Hygienic hand washing among nursing students in Turkey

Review of literature: Knowledge and practice of standard precautions by nursing student and teaching techniques used in training

INTRODUCTION

Standard precautions (SP) help to combat healthcare-associated infections. It is of paramount importance that they be taught during nursing studies. The objective of this review of the literature was to determine the level of knowledge and practice of SP and hand hygiene (HH) of nursing students (NSs) and to identify the different pedagogical hygiene techniques applied in nursing training.

METHODS

A review of the relevant literature was carried out according to the PRISMA method between January 2010 and April 2021.

RESULTS

Eighty-one articles were selected: 36 studies were dedicated to NSs' knowledge, 43 to the SP practice of NSs, and 21 to hygiene teaching techniques in nursing training. While NSs knowledge of HH was found to be moderate, their knowledge of SP was moderate or good. Alcohol-based hand rub were little known. SP practice and compliance with SP and HH was moderate. The hygiene training programs set up in view of improving knowledge and practices have applied diversified pedagogical techniques. Multimodal approaches have proposed different associations of pedagogical techniques. As of now, no single teaching methods has been found clearly superior to the others.

CONCLUSION

Enhanced training for nurses by means of new technologies and a combination of different approaches is indispensable in view of improving their levels of knowledge and practice.

Increasing nursing students' knowledge of evidence-based hand-hygiene: A quasi-experimental study

Aim of study was to evaluate the effects of a multi-component intervention on nursing students' knowledge of evidence-based hand-hygiene. A quasi-experimental design was used. Nursing students (N = 146) from two universities of applied sciences (experimental group n = 107, control group n = 39) completed an instrument based on international clinical guidelines related to hand hygiene that consisted of 17 Likert-scale items. Data were collected at three time points (baseline, after university-based training and after clinical training) between autumn 2014 and spring 2016. Group differences were examined using chi-squared or Fisher Exact tests, the Mann-Whitney and U test. Within-group differences were assessed with the McNemar test for paired nominal data. At the first and second time points the experimental group had better hand hygiene knowledge than the controls. There were no group differences in responses to items concerning the appropriate length of hand disinfection. The experimental group showed improvements in the practice of washing hands with soap and water, but not in the other statements concerning hand disinfection. Theoretical recap and training at school seemed to influence students' hand hygiene knowledge, but reinforcement during clinical training may be required to ensure that learning practical evidence-based skills, such as hand-hygiene, may be established.

A systematic review on hand hygiene knowledge and compliance in student nurses

BACKGROUND

Hand hygiene competence is one of the critical outcomes in nursing education. Ensuring nursing students recognize the what, when and how of hand hygiene is critical in the light of the increasing rates of healthcare-associated infections.

AIM

To systematically appraise and synthesize articles on hand hygiene knowledge and compliance among nursing students.

METHODS

This is a systematic review of scientific articles published from 2006 to 2016. The primary databases used were as follows: PubMed, Embase, Cumulative Index to Nursing & Allied Health Literature, Proquest and PsychINFO. Key search terms utilized were as follows: 'handwashing', 'hand hygiene', 'compliance', 'knowledge', 'practice' and 'nursing students'.

FINDINGS

Nineteen studies met the review criteria. The findings revealed a low-to-moderate knowledge of and compliance with hand hygiene among nursing students. In addition, there were significantly higher rates of hand hygiene compliance in nursing students when compared to medical students. Relatively few studies attempted to identify predictors of hand hygiene knowledge and compliance.

CONCLUSION

This review demonstrated suboptimal knowledge and compliance to hand hygiene among student nurses. In addition, this review also highlighted the paucity of studies that examined individual and organizational factors, which influence nursing students hand hygiene knowledge and compliance.

IMPLICATIONS FOR NURSING AND POLICY

The findings of this review emphasized the role of nurse educators in enhancing hand hygiene competence in nursing students. Implementation of empirically tested strategies such as utilizing multidimensional interventions, scenario-based hand hygiene simulation activities and hand hygiene education programmes that would enhance nursing students' hand hygiene knowledge and compliance is an asset. Hospital and nursing administrators should ensure continuous support and monitoring to guarantee that hand hygiene programmes are institutionalized in every healthcare setting by every healthcare worker.

Contact infection of infectious disease onboard a cruise ship

Cruise tourism has become more popular. Long-term personal contact, complex population flows, a lack of medical care facilities, and defective infrastructure aboard most cruise ships is likely to result in the ship becoming an incubator for infectious diseases. In this paper, we use a cruise ship as a research scenario. Taking into consideration personal behavior, the nature and transfer route of the virus across different surfaces, virus reproduction, and disinfection, we studied contact infection of infectious disease on a cruise ship. Using gastroenteritis caused by the norovirus as an example, we analyzed the characteristics of infectious disease propagation based on simulation results under different conditions. We found hand washing are the most important factors affecting virus propagation and passenger infection. It also decides either the total number of virus microorganisms or the virus distribution in different functional areas. The transfer rate between different surfaces is a key factor influencing the concentricity of the virus. A high transfer rate leads to high concentricity. In addition, the risk of getting infected is effectively reduced when the disinfection frequency is above a certain threshold. The efficiency of disinfection of functional areas is determined by total virus number and total contact times of surfaces.

Jordanian nursing students' knowledge of, attitudes towards, and compliance with infection control precautions

Nursing students' noncompliance with infection control precautions has its effects not only on patients, but also on nursing students themselves. Little is known about the actual status of infection control knowledge and compliance among Jordanian nursing students. This correlational descriptive study used a cross-sectional survey design to explore Jordanian nursing students' knowledge of, attitudes toward, and compliance with infection control precautions. The target population was all nursing students at the faculty of nursing-University of Jordan. Participants were found to have inadequate knowledge about infection control precautions (M=49.64%), positive attitudes (M=89.8%), and moderate compliance (M=75.91%). Participants' attitudes toward infection control precautions was the only variable that predicts (B=.410, p=0.000) and correlates (r=.51, p<0.01) with their compliance score. Special courses for infection control precautions within nursing schools in Jordan are recommended with special focus on students' attitudes.

Compliance of nursing students with infection prevention precautions: effectiveness of a teaching program

BACKGROUND

In Jordan's nursing schools, infection prevention precautions are not taught in special courses. Instead, most nursing schools include the topic as a 1-hour lecture within the clinical courses, which is believed to be insufficient. This study aimed to test the effectiveness of a nursing infection prevention educational program presented to nursing students before graduation, to promote their knowledge of infection prevention precautions.

METHODS

A true experimental design was used to examine the effects of the infection prevention educational program on students' educational knowledge. This study involved a random assignment of subjects to experimental and control groups, and administration of the pretest and the posttest to all subjects in both groups separately.

RESULTS

Participants in the experimental group demonstrated significantly better knowledge (t = 19.15; df = 95; P = .000) and attitude scores (t = 2.29; df = 46; P = .04) than participants in the control group after particpating in the infection prevention educational program. However, compliance scores were not significantly differernt between the 2 groups (t = 1.92; df = 95; P = .067); indeed, compliance was found to be significant within the experimental group (t = 10.65; df = 46; P = .000).

CONCLUSIONS

It is important that nursing students be competent in infection prevention precautions; however, there may be deficits in their education in this area. The nursing curriculum should include additional emphasis on practice as a means to help translate theory into clinical behavior.

Investigating Jordanian nurses' handwashing beliefs, attitudes, and compliance

BACKGROUND

Low rates of handwashing compliance among nurses are still reported in literature. Handwashing beliefs and attitudes were found to correlate and predict handwashing practices. However, such an important field is not fully explored in Jordan.

OBJECTIVES

This study aims at exploring Jordanian nurses' handwashing beliefs, attitudes, and compliance and examining the predictors of their handwashing compliance.

METHODS

A cross-sectional multicenter survey design was used to collect data from registered nurses and nursing assistants (N = 198) who were providing care to patients in governmental hospitals in Jordan. Data collection took place over 3 months during the period of February 2011 to April 2011 using the Handwashing Assessment Inventory.

RESULTS

Participants' mean score of handwashing compliance was 74.29%. They showed positive attitudes but seemed to lack knowledge concerning handwashing. Analysis revealed a 5-predictor model, which accounted for 37.5% of the variance in nurses' handwashing compliance. Nurses' beliefs relatively had the highest prediction effects (β = .309, P < .01), followed by skin assessment (β = .290, P < .01).

CONCLUSION

Jordanian nurses reported moderate handwashing compliance and were found to lack knowledge concerning handwashing protocols, for which education programs are recommended. This study raised the awareness regarding the importance of complying with handwashing protocols.

Hand hygiene knowledge and attitudes: comparisons between student nurses

It is recognised that early intervention in healthcare workers’ education is important in terms of embedding effective infection prevention and control knowledge into practice. One of the most important aspects of this education is hand hygiene compliance and technique expectations. This small study was undertaken in collaboration with the University of Dundee, School of Nursing and Midwifery and NHS Tayside. It explored the differences in knowledge, attitudes and practice towards hand hygiene among second and third year student nurses with the aim of reviewing and informing the development of future educational material at undergraduate level in order to continually enhance knowledge and skills and bridge the theory–practice gap. This study concluded that third year student nurses did have a slightly better knowledge base than the second years and that although knowledge, attitudes and practice were reported to be of a good standard overall, there were still some important issues that must be addressed.

Evaluation of handwashing behaviors and analysis of hand flora of intensive care unit nurses

PURPOSE

The aim of this study was to evaluate the handwashing behaviors of intensive care nurses based on personal statements, and to identify the microorganisms represented in the hand flora preshift and postshift.

METHODS

This prospective study was performed with 60 intensive care nurses between January and December 2008, at a training and research hospital at a university in Turkey. Samples were taken from the hands of the nurses for bacteriological culture, using the bag-broth method, at the beginning and end of the shift. The samples were cultured aerobically and the colonies that grew were counted and identified. The nurses completed a self-report questionnaire, and their answers were evaluated.

RESULTS

The frequency of handwashing by participants during each shift was 32.8±13.9. Overall, 65% of the nurses preferred alcohol-based antiseptic solutions for handwashing, 95% used paper towels to dry their hands, and 98.3-100% of the nurses washed their hands after performing care procedures. The Escherichia coli and coagulase negative Staphylococcus species were found to be at significantly higher levels in the postshift hand culture samples when compared to the preshift hand culture sample values. Enterobacter cloacae was the only species found in the postshift hand culture samples of the nurses.

CONCLUSIONS

The number of colonies of the microorganisms in the hand flora of the nurses increased postshift. The handwashing behavior of intensive care nurses must be improved as they nurse critical patients.

Assessing methicillin-resistant Staphylococcusaureus knowledge among nursing students

MRSA is becoming more prevalent in healthcare settings and community settings. The purpose of the study is to assess MRSA knowledge among nursing students. A MRSA Survey was administered to nursing students to gauge their general knowledge about MRSA. The scores from the MRSA Survey indicated that nursing students had a knowledge deficit regarding MRSA. Nursing student's need specific MRSA content in the nursing curriculum and need role models in healthcare settings who are following infection control guidelines. A variety of teaching strategies may be used to effectively teach this topic to nursing students. The goal of this education is to prevent the spread of MRSA organisms and decrease the related costs of treating MRSA infections.

Hand disinfectant practice: the impact of an education intervention

The primary hypothesis of this study was that a lecture on basic hygiene routines could be associated with an increase in the use of disinfectant for hand hygiene. A secondary hypothesis was that the lecture could positively affect the staff's knowledge of and attitudes toward basic hygiene routines.A quasi-experimental design including one ward of the department of orthopedics in a Swedish university hospital was adopted.During the pre-intervention test period the consumption of hand disinfectant was measured for 30 days and a questionnaire was distributed to all staff. The hospital hygiene nurse subsequently provided a lecture on basic hygiene routines to all employees on the ward. During the post-intervention test period the hand disinfectant consumption was measured for another 30 days, and the questionnaire was distributed once again. A follow-up measurement was performed 9 months after the intervention.After the lecture on hygiene routines, the consumption of hand disinfectant increased by 93%. Nine months after the intervention, the consumption was still 21% higher than before the intervention. The result of the questionnaire showed that the employees considered themselves applying the disinfectant more thoroughly after the intervention. Some employees changed their perspective on basic hygiene routines after the lecture and stopped using watches and private clothes at work.Our findings suggest that a single education session, a hygiene lecture, could be a simple and cost-effective method to increase the use of hand disinfectant, thereby reducing the number of nosocomial infections on the wards.