Hand hygiene of nursing and midwifery students in Cambodia

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.

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.