Using a Multidimensional Approach to Improve Quality Related to Students’ Hand Hygiene Practice

Hand hygiene knowledge among nurses and nursing students-a descriptive cross-sectional comparative survey using the WHO's "Hand Hygiene Knowledge Questionnaire"

Aim

To determine the level of knowledge and explore the difference of hand hygiene between nursing students and nurses.

Background

Annually, 3.8 million people in Europe acquire healthcare-associated infections, highlighting the importance of hand hygiene. Despite WHO's emphasis on the fact that greater hand hygiene knowledge correlates with improved hand hygiene compliance, several studies have shown knowledge gaps among nurses and nursing students regarding hand hygiene.

Design

Descriptive cross-sectional comparative survey.

Methods

A version of the WHO "Hand Hygiene Knowledge Questionnaire", translated into Swedish, was used for data collection among nursing students in the first and last semester, and registered nurses from a university and associated hospital. Data were analyzed by descriptive statistics, and comparison between groups with Fisher's exact test, one-way ANOVA, and post-hoc tests (Pairwise Z-Tests, Tukey HSD).

Results

The survey, conducted between December 2020 and January 2021, received responses from 201 participants, including 71 first semester students, 46 last semester students and 84 registered nurses, showing moderate (55.7% [50-74% correct answers]) to good (43.8% [75-100% correct answers]) knowledge levels. First-semester students scored lower (17.0 ± 2.1) than last-semester students (18.8 ± 1.8) and registered nurses (18.3 ± 2.1) out of 25 questions.

Discussion

It is necessary for all groups to receive proper education on hand hygiene knowledge and to have an educational program that does not separate the groups but combines them with continuing education, since the students will someday be influencing future hand hygiene knowledge as a peer, together with the nurse.

Interventions to improve knowledge or compliance to hand hygiene in nursing students: A scoping review

Background

During their training process, nursing students carry out internships in different care settings, which implies direct contact with more than one patient simultaneously. Their hands represent a vehicle for transmitting pathogens that cause healthcare-related infections. Various interventions have been proposed to improve nursing students' knowledge or compliance to hand hygiene. However, the information on these interventions is scattered in the literature.

Objectives

This study was conducted to identify and describe the interventions to improve knowledge or compliance to hand hygiene in nursing students evaluated in the scientific literature.

Methods

The scoping review methodology guided by the Joanna Briggs Institute (JBI) was adopted. Screening and data extraction were performed by two reviewers using templates developed by the authors.

Results

Thirteen studies were included. Education and training were highlighted as the central core components for interventions. The duration ranged from 15 min to 1 week. The number of sessions varied between one to three sessions. The content was based mainly on the recommendations of the World Health Organization and the Centers for Disease Control and Prevention (CDC).

Conclusions

There is a limited body of interventions to improve knowledge or compliance to the hand hygiene technique in nursing students. Education and training were highlighted as the central core components for interventions. New primary studies are needed and should include a description in detail of the characteristics of the interventions.

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.

Infection Concept Integration and Teaching Strategies in US Baccalaureate Nursing Programs in an Era of Concept-Based Curriculum

BACKGROUND

Health care-associated infections remain a major patient safety problem. Antibiotic resistance and the resurgence of infectious diseases pose an escalating threat to public health. It is essential for nursing students to develop an understanding of the infection concept and the ability to apply their knowledge and skills in all settings.

PURPOSE

The purpose was to describe the integration of the infection concept and associated teaching strategies in US baccalaureate nursing programs.

METHODS

A comprehensive literature review was conducted using multiple online databases.

RESULTS

There is some evidence of infection concept integration within single courses but limited evidence of integration across courses. We were unable to ascertain the degree of infection concept integration throughout a curriculum. Faculty used a blend of creative, innovative strategies to foster active teaching and learning.

CONCLUSION

The concept of infection and the related teaching strategies used to help students organize infection-related knowledge, skills, and attitudes to form logical connections needs greater attention.

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.