Nursing students' knowledge and practices of standard precautions: A Jordanian web-based survey

Factors responsible for student nurses' use of non-sterile gloves: An exploratory qualitative study

Background

Disposable non-sterile gloves are part of the personal protective equipment (PPE) to be considered to protect oneself from the risk of infection. They have subsequently become the topic of concern related to increased use, inappropriate use, and potentially increasing the risk of cross-infection and environmental impact of plastic waste.

Aim/objective

This study aimed to explore the views of pre-registration student nurses about non-sterile glove use in clinical practice and to identify the factors that impact student nurses' decision on whether to wear non- sterile gloves.

Methods

Using a social constructivist approach, the study was organised in a higher education institution. Semi-structured interviews were conducted with second year student nurses, utilising a theoretical domains framework (TDF).

Findings/Results

The key findings showed that students had limited awareness of the national infection prevention and control best practice procedures. The primary influential factors for non-sterile gloves use behaviour were personal protection, the type of care interventions required and the observations of peers and role models.

Discussion

The study found limited awareness on the importance of infection prevention and control precautions, including the correct procedure for donning, and doffing of personal protection equipment, along with a lack of confidence to challenge non-compliance.

Infection prevention and control continuous education and training in pre-registration nursing programmes

BACKGROUND

Infection prevention and control (IPC) education and training in pre-registration nursing programmes are imperative in developing student nurses' clinical aptitudes. The IPC core competencies must be consistent amongst student nurses across different settings, asserting the need for education and training providers to respond. Continuous education and training can improve IPC core competencies through enhanced knowledge, compliance, and attitude in the academic and clinical contexts, impacting future nursing practice and patient safety.

OBJECTIVE

This integrative review critically examines the reported IPC core competencies in pre-registration nursing programmes to contribute to future continuous IPC education and training.

REVIEW METHODS

An integrative literature review methodology was utilised to conduct a structured literature search within the last five years using CINAHL Plus, EMBASE, ERIC, MEDLINE, and PubMed databases. The following keywords were used: infection prevention and control; pre-registration nursing; higher education; core competencies in the databases. A total of 15 articles were identified under the inclusion criteria of peer-reviewed primary research in English on the pre-registration nurse population and their nursing programmes.

RESULTS

The final review of the 15 reports yielded continuous IPC education and training, knowledge, skills, and attitudes, and clinical placements as key components to develop and elevate student nurses' IPC core competencies.

CONCLUSION

All reports acknowledged the challenges of maintaining IPC core competencies and seeking diversified strategies to support continuous education and training utilising interactive tools embedded with simulated scenarios and quizzes, translating knowledge and skills to exemplary professional behaviours, and consistent academic and clinical support as the IPC demand intensifies.

Assessment of neonatal intensive care unit nurses' compliance with standard precautions of infection control and identification of enabling factors

Background

Rigorous implementation of infection prevention and control practices by healthcare workers in different healthcare settings is of utmost importance. Neonates, particularly preterm babies in neonatal intensive care units, are a vulnerable population at high risk for developing nosocomial infections. Nurses have the greatest risk of spreading healthcare-associated infections among patients and healthcare workers. This study was conducted to assess the compliance of neonatal intensive care unit nurses with standard precautions of infection control and to identify the potential influencing factors.

Results

This was a cross-sectional study, whereby the compliance of a total of 58 neonatal intensive care unit nurses with standard precautions of infection control was assessed using the Arabic version of the Compliance with Standard Precautions Scale (CSPS-A). Student's t test, ANOVA test, and post hoc test were used for analysis.A suboptimal compliance rate (66.7%) was detected, with the highest for disposal of sharp articles into sharps boxes (86.2%) and the lowest for disposal of sharps box not only when full (27.6%). Significant differences were observed when participants were grouped according to their clinical experience and qualifications, where participants with longer clinical experience displayed higher mean scores for the use of protective devices score (P = 0.024), disposal of sharps score (P = 0.003), and total CSPS score (P = 0.006).

Conclusions

Clinical experience and educational qualifications are key factors that impact nurses' compliance with infection control practices. Nurses should receive up-to-date evidence-based educational and practical sessions that link theory to clinical practice and elucidate the importance of accurate implementation of proper infection prevention and control practices.

Knowledge and Compliance With Standard Precautions Among Nurses

Introduction

The spread of microorganisms is caused by direct or indirect contact, respiratory droplets, and airborne transmission. Knowledge and compliance with standard precautions are crucial in preventing infection in the hospital.

Objectives

To assess the level of knowledge and compliance with standard precautions among registered nurses who work in military hospitals and the factors affecting compliance with standard precautions.

Methods

A descriptive cross-sectional study was conducted. Four hundred and eight registered nurses at three Jordanian Royal Medical Services hospitals completed an online self-report questionnaire using a convenience sampling technique. The statistical package for social sciences (SPSS) version 25 was used to analyze the data.

Results

The level of knowledge of standard precautions among nurses was excellent, with an overall mean score of 15.59 ± 2.22 out of 20; around half (54%) of them had an excellent level. Nurses' compliance with standard precautions was intermediate, with an overall mean score of 59.65 ± 14.57 out of 80. Forty-seven percent of nurses had a high degree of compliance. Compliance with standard precautions was correlated positively with age, working experience in years, total knowledge score, training in standard precautions, and availability of personal protective equipment, and negatively with exposure to sharp injuries.

Conclusion

Nurses play a key role in preventing and managing hospital infections through their responsibility for a large proportion of patient treatment and care. Therefore, efforts should be made to improve nurses' perceptions of the basic elements of standard precautions. Even so, results showed that compliance with standard precautions was intermediate. This highlights the need to take the necessary measures to raise the level of compliance. Even so, results showed that compliance with standard precautions was intermediate. This highlights the need to take the necessary measures to raise the level of compliance.

Effectiveness of game-based virtual reality phone application and online education on knowledge, attitude and compliance of standard precautions among nursing students

Game-based virtual reality phone applications can create a realistic environment to prepare for clinical applications and improve students’ knowledge of and compliance with standard precautions. An experimental study was performed among 126 nursing students’ from the third and fourth nursing levels to determine the effect of online education and game-based virtual reality phone applications related to standard precautions. Students were divided randomly into two groups; the experimental group used online education and game-based virtual reality phone applications, while the control group used traditional education. The study was performed between July and August 2019 to prevent clashes with lectures and midterm and final examinations. A tool package including knowledge, attitude, and compliance with standard precautions was used in pre-and post-tests among nursing students. The results showed that the knowledge of, attitudes towards, and compliance with standard precautions differed between the two groups. The performance of the experimental group of nursing students significantly improved with online instruction and game-based virtual reality phone applications. This study demonstrated the effectiveness of online education and game-based virtual reality phone application among nursing students.

Assessing knowledge of nosocomial infection among Omani student nurses: a cross-sectional study

BACKGROUND

The total cost and negative health associated with nosocomial infection are high and early interventions are required. Assessing students' knowledge about nosocomial infection may contribute to solving this issue.

AIMS

The present study aimed to assess the level of knowledge of nosocomial infection among student nurses and to identify their main sources of information on the topic.

METHODS

A total of 330 student nurses at Sultan Qaboos University completed the online survey, which included participants' demographics and the Infection Control Standardized Questionnaire (ICSQ).

FINDINGS

The results of the study reveal the average total corrected score of the participants was 51.53 (SD=0.89) out of 100, with a minimum score of 16 and a maximum score of 96. Female students had a higher average score (13.9, SD=4.34) than male students (11.6, SD=3.2); t(328)=5.35.

CONCLUSION

The student nurses did not have a sufficient level of knowledge about nosocomial infection. This calls for a review of nursing curricula to pave the way for more pragmatic teaching of infection control.

An investigation into nursing students' application of infection prevention and control precautions

BACKGROUND

Undergraduate education of Health Care Workers is pivotal to ensuring that frontline clinicians have appropriate knowledge and skills in Infection Prevention and Control (IPC).

OBJECTIVES

The aim of this study was to describe undergraduate nursing students' self-reported compliance with Standard Precautions and to explore the psychosocial factors that influence adherence in clinical practice.

DESIGN

A cross-sectional survey design was used.

SETTING

The study was conducted in the School of Nursing and Midwifery at an Australian University.

PARTICIPANTS

All undergraduate nursing students were invited to participate in an online survey; 321 participated, mean age 25.7 years (SD = 8.4). The majority, 196 (61%), had no healthcare work experience, 54 (17%) were patient-care assistants, 40 (13%) enrolled nurses, and 31 (9%) were nurses registered overseas.

METHODS

Two validated instruments were used: the Compliance with Standard Precautions Scale (CSPS) and the Factors Influencing Adherence to Standard Precautions Scale- Student version (FIASPS-SV). Linear regression was used to measure the impact of psychosocial factors on self-reported compliance.

RESULTS

Overall self-reported compliance with prevention of cross-infection was 83%, use of Personal Protective Equipment (81%), correct disposal of sharps (83%) and general waste (75%), and equipment decontamination (69%). The predominant factors endorsed on the FIASPS-SV were 'Leadership' (M = 15.21 SD = 5.28) and 'Contextual cues' (M = 19.09 SD = 6.37). Multivariate linear regression demonstrated that after adjusting for age, gender and years of nursing study, the Leadership factor predicted participants' self-reported compliance on the 'prevention of cross-infection' (p < .001), 'use of PPE' (p < .001), 'waste disposal' (p = .021), and 'decontamination of equipment' (p < .001) sub-domains of the CSPS.

CONCLUSIONS

These findings highlight that strong clinical leadership and role modelling are essential to ensure all healthcare students prioritise rigorous adherence with infection prevention and control guidelines.

COVID-19 knowledge, attitude, and precautionary practices among health professional students in Oman

Assessing knowledge, attitude, and practices of healthcare students regarding any infectious outbreak became a fundamental step to set an effective plan related to their preparedness. The purpose of this study was to assess COVID-19 knowledge, attitude, and precautionary practices among health professional students in Oman. Data were collected using the Web-based survey method. The sample was recruited from the largest college of Medicine in Oman, while the nursing sample was recruited from two different nursing colleges in Oman. The study tool was developed based on the most recent advisory COVID-19 recommendations from the WHO and the CDC. A total of 222 students filled the survey, of which 55% were medical students and 59.9% were females. The mean knowledge score was 16.5 (SD = 4.2), which represents 66% of the highest possible score, with 25.7% were classified as ‘excellent knowledge’. Participants reported a high level of public precautionary practices (M = 44.1, SD = 5.0), which represents 84.6% of the highest score, with 61.3% were classified as ‘high compliance. The mean attitude score was 40.3 (SD = 5.9), which represents 67% of the highest possible score. According to the classification categories, most students (81%, n = 180) expressed a positive attitude toward COVID-19. More efforts should be done toward preparing the healthcare students to deal with the outbreak. Preparing healthcare students with the right knowledge, attitude, and precautionary practices during the COVID-19 outbreak is very essential to patient and public safety. Healthcare students can play a major role in increasing public awareness about COVID-19 precautionary practices.

Compliance with Infection Prevention and Control Practice among Prospective Graduates of Nursing School in South Korea

The purpose of this study was to examine compliance with infection prevention and control practice and factors affecting compliance in nursing students who are about to graduate. A cross-sectional survey design was used. A total of 178 students from two nursing colleges in South Korea responded to self-reported questionnaires. Descriptive statistics, independent t-test, Pearson correlation, and multiple regression analysis were conducted. Mean score for compliance was 4.09 ± 0.43 out of 5. The highest score was on compliance with prevention of cross-infection (4.42 ± 0.54) and the lowest was on use of protective devices (3.86 ± 0.78). Non-occupational exposure scores on compliance subcategories were significantly higher than those for occupational exposure. Students' perception of safe environment for infection control and a positive attitude toward infection control predicted compliance significantly (β = 0.28, p < 0.001; β = 0.18, p = 0.014, respectively). The findings clarify that the level of infection control compliance among Korean nursing students is moderate. In order to increase the level of compliance, a climate that emphasizes a safe environment for healthcare-associated infections should be strengthened. In addition, nursing education should endeavor to develop a positive attitude toward infection prevention.

Nurses and physicians knowledge of guidelines for preventing catheter-related blood stream infections

BACKGROUND

Catheter-related blood stream infection (CRBSI) is considered a major challenge for health care providers working in intensive care units.

AIM

This study aimed to evaluate and compare the knowledge of evidence-based guidelines for preventing catheter-related blood Stream infections among physicians and nurses working in critical care units in Jordan.

DESIGN

A cross-sectional survey design was utilized.

METHODS

The study was conducted in five intensive care units; 181 nurses and 68 physicians were recruited from four governmental hospitals and one university-affiliated hospital.

RESULTS

The mean total knowledge score for physicians' knowledge was low at 2.6, SD 1.5 (out of 10). While the mean total score for nurses' knowledge was low at 3.3, SD 1.8 (out of 10). The independent t test shows that nurses had a significantly higher mean total knowledge score than physicians (P < .05).

CONCLUSIONS

The current study demonstrates that Jordanian nurses and physicians working in intensive care units have a low level of knowledge of the guidelines for preventing CRBSI. This problem should be addressed through routine assessment and evaluation and adoption and policies that make nurses and physicians comply with the evidence-based guidelines. Finally, conducting regular educational programmes on CRBSI prevention, and evaluation of compliance with the guidelines in daily clinical practice, are strongly recommended.

RELEVANCE TO CLINICAL PRACTICE

The results of the current study suggest the need for regular assessment of physicians' and nurses' knowledge and skills with regard to central venous catheter insertion and maintenance care. Based on this assessment and using the best available evidence, training programmes on the prevention of CRBSI should be developed. Courses might be online, face to face, or using high fidelity simulation. Finally, regular observation and evaluation of compliance with the CRBSI guidelines in daily clinical practice is needed.

Predictors of nursing interns' standard precautions compliance during internship training in four teaching hospitals in Saudi Arabia

AIM

The aim of this study was to assess compliance with standard precautions by Saudi nursing interns who were undergoing their internship training in four governmental tertiary teaching hospitals in Riyadh, Kingdom of Saudi Arabia, and to determine factors predictive of this.

BACKGROUND

Cross-transmission and infection prevention when delivering care must be strictly followed by nursing interns by complying with standard precautions during internship training.

DESIGN

The study employed a descriptive-correlational and cross-sectional design.

METHODS

A total of 224 nursing interns participated in the study by completing the Compliance with Standard Precautions Scale Arabic version between March 2017 and June 2017.

RESULTS/FINDINGS

A high overall compliance rate (84.8%) was observed. Nursing interns reported the highest compliance score in changing gloves between each patient contact and the lowest score in disposing of sharps boxes only when full. Nursing interns in hospital D showed the highest compliance rate over those in other hospitals. Age, sex, marital status, months in internship training and attendance of nursing interns in infection control seminars/trainings influenced their standard precautions compliance.

CONCLUSION

The study revealed good compliance by nursing interns with standard precautions. However, regular educational and clinical interventions are still needed to improve some areas and to ensure the continuity of high levels of compliance in other areas of standard precautions among nursing interns.

Prevention of ventilator-associated pneumonia in intensive care units: Barriers and compliance

AIM

The purpose of this study was to evaluate the compliance of Jordanian nurses with ventilator-associated pneumonia prevention guidelines and the barriers to compliance.

METHOD

A descriptive, cross-sectional design was used. A convenience sample of 294 nurses from nine hospitals in Jordan completed a self-reported questionnaire.

RESULTS

According to the study compliance categories, 45.6% of the participants reported 'insufficient compliance,' 24.8% 'weak compliance' and 29.6% 'sufficient compliance.' Nurses with more experience and previous education on ventilator-associated pneumonia reported higher compliance scores than their counterparts with less experience and no previous education. Nurses reported several barriers that limited their own compliance, such as lack of education, lack of policies and protocols, lack of resources and the shortage of staff.

CONCLUSION

The compliance of nursing staff with the prevention guidelines was poor. Applying tailored educational programs may help improve their level of compliance. These programs must target new graduate nurses and be conducted in those hospitals with limited resources.

Factors influencing hand hygiene practice of nursing students: A descriptive, mixed-methods study

Developing nursing students' knowledge and practice of infection prevention and control (IPC) is fundamental to safe healthcare. A two-phase descriptive, mixed-method study conducted within a Bachelor of Nursing program at an Australian university aimed to explore: (i) theoretical knowledge of IPC, highlighting hand hygiene, of nursing students and; (ii) nursing students' and clinical facilitators' perceptions of factors influencing these practices during clinical placement. Phase One utilised an anonymous validated questionnaire assessing students' knowledge; identifying variables influencing students' IPC practices, subjected to descriptive and inferential analysis. Phase Two were semi-structured interviews exploring clinical facilitators' experiences/perceptions of students during clinical placement, analysed thematically. Students' demonstrated satisfactory knowledge of IPC in their second and third year, but clinical facilitators perceived that. students lacked awareness of the importance of these practices. Five themes arose from the interviews: (i) understanding workplace culture; (ii) students' modelling local behaviour; (iii) enhancing and consolidating knowledge for practice; (iv) adjusting to practice reality and; (v) accessing additional hand hygiene resources. Factors specific to workplace setting and culture were perceived to influence nursing students' socialisation. Future practice/education strategies could address these factors by ensuring students receive adequate supervision during clinical placement, and having strong advocates/role models present in the workplace.

Knowledge and performance of nursing students of Kermanshah-Iran regarding the standards of nosocomial infections control: a cross-sectional study

Objectives

The aim of this study was to determine the level of knowledge and performance of nursing students in regard to the standards of nosocomial infections control.

Results

The average score of knowledge and performance of the subjects was 12.49 ± 2.3 from 18 and 43.07 ± 0.67 from 54, respectively. There was a direct and significant correlation between the knowledge and performance of students (r = 0.46, p < 0.0001). There was no statistically significant relationship between the knowledge of students and variables such as gender and academic year of the students, but there was a significant relationship between students’ performance, and gender (p = 0.014) and academic year (p = 0.015).

Knowledge, attitude, practice, and clinical recommendation toward infection control and prevention standards among nurses: A systematic review

BACKGROUND

The purpose of this study was to systematically review the literature to describe nurses' knowledge and practice of and attitude toward infection control and prevention standards.

METHODS

In the present systematic review, 4 electronic databases were searched from the inception of databases through March 2018. Quality of included studies was assessed using the Hoy tool.

RESULTS

Eighteen studies conducted on 4,577 employed nurses and nursing students entered the final stage. Results indicated that nurses in most studies had adequate knowledge (n = 10, 40%-90%) and positive attitude (n = 4, 37%-100%). However, most studies reflected average and poor nursing practices with regard to adherence to infection control and prevention standards. The most frequent recommendations proposed for improving nurses' knowledge, attitude, and practice included periodic training via scientific conferences and relevant practical courses (n = 12), combining up-to-date theoretical and practical programs (n = 6), and training at the beginning of hospital employment (n = 4).

CONCLUSIONS

The results of the present study indicate that although nurses in most studies had adequate knowledge of and positive attitude toward health care-associated infections, because of average and poor practices, they need systematic and integrated implementation of the presented recommendations.

Effects of a multi-component educational intervention on nurses' knowledge and adherence to standard precautions in intensive care units

Background

The standard precautions (SPs) should be disseminated and implemented by healthcare providers. This study aimed to examine the effects of a multi-component educational intervention on nurses' knowledge and adherence to the SP guidelines in intensive care units (ICUs).

Methods

This small-scale study consisted of a cluster randomised trial. Two ICUs, located in different hospitals, participated in the study. Nurses (n = 15) in one ICU received the multi-component educational intervention. The intervention involved an educational (with multiple instructional media) and a behavioural (with hands-on practice) component. Nurses' knowledge and adherence were assessed at pre-test and two and six weeks after the intervention.

Results

Results showed significant group by time interaction effects for both outcomes: a large improvement was found in the experimental group over time, but not in the control group. The experimental nurses' knowledge improved from 15 ± 2.47 at pre-test to 19 ± 2.65 and 19.53 ± 0.92 at follow-ups. Similarly, their adherence increased from 19.87 ± 4.44 at pre-test to 29.20 ± 5.00 and 28.40 ± 4.37 at two and six weeks post-test, respectively.

Conclusions

The multi-component educational interventions had demonstrated initial effectiveness in enhancing ICU nurses' knowledge and adherence to the SPs guidelines. The intervention is a promising approach for designing effective continuing education initiatives aimed to improve nurses' practice.

Nursing students' knowledge, attitude and practices of infection prevention and control guidelines at a tertiary institution in the Western Cape: A cross sectional study

BACKGROUND

Nurses in sub-Saharan Africa are particularly at a higher risk of acquiring nosocomial infections, considering the increased prevalence of infectious diseases. It is therefore imperative that these nurses have a sound knowledge and understanding of infection prevention procedures.

OBJECTIVE

The main objective of this study was to describe the knowledge, attitudes and practices concerning infection prevention and control precautions among nursing students in a resource limited setting.

METHOD

A cross sectional study design was employed. A self-administered questionnaire concerning infection prevention and control guidelines were made available to students enrolled in a mainstream programme for completion of an undergraduate nursing degree.

SETTING AND PARTICIPANTS

A total of 301 students at second, third and final years of study from a tertiary institution in the Western Cape were invited to participate.

RESULTS

The final cohort comprised of 301 students with the majority between the ages of 17-26 (88.2%), with a mean age of 23 ± 4.7 (SD) years and the dominant gender being female (83.4%). According to the classification system used in this study, the majority of the students were overall evaluated as having good level of knowledge (47.4%) and poor attitude (41.7%) scores, with little difference in practice scores observed between different years of study. There was a positive correlation found between students' total attitude and total practice scores (r = 0.48 p < 0.01). Results showed that significant associations between gender and knowledge (p < 0.05), attitudes (p < 0.05) and practice (p < 0.05) exists. There was also a significant association between province and those who repeated a year with total knowledge scores (p < 0.05).

CONCLUSION

Based on the results of this study, it is recommended that interactive infection control courses that promote critical thinking are implemented at undergraduate level along with more stringent forms of assessments focusing on infection prevention and control, during clinical training.

Knowledge and practices of isolation precautions among nurses in Jordan

Background

Implementation of isolation precautions from the Centers for Disease Control and Prevention (CDC) has been justified through research and clinical evidence. However, nurses' understanding and compliance with these precautions is still unknown. The aim of this study was to assess nurses' knowledge and practices in relation to isolation precautions in Jordan.

Methods

A cross-sectional, descriptive design was used. The study took place in 8 hospitals in Jordan. A self-reported questionnaire and an observational checklist were developed based on the CDC (2007) isolation precautions guidelines.

Results

A total of 247 questionnaires were returned out of 400, for a response rate of 61.7%. The results show that most nurses (90%) have good knowledge of isolation precautions. However, only 65% of nurses reported good compliance with isolation precautions. The results of a t test revealed that nurses with Bachelor's degrees perform better in knowledge examinations than nurses with 2-year diplomas (P < .001). However, there was no significant difference in knowledge and self-report practices scores based on nurses' previous training and existence of isolation guidelines in their units or wards (P > .05). The results of the checklists confirm that there is a low compliance with standard isolation practice. In addition, the checklist shows that a high percentage of units and wards do not use isolation signs (46.4%) and posters (34.5%).

Conclusions

This study revealed that educating nurses about isolation is not enough strategy to improve their compliance. It is important to adapt other strategies, such as supporting nurses by giving them a manageable workload, and providing more supplies and reminders of isolation precautions in the hospitals.

Improving knowledge and compliance with infection control Standard Precautions among undergraduate nursing students in Jordan

Introduction

The recent emergence and reemergence of infectious diseases have made the knowledge and practice of standard infection control precautions in developing countries more important than ever. However, schools of nursing in Jordan do not have a prescribed curriculum in Standard Precautions.

Purpose

To test the effectiveness of using of an online education module and a learning contract on knowledge and compliance with infection control Standard Precautions among undergraduate nursing students in Jordan.

Methods

A sample of 256 undergraduate nursing students participated in an online education module in infection control Standard Precautions. A pretest–posttest design tested effectiveness using an online questionnaire (Questionnaires for Knowledge and Compliance with Standard Precautions) before and after the online instruction.

Results

Initially, subjects reported low levels of knowledge and compliance with Standard Precaution practices and relatively few (15.2%) had high scores. Compliance with Standard Precautions was somewhat better (27%). Significant differences in the mean scores of knowledge and compliance between pretest and posttest were found.

Conclusion

Online instruction offers a consistent and effective method to include Standard Precautions into nursing education. Organizations that oversee nursing in Jordan have the option to strengthen all nursing curricula by mandating a standardized infection control curricula across all schools of nursing.

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.

A concealed observational study of infection control and safe injection practices in Jordanian governmental hospitals

BACKGROUND

The recognized international organizations on infection prevention recommend using an observational method as the gold standard procedure for assessing health care professional's compliance with standard infection control practices. However, observational studies are rarely used in Jordanian infection control studies. This study aimed to evaluate injection practices among nurses working in Jordanian governmental hospitals.

METHODS

A cross-sectional concealed observational design is used for this study. A convenience sampling technique was used to recruit a sample of nurses working in governmental hospitals in Jordan. Participants were unaware of the time and observer during the observation episode.

RESULTS

A total of 384 nurses from 9 different hospitals participated in the study. A total of 835 injections events were observed, of which 73.9% were performed without handwashing, 64.5% without gloving, and 27.5% were followed by needle recapping. Handwashing rate was the lowest (18.9%) when injections were performed by beginner nurses. Subcutaneous injections were associated with the lowest rate (26.7%) of postinjection handwashing compared with other routes.

CONCLUSIONS

This study demonstrates the need for focused and effective infection control educational programs in Jordanian hospitals. Future studies should consider exploring the whole infection control practices related to waste disposal and the roles of the infection control nurse in this process in Jordanian hospitals.

Compliance with standard precautions among baccalaureate nursing students in a Saudi university: A self-report study

Meticulous observance of standard infection control precautions by health care providers is strongly recommended for every patient encounter. Assessment of nursing students' compliance should be carried out regularly in order to ensure adherence to protocols. Thus, this study was conducted to assess self-reported compliance with standard precautions among baccalaureates in nursing students in a Saudi university. A convenience sample of 236 nursing students was surveyed in this cross-sectional, self-reported study, using the Compliance with Standard Precaution Scale Arabic version (CSPS-A). Independent t-test and one-way analyses of variance (ANOVA) were performed to examine the differences on compliance. A multiple regression analysis was performed to identify the factors affecting compliance. The overall compliance rate was 61.0%. The students reported highest compliance in disposing used sharp instruments and other sharp objects into sharps-only boxes, while the lowest compliance rate in using water only for hand washing. Significant differences in compliance were observed when respondents were grouped according to their demographic characteristics. Cultivating a supportive culture of adherence to infection control precautions among nursing students is of paramount importance. The clinical environment should be supportive of a culture where strict compliance with the control and prevention of infection is of prime importance.