 cases of infections with multi-resistant bacteria associated with health care registered in Europe. Healthcare-associated infections are a major cause of morbidity and mortality in nursing homes. In addition, nursing managers should be made aware of the impact of their role model function and they should implement this in daily practice. These results suggest that improving hand hygiene should focus on strategies that facilitate the provision of hand disinfectant materials in the immediate work area of nurses. Despite a general awareness of the impact of leadership on staff behaviour, not all nursing managers fully appreciated the impact of their own consistent role modelling regarding hand hygiene behaviours. Hygiene standards and equipment were all generally available but compliance to standards also depended upon availability in the immediate work area and role modelling. Most nurses and nursing managers held the knowledge of effective hand hygiene procedures. We conducted a mixed-methods study surveying 165 nurses and interviewing 27 nursing managers from nursing homes in Germany. We aim to explore these influences of individual and organisational factors of hand hygiene in nursing home staff, with a particular focus on the function of role modelling by nursing managers. Therefore, it may be important to examine individual and organisational factors that foster improvement of these factors in hand hygiene. Studies have shown that increasing knowledge, behaviour and attitudes could enhance hand hygiene compliance in nursing homes. The nursing home setting differs from other healthcare environments in individual and organisational factors such as knowledge, behaviour, and attitude to improve hand hygiene and it is therefore difficult to research the influential factors to improve hand hygiene. Infections with multi-resistant bacteria’s, associated with healthcare, is a known problem. Effective hand hygiene is one of the most important measures for protecting nursing home residents from nosocomial infections.
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