Impact of the fluorescent concretization intervention on effectiveness of hand hygiene in nursing students: A randomized controlled study

Exploring determinants of hand hygiene among nursing students: A theory of planned behavior approach

BACKGROUND

This study aims to assess the hand hygiene behavior of nursing students and identify the factors influencing this behavior through the "Scale for Assessment Hand Washing Behavior in the Frame of Theory of Planned Behaviour (SAHBTPB)".

METHODS

This descriptive and cross-sectional study was undertaken at the nursing departments of the university's faculty of health sciences in İzmir, Turkey between 2021 and 2022. A total of 240 nursing students were recruited as participants for this study. Data were collected with the SAHBTPB. The data was analyzed using descriptive statistics, the Chi-square test, and correlation analysis in the SPSS 21.0 program (p < .05).

RESULTS

Participation rate was 74.76%. The mean age of the students was 20.59 ± 1.59 years and 69.9% were woman. The nursing students' total mean score of SAHBTPB was 147.5 ± 14.0 (min = 94; max = 176). There was a positively significant association between the total score and students' gender, graduate level, and hand hygiene education status. There was no significant difference in scale total score mean based on the existence of dermatological problems on the students' hands or their frequency of hand hygiene (p > .05).

CONCLUSION

The mean scores of nursing students on the SAHBTPB were found to be at a good level. The sub-dimension "intention" was identified as an effective factor in predicting the hand hygiene behavior of the students. The findings have the potential to positively impact nursing education by increasing awareness among students and offering valuable insights for nurses and educators.

Contributing Risk Factors to Self-Contamination During the Process of Donning and Doffing Personal Protective Equipment

OBJECTIVE

The goal of this study is to explore the risk factors associated with self-contamination points during personal protective equipment (PPE) donning and doffing among health care workers (HCWs).

METHODS

In total, 116 HCWs were randomly sampled and trained to don and doff the whole PPE set. We smeared the whole PPE set with the fluorescent powder. After each participant finished PPE doffing, the whole body was irradiated with ultraviolet light in order to detect contamination points and record the position and quantity. Sociodemographic characteristics and previous infection prevention control (IPC) training experience, among others, were collected by using electronic questionnaires. Poisson regression was used in identifying risk factors that are associated with the number of contamination points, and the relative risk (RR) and its 95% confidence interval (CI) were calculated.

RESULTS

About 78.5% of participants were contaminated. Ever training experience (RR = 0.37; 0.26, 0.52), clinical departments (RR = 0.67; 0.49, 0.93), body mass index (BMI) (RR = 1.09; 1.01, 1.18), and shoulder width (RR = 1.07; 1.01, 1.13) were associated with the number of contamination points.

CONCLUSIONS

Previous IPC training experience, department types, BMI, and shoulder width were associated with self-contamination points after the PPE was removed.

The Effect of Video-Assisted Training and Visual Feedback With UV Germ Technology on Nursing Students' Hand Hygiene Beliefs, Practices, and Compliance: A Randomized Controlled Study

BACKGROUND

Hand hygiene (HH) is the most effective way to prevent health care-associated infections; however, HH compliance rates continue to be suboptimal.

PURPOSE

To determine the effectiveness of video-assisted training and visual feedback with ultraviolet (UV) germ technology on nursing students' HH beliefs, practices, and compliance.

METHODS

This study used a double-blind, posttest randomized controlled design. The experimental group received training, visual feedback with UV germ technology, and instructional videos.

RESULTS

A total of 46 students were included in the study (experimental 21 and control 25). The mean score of the HH skills checklist of the experimental group was significantly higher than that of the control group ( P = .0001). The HH compliance rate was also higher in the experimental group (52.62%) compared with the control group (39.1%).

CONCLUSIONS

The training, visual feedback with UV germ technology, and instructional videos increased HH compliance rates in nursing students.

Quantifying Simulated Contamination Deposition on Healthcare Providers Using Image Analysis

INTRODUCTION

Simulation-based research has played an important role in improving care for communicable diseases. Unfortunately, few studies have attempted to quantify the level of contamination in these simulation activities. We aim to assess the feasibility and provide validity evidence for using integrated density values and area of contamination (AOC) to differentiate various levels of simulated contamination.

METHODS

An increasing number of simulated contamination spots using fluorescent marker were applied on a manikin chest to simulate a contaminated healthcare provider. An ultraviolet light was used to illuminate the manikin to highlight the simulated contamination. Images of increasing contamination levels were captured using a camera with different exposure settings. Image processing software was used to measure 2 outcomes: (1) natural logarithm of integrated density; and (2) AOC. Mixed-effects linear regression models were used to assess the effect of contamination levels and exposure settings on both outcome measures. A standardized "proof-of-concept" exercise was set up to calibrate and formalize the process for human subjects.

RESULTS

A total of 140 images were included in the analyses. Dose-response relationships were observed between contamination levels and both outcome measures. For each increment in the number of contaminated simulation spots (ie, simulated contaminated area increased by 38.5 mm 2 ), on average, log-integrated density increased by 0.009 (95% confidence interval, 0.006-0.012; P < 0.001) and measured AOC increased by 37.8 mm 2 (95% confidence interval, 36.7-38.8 mm 2 ; P < 0.001), which is very close to actual value (38.5 mm 2 ). The "proof-of-concept" demonstration further verified results.

CONCLUSIONS

Integrated density and AOC measured by image processing can differentiate various levels of simulated, fluorescent contamination. The AOC measured highly agrees with the actual value. This method should be optimized and used in the future research to detect simulated contamination deposited on healthcare providers.

Teaching health care students hand hygiene theory and skills: a systematic review

Hand hygiene is the cornerstone of infection prevention but is poorly undertaken and under-appreciated by medical, nursing, and other health care students. This systematic review aimed to identify and describe strategies used to teach the theory and practice of hand hygiene, determine impact on knowledge and practice, and identify need for future education and research. Ten studies met the criteria for review. Health care students' theoretical knowledge of hand hygiene and their ability to practise are suboptimal and should be improved before they have contact with vulnerable patients. Educational input can increase knowledge and practice but the methodological heterogeneity of the studies and lack of rigour make it impossible to determine which interventions are most likely to be successful. The literature provides little evidence upon which to base educational practice in this area. There is a need for multi-centred longitudinal studies to measure effectiveness of teaching methods over time.

Posters as a Tool to Improve Hand Hygiene among Health Science Students: Case-Control Study

(1) Background: Numerous educational interventions have been conducted to improve hand hygiene (HH) compliance and effectiveness among nursing students, with mixed results. The aim is to evaluate the effectiveness of posters as a teaching tool and factors associated with HH quality. (2) Methods: A pre-post experimental intervention study was conducted with a total of 293 nursing students randomly assigned to two groups (experimental and control) who, before and after HH, took cell culture samples from their non-dominant hands. Only the experimental group was exposed to the poster. (3) Results: In the experimental group, significant differences were observed among students older than 22 years (p = 0.017; V = 0.188), with a higher percentage of failures (15.7% vs. 3.6%). Poster displaying was associated with passing, other variables being equal, although without statistical significance (ORa = 2.07; 95% CI = 0.81-5.26). Pre-practice hand contamination was weakly associated with lower HH quality (ORa = 0.99, 95% CI = 0.99-0.99). (4) Conclusions: The use of posters as a teaching method shows indications of efficacy. Prior hand contamination slightly affects the quality of HH. Further evaluation of teaching methods is needed to ensure good technical performance of HH to prevent the spread of infectious diseases during the COVID-19 pandemic.

Hand Areas Which Are Commonly Missed during Hand Disinfection by Nursing Students Who Completed a Basic Educational Course in Hand Hygiene

BACKGROUND

Teaching nursing students how to correctly perform hand hygiene procedures may guarantee a reduction in transmitting pathogens through direct contact and, thus, it may lead to a decrease in the number of hospital infections. The aim of the study, which was conducted in low fidelity simulation conditions, was to assess the performance and the efficiency of a hand-rubbing disinfection technique among nursing students on the last day of their course.

MATERIALS AND METHODS

The study was conducted in a group of 190 nursing students studying at the Jagiellonian University and it focused on the performed hand-rubbing disinfection procedure. The accuracy of the task performance was assessed by measuring the percentage of the amount of Fluo-Rub (B. Braun) fluorescent alcohol-based gel remaining on students' hands after disinfection. The gel was rubbed into particular hand parts including four surfaces (left palm, right palm, left back and right back) divided into thirteen areas (I-XIII) and each surface was examined separately. The results were then dichotomized based on the cut-off point of 10% and two categories: "clean" and "dirty" were established. Additionally, the range of negligence in the disinfection procedure was assessed by counting the total number of the areas classified as "dirty". The comparison of continuous and categorical variables was conducted by means of Friedman's and Cochrane's tests, respectively.

RESULTS

It was found out that the palm surfaces that were commonly missed during hand disinfection included the whole thumb (I and VI), the fingertip of the little finger (V) and the midpalm (XIII), whereas in the case of back surfaces (on both right and left hand) the most commonly missed areas were the fingertips and the whole thumb I-VI. Only 30 students (13%) had all 52 areas of both hands completely clean, whereas more than one third-66 students (33%)-failed to disinfect properly more than 10 areas out of all assessed ones on the surfaces of both hands.

CONCLUSIONS

In the examined group of nursing students, a significant lack of compliance with hand disinfection procedures was observed and it was related mainly to thumbs and back parts of both hands. Therefore, it is essential to conduct systematic training sessions and assessment of hand hygiene procedures for nursing students at the end of every educational stage as it can lead to their developing these skills properly.