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

Impact of and strategies to address negative role models and adherence of nursing students to standard precautions: An integrative review

BACKGROUND

Negative role models can significantly impact nursing students' adherence to standard infection control precautions (SP) but there has been limited research on impacts and relevant strategies.

PURPOSE

This review examined the impact of negative role models on nursing students' adherence to SP and explored strategies that nursing instructors could use to help students effectively manage the influence of negative role models.

METHODS

An integrative review was conducted, guided by Whittemore and Knafl's methodology (2005). PubMed, CINAHL, and Scopus were searched for articles from 2008-2023. Research studies were critically appraised using appropriate tools.

RESULTS

Fourteen articles met the inclusion criteria and were included in this review. The literature indicates that nursing students frequently encounter negative role models during their clinical placements and that such negative encounters detrimentally impact their adherence to SP. Five strategies to potentially mitigate the impact of negative role models were identified.

CONCLUSION

To address the issue of negative role models, nursing instructors can help students learn specific strategies to manage encounters with negative role models, promote discussion of role modeling with students and clinical staff, and act as role models themselves. Further research is needed to inform specific strategies.

Association between Hand Hygiene Knowledge and Self-Efficacy in Nursing Students: A Multicenter Cross-Sectional Study within the Framework of the Erasmus Project

Adherence to hand hygiene procedures is crucial for all populations, and the World Health Organization (WHO) has implemented specific guidelines for infection control. Frequent and correct hand hygiene can prevent infections, but non-compliance with hand hygiene is pervasive. Nursing students address this issue from the beginning of their training. In nursing training, self-efficacy is crucial in enhancing students' competence, motivation, and clinical performance. We performed a cross-sectional multicenter study in five European countries, with a cross-sectional design with an online application of an instrument measuring hand hygiene knowledge based on WHO guidelines and general self-efficacy and specific self-efficacy for infection control. A total of 638 first-year nursing students participated in this study. The mean percentage of correct answers was 67.9%, with a considerable difference depending on the items. The worst results were obtained for questions related to sources of infection and types of hand hygiene methods in different situations. Finnish students displayed significantly (p < 0.001) higher scores in HH knowledge, whereas Estonian students had significantly (p < 0.001) higher levels of self-efficacy. There were significant correlations between the hand hygiene knowledge score and the self-efficacy score (p < 0.001). A multivariate analysis by linear regression analysis showed significant associations between the hand hygiene knowledge survey score and the students' age (p < 0.001, OR = 0.18, 95% CI 0.04-0.10), as well as their country of origin (p = 0.01, OR = 0.09, 95% CI 0.03-0.34). HH knowledge is quite low among nursing students, and is correlated with self-efficacy, although the strongest predictors are age and country of origin. Different nursing curricula must favor HH knowledge, with varying degrees of emphasis depending on the country.

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.

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.

Health Science Students' Perceptions of Hand Hygiene Education and Practice in a South African University: Introducing the University Hand Hygiene Improvement Model

Hand hygiene serves as a critical preventative measure against the spread of acquired infections in healthcare facilities and is an integral component of patient safety programs. While healthcare students in training are typically introduced to the principles underlying hand hygiene, the translation of this understanding into practice is often lacking, and compliance has remained low. This study aimed to evaluate health science students' in biomedical sciences, chiropractic and emergency medical care, environmental health, complementary medicine, medical imaging and radiation sciences, nursing, optometry, podiatry, and sports and movement studies perceptions regarding hand hygiene education (knowledge and attitude) and practice at a university in South Africa. Consenting students were asked to complete an online questionnaire that tested their knowledge, practices, and skills in handwashing. The ANOVA analysis results suggested significant differences in hand hygiene scores across departments and years of study. The multiple regression analyses confirmed these findings, suggesting that the department of study significantly influenced all aspects of hand hygiene, while the year of study affected hand hygiene skills, and age group influenced hand hygiene practices. Based on these findings, a conceptual model, the University Hand Hygiene Improvement Model (UHHIM), was proposed to enhance the teaching and learning of hand hygiene at the university level. The model underscores the necessity of targeted education, continuous monitoring, and feedback, and the pivotal roles of hand hygiene facilitators and student participation in enhancing hand hygiene behaviors.

Nursing Students' Medication Administration: A Focus on Hand Hygiene and Patient Identification

BACKGROUND

Procedural failures during medication administration include a lack of appropriate hand hygiene and failure to verify patient identification prior to administration of medication. Procedural failures are common among nurses and nursing students and can lead to serious patient harm.

METHOD

A descriptive cross-sectional research design was used to collect observational data from a simulation-based experience of a medication administration scenario.

RESULTS

Thirty-five senior baccalaureate nursing students from two geographically distant universities in the United States participated in the study. All of the participants made at least one procedural failure during the simulated experience. Hand hygiene compliance was 40.3%, and patient identification compliance was 43.8%.

CONCLUSION

Students often failed to comply with medication administration safety guidelines. Nursing programs must make changes to the methods used to teach safe medication administration to prepare students for this critical skill. [J Nurs Educ. 2023;62(7):403-407.].

Hidden power of affective products and environments

BACKGROUND: Designs that evoke fun and surprise have been successful in driving uncommon positive behavior. Affective design (AD) is based on the premise that products and services can elicit strong affective responses that can be harnessed for specific purposes such as increasing consumption. OBJECTIVE: This paper aims to discuss the theoretical foundations and applications of AD to address contemporary consumption, recycling, and healthcare issues. METHODS: Current applications of AD to address environmental and health issues were analyzed in terms of effectiveness in changing user behavior. Relevant concepts were used to provide future research directions in this field. RESULTS: Early applications of AD focused on designing products to increase customer satisfaction and stimulate consumption. The method, however, is auspicious in solving relevant societal and global problems. To pave the way for successful integration of AD, one research direction is the need to identify the right emotion to elicit in a certain context. There is a dearth of literature to promote sustainable consumption, such as using less energy, minimizing carbon footprint, or just taking care of the environment using AD. CONCLUSION: The integration of AD is a strategy that can be used to prompt behavior beneficial to society and the environment. Literature on AD suggests that a deliberate effort to manipulate design factors can work to elicit strong affective responses.

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.

Knowledge, Perception, and Performance of Hand Hygiene and Their Correlation among Nursing Students in Republic of Korea

Recently, various outbreaks of newly emerging or reemerging diseases are expected more frequently and regularly. The importance of hand hygiene (HH) competency of nursing students (NS) is further required as a crucial learning objective of nursing education in universities. Purpose: This study aimed to investigate knowledge, perception, and performance of HH among NS and analyze their correlation. Methods: A cross-sectional questionnaire (modified from a World Health Organization questionnaire) was conducted from 23 November to 22 December 2019; 233 responses were used for the final analysis. Results: The average scores (mean ± standard deviation (range)) for knowledge, perception, and performance of HH were 17.82 ± 2.15 (0–25), 77.24 ± 10.78 (15–96), and 67.42 ± 23.10 (0–100), respectively. No significant variables were discovered to the knowledge of HH. Grade, university-affiliated hospitals, and the most recent healthcare institute of clinical practice nursing course significantly affected perceptions of HH (p < 0.039, p = 044, p < 0.001). Knowledge of HH was positively correlated with performance of HH (p = 0.002). The perception and the performance of HH of NS were positively correlated with HH performance of healthcare workers (HCWs); p < 0.001, p = 0.002. Conclusion: HH education for NS is crucial for improving the performance and the knowledge of HH. Good HH performance of healthcare workers (HCWs) can contribute to increased perception and performance of HH among NS. The cooperation of nursing education in a university and clinical practice with competent HCWs in healthcare institutions may create an effective education program for good HH performance of NS, who will be nurses during unpredictable pandemics.

Undergraduate nursing students' education and training in aseptic technique: A mixed methods systematic review

AIM

To appraise and synthesize empirical studies exploring undergraduate nursing students' education and training in aseptic technique.

DESIGN

Mixed methods, systematic literature review adopting Joanna Briggs Institute methodology.

DATA SOURCES

Thirteen electronic databases were searched 1996-2020, followed by searches with a general browser, hand-searching key journals and reviewing reference lists of retrieved papers.

REVIEW METHODS

Potentially eligible papers were scrutinised by two reviewers. Those eligible were critically appraised and quality assessed using the Critical Appraisal Skills Programme and Specialist Unit for Review Evidence checklists.

RESULTS

Of 538 potentially eligible studies, 27 met the inclusion criteria. There was limited evidence of the effectiveness of different teaching methods. Students' knowledge, understanding and competency varied and were often poor, although they reported confidence in their ability to perform aseptic technique. Students and qualified nurses perceived that education and training in aseptic techniques might be improved.

CONCLUSION

Education and training in aseptic technique might be improved but the review findings should be viewed cautiously because the studies lacked methodological rigour.

IMPACT

This appears to be the first systematic review to explore undergraduate nursing students' education and training in relation to aseptic technique. There was limited evidence to support the effectiveness of different teaching methods and scope for improving nursing students' knowledge, understanding and competency in aseptic technique. Students and qualified nurses suggested that education and training might be enhanced. More robust studies are required to support education, practice and policy.