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Linnik L, Turan N, Polat Dünya C, Lahtinen K, Franck T, Valta M, Ayoğlu T, Akyüz N, Coutinho V, Paiva L, Brito I, Colomer-Pérez N, Giménez-Espert MDC, Buigues C, Cauli O. Association between Hand Hygiene Knowledge and Self-Efficacy in Nursing Students: A Multicenter Cross-Sectional Study within the Framework of the Erasmus Project. NURSING REPORTS 2024; 14:1973-1986. [PMID: 39189277 PMCID: PMC11348245 DOI: 10.3390/nursrep14030147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 08/28/2024] Open
Abstract
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.
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Affiliation(s)
| | - Nuray Turan
- Department of Fundamentals of Nursing, Faculty of Nursing, Istanbul University, 34116 Istanbul, Turkey;
| | - Cansu Polat Dünya
- Department of Internal Medicine Nursing, Faculty of Nursing, Istanbul University, 34116 Istanbul, Turkey;
| | - Kati Lahtinen
- Faculty of Health and Well-Being, Turku University of Applied Science, 20520 Turku, Finland; (K.L.); (T.F.); (M.V.)
| | - Teija Franck
- Faculty of Health and Well-Being, Turku University of Applied Science, 20520 Turku, Finland; (K.L.); (T.F.); (M.V.)
| | - Maija Valta
- Faculty of Health and Well-Being, Turku University of Applied Science, 20520 Turku, Finland; (K.L.); (T.F.); (M.V.)
| | - Tuluha Ayoğlu
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, 34381 Istanbul, Turkey; (T.A.); (N.A.)
| | - Nuray Akyüz
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, 34381 Istanbul, Turkey; (T.A.); (N.A.)
| | - Verónica Coutinho
- Escola Superior de Enfermagem de Coimbra & UICISA:E, 3046-851 Coimbra, Portugal; (V.C.); (L.P.); (I.B.)
| | - Luis Paiva
- Escola Superior de Enfermagem de Coimbra & UICISA:E, 3046-851 Coimbra, Portugal; (V.C.); (L.P.); (I.B.)
| | - Irma Brito
- Escola Superior de Enfermagem de Coimbra & UICISA:E, 3046-851 Coimbra, Portugal; (V.C.); (L.P.); (I.B.)
| | - Natura Colomer-Pérez
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (N.C.-P.); (M.d.C.G.-E.); (C.B.)
| | | | - Cristina Buigues
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (N.C.-P.); (M.d.C.G.-E.); (C.B.)
| | - Omar Cauli
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (N.C.-P.); (M.d.C.G.-E.); (C.B.)
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Arvidsson L, Skytt B, Lindberg M, Lindberg M. Nurses' assessed self-efficacy levels to medical asepsis and their relation to structural empowerment, work engagement and work-related stress. Work 2023; 74:501-513. [PMID: 36314182 PMCID: PMC9986691 DOI: 10.3233/wor-211305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/25/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Nurses' working conditions are important for their well-being at work and for their ability to provide patients with safe care. Self-efficacy can influence employees' behaviour at work. Therefore, it is valuable to study self-efficacy levels to medical asepsis in relation to working conditions. OBJECTIVE To investigate the relationship between nurses' assessed self-efficacy levels to medical asepsis in care situations and structural empowerment, work engagement and work-related stress. METHODS A cross-sectional study with a correlational design was conducted. A total of 417 registered nurses and licensed practical nurses at surgical and orthopaedic units responded to a questionnaire containing: the Infection Prevention Appraisal Scale, the Conditions of Work Effectiveness Questionnaire-II, the Utrecht Work Engagement Scale-9 and the Health & Safety Executive Management Standards Indicator Tool. Correlational analyses and group comparisons were performed. RESULTS The nurses rated high levels of self-efficacy to medical asepsis in care situations. The correlational analyses revealed that correlation coefficients between structural empowerment, work engagement, work-related stress and self-efficacy to medical asepsis were 0.254-0.268. Significant differences in self-efficacy were found in the grouped working conditions. CONCLUSIONS This study revealed that nurses rated high self-efficacy levels to medical asepsis and, to some extent, this seemed related to structural empowerment, work engagement and work-related stress. This valuable knowledge could enable improvements at the managerial and organisational levels, benefiting both nurses and patients in the long run.
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Affiliation(s)
- Lisa Arvidsson
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Bernice Skytt
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Maria Lindberg
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden
| | - Magnus Lindberg
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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Lamping J, Tomsic I, Stolz M, Krauth C, Chaberny IF, von Lengerke T. Do task and item difficulty affect overestimation of one's hand hygiene compliance? A cross-sectional survey of physicians and nurses in surgical clinics of six hospitals in Germany. Antimicrob Resist Infect Control 2022; 11:147. [PMID: 36461038 PMCID: PMC9716516 DOI: 10.1186/s13756-022-01188-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 11/24/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND One barrier to hand hygiene compliance is overestimation of one's own performance. Overconfidence research shows that overestimation tends to be higher for difficult tasks, which suggests that the magnitude of overestimation also depends on how it is assessed. Thus, we tested the hypothesis that overestimation was stronger for hand hygiene indications with low compliance (i.e., high difficulty), and the hypothesis that self-reported overall compliance based on a single item is higher than based on "5 Moments of Hand Hygiene" (WHO-5) items, since the single item implies an aggregation across indications. METHODS In the WACH trial (German Clinical Trials Register [DRKS] ID: DRKS00015502), a questionnaire survey was conducted among physicians and nurses in nine surgical clinics (general/visceral surgery or orthopedics/trauma surgery) of six German hospitals. Self-reported compliance was assessed both by a single item and the WHO-5-items using percentage scales. These were compared with each other and with direct observations. Relative frequencies of the WHO-5 indications used to calculate the WHO-5-based self-reported overall compliance rate were estimated by a systematized review of the literature (see appendix). In analysis, t-tests, Chi2-tests and multiple linear regressions were used. RESULTS Ninety-three physicians (response rate: 28.4%) and 225 nurses (30.4%) participated. Significant compliance differences between physicians and nurses were found for direct observations and were in favor of nurses, while no such differences were found for self-reports. Across the WHO-5, overestimation showed inverse correlations with observed compliance (physicians: r = -0.88, p = 0.049; nurses: r = -0.81, p = 0.093). Support for the hypothesis that the self-reported overall compliance based on one item is higher than that based on WHO-5 items was found for physicians (M = 87.2 vs. 84.1%, p = 0.041; nurses: 84.4 vs. 85.5%, p = 0.296). Exploratory analyses showed that this effect was confined to orthopedic/trauma surgeons (89.9 vs. 81.7%, p = 0.006). CONCLUSION Among physicians, results indicate stronger hand hygiene overestimation for low-compliance indications, and when measurements are based on a single item versus the five WHO-5 items. For practice, results contribute to infection prevention and control's understanding of overestimation as a psychological mechanism that is relevant to professional hand hygiene.
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Affiliation(s)
- Jonas Lamping
- Department of Medical Psychology, Center of Public Health and Health Care, Hannover Medical School, Hannover, Germany
| | - Ivonne Tomsic
- Department of Medical Psychology, Center of Public Health and Health Care, Hannover Medical School, Hannover, Germany
| | - Maike Stolz
- Institute of Epidemiology, Social Medicine and Health Systems Research, Center of Public Health and Health Care, Hannover Medical School, Hannover, Germany
| | - Christian Krauth
- Institute of Epidemiology, Social Medicine and Health Systems Research, Center of Public Health and Health Care, Hannover Medical School, Hannover, Germany
| | - Iris F Chaberny
- Institute of Hygiene, Hospital Epidemiology and Environmental Medicine, Interdisciplinary Center for Infectious Medicine, Leipzig University Hospital, Leipzig, Germany
| | - Thomas von Lengerke
- Department of Medical Psychology, Center of Public Health and Health Care, Hannover Medical School, Hannover, Germany.
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Davies R, Mowbray F, Martin AF, Smith LE, Rubin GJ. A systematic review of observational methods used to quantify personal protective behaviours among members of the public during the COVID-19 pandemic, and the concordance between observational and self-report measures in infectious disease health protection. BMC Public Health 2022; 22:1436. [PMID: 35902818 PMCID: PMC9330943 DOI: 10.1186/s12889-022-13819-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/11/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To assess the quantity and quality of studies using an observational measure of behaviour during the COVID-19 pandemic, and to narratively describe the association between self-report and observational data for behaviours relevant to controlling an infectious disease outbreak. DESIGN Systematic review and narrative synthesis of observational studies. DATA SOURCES We searched Medline, Embase, PsychInfo, Publons, Scopus and the UK Health Security Agency behavioural science LitRep database from inception to 17th September 2021 for relevant studies. STUDY SELECTION We included studies which collected observational data of at least one of three health protective behaviours (hand hygiene, face covering use and maintaining physical distance from others ('social distancing') during the COVID-19 pandemic. Studies where observational data were compared to self-report data in relation to any infectious disease were also included. DATA EXTRACTION AND SYNTHESIS We evaluated the quality of studies using the NIH quality assessment scale for observational studies, extracted data on sample size, setting and adherence to health protective behaviours, and synthesized results narratively. RESULTS Of 27,279 published papers on COVID-19 relevant health protective behaviours that included one or more terms relating to hand hygiene, face covering and social distancing, we identified 48 studies that included an objective observational measure. Of these, 35 assessed face covering use, 17 assessed hand hygiene behaviour and seven assessed physical distancing. The general quality of these studies was good. When expanding the search to all infectious diseases, we included 21 studies that compared observational versus self-report data. These almost exclusively studied hand hygiene. The difference in outcomes was striking, with self-report over-estimating observed adherence by up to a factor of five in some settings. In only four papers did self-report match observational data in any domains. CONCLUSIONS Despite their importance in controlling the pandemic, we found remarkably few studies assessing protective behaviours by observation, rather than self-report, though these studies tended to be of reasonably good quality. Observed adherence tends to be substantially lower than estimates obtained via self-report. Accurate assessment of levels of personal protective behaviour, and evaluation of interventions to increase this, would benefit from the use of observational methods.
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Affiliation(s)
- Rachel Davies
- National Institute of Health Research Health Protection Research Unit in Emergency Preparedness and Response at King's College London, in partnership with the UK Health Security Agency, London, UK.
| | - Fiona Mowbray
- National Institute of Health Research Health Protection Research Unit in Emergency Preparedness and Response at King's College London, in partnership with the UK Health Security Agency, London, UK
| | - Alex F Martin
- National Institute of Health Research Health Protection Research Unit in Emergency Preparedness and Response at King's College London, in partnership with the UK Health Security Agency, London, UK
| | - Louise E Smith
- National Institute of Health Research Health Protection Research Unit in Emergency Preparedness and Response at King's College London, in partnership with the UK Health Security Agency, London, UK
| | - G James Rubin
- National Institute of Health Research Health Protection Research Unit in Emergency Preparedness and Response at King's College London, in partnership with the UK Health Security Agency, London, UK
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Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion and occupational exposure of employees at a Swiss university hospital: A large longitudinal cohort study. Infect Control Hosp Epidemiol 2022; 43:326-333. [PMID: 33736734 PMCID: PMC8082127 DOI: 10.1017/ice.2021.117] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The dynamics of coronavirus disease 2019 (COVID-19) seroconversion of hospital employees are understudied. We measured the proportion of seroconverted employees and evaluated risk factors for seroconversion during the first pandemic wave. METHODS In this prospective cohort study, we recruited Geneva University Hospitals employees and sampled them 3 times, every 3 weeks from March 30 to June 12, 2020. We measured the proportion of seroconverted employees and determined prevalence ratios of risk factors for seroconversion using multivariate mixed-effects Poisson regression models. RESULTS Overall, 3,421 participants (29% of all employees) were included, with 92% follow-up. The proportion of seroconverted employees increased from 4.4% (95% confidence interval [CI], 3.7%-5.1%) at baseline to 8.5% [(95% CI, 7.6%-9.5%) at the last visit. The proportions of seroconverted employees working in COVID-19 geriatrics and rehabilitation (G&R) wards (32.3%) and non-COVID-19 G&R wards (12.3%) were higher compared to office workers (4.9%) at the last visit. Only nursing assistants had a significantly higher risk of seroconversion compared to office workers (11.7% vs 4.9%; P = .006). Significant risk factors for seroconversion included the use of public transportation (adjusted prevalence ratio, 1.59; 95% CI, 1.25-2.03), known community exposure to severe acute respiratory coronavirus virus 2 (2.80; 95% CI, 2.22-3.54), working in a ward with a nosocomial COVID outbreak (2.93; 95% CI, 2.27-3.79), and working in a COVID-19 G&R ward (3.47; 95% CI, 2.45-4.91) or a non-COVID-19 G&R ward (1.96; 95% CI, 1.46-2.63). We observed an association between reported use of respirators and lower risk of seroconversion (0.73; 95% CI, 0.55-0.96). CONCLUSION Additional preventive measures should be implemented to protect employees in G&R wards. Randomized trials on the protective effect of respirators are urgently needed.
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Bimerew M, Muhawenima F. Knowledge, attitudes, and practices of nurses towards hand washing in infection prevention and control at a psychiatric hospital. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kelčíková S, Mazúchová L, Malinovská N, Kopincová J, Tonhajzerová I. Evaluation of hand hygiene: Is university medical education effective in prevention of hospital-acquired infections? Cent Eur J Public Health 2021; 29:102-108. [PMID: 34245549 DOI: 10.21101/cejph.a6501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 04/19/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Hand hygiene (HH) compliance is associated with effective prevention of health care-associated infections (HAI), the topic being very important due to current COVID-19 pandemic. There is a growing debate about the role of educational institutions in the low HH compliance of health workers. This study aimed to assess HH knowledge, self-assessment and attitudes of medical students in relation to provided educational background. METHODS A cross-sectional survey (mixed methods-approach) combined with the curriculum analysis and questionnaires. Quantitative method: a questionnaire of knowledge of HH issues (QK), and a questionnaire of self-assessment and attitudes (SAQ) towards HH. Qualitative method focused on an analysis of content of the curriculum documents. RESULTS 250 (KQ) and 238 (SAQ) questionnaires were analysed from students of general medicine (n = 262; average age 22.5 years). Below-average knowledge of HH and a high self-assessment of knowledge and compliance with HH was reported by 72.2% and 76.0% of students, respectively. Significant differences in knowledge and self-assessment of HH were found among study years and gender. The content analysis has revealed gaps in HH-related information in general medicine educational programme. CONCLUSIONS It is highly expected that there might be some association between low HH knowledge level, false self-assessment and educational programme in medical students.
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Affiliation(s)
- Simona Kelčíková
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Lucia Mazúchová
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Nora Malinovská
- Department of Foreign Languages, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Jana Kopincová
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Ingrid Tonhajzerová
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
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Rezk F, Stenmarker M, Acosta S, Johansson K, Bengnér M, Åstrand H, Andersson AC. Healthcare professionals' experiences of being observed regarding hygiene routines: the Hawthorne effect in vascular surgery. BMC Infect Dis 2021; 21:420. [PMID: 33947338 PMCID: PMC8097954 DOI: 10.1186/s12879-021-06097-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/21/2021] [Indexed: 11/15/2022] Open
Abstract
Background The Hawthorne Effect is the change in behaviour by subjects due to their awareness of being observed and is evident in both research and clinical settings as a result of various forms of observation. When the Hawthorne effect exists, it is short-lived, and likely leads to increased productivity, compliance, or adherence to standard protocols. This study is a qualitative component of an ongoing multicentre study, examining the role of Incisional Negative Pressure Wound Therapy after vascular surgery (INVIPS Trial). Here we examine the factors that influence hygiene and the role of the Hawthorne effect on the adherence of healthcare professionals to standard hygiene precautions. Methods This is a qualitative interview study, investigating how healthcare professionals perceive the observation regarding hygiene routines and their compliance with them. Seven semi-structured focus group interviews were conducted, each interview included a different staff category and one individual interview with a nurse from the Department for Communicable Disease Control. Additionally, a structured questionnaire interview was performed with environmental services staff. The results were analysed based on the inductive qualitative content analysis approach. Results The analysis revealed four themes and 12 subthemes. Communication and hindering hierarchy were found to be crucial. Healthcare professionals sought more personal and direct feedback. All participants believed that there were routines that should be adhered to but did not know where to find information on them. Staff in the operating theatre were most meticulous in adhering to standard hygiene precautions. The need to give observers a clear mandate and support their work was identified. The staff had different opinions concerning the patient’s awareness of the importance of hygiene following surgery. The INVIPS Trial had mediated the Hawthorne effect. Conclusion The results of this study indicate that the themes identified, encompassing communication, behaviour, rules and routines, and work environment, influence the adherence of healthcare professionals to standard precautions to a considerable extent of which many factors could be mediated by a Hawthorne effect. It is important that managers within the healthcare system put into place an improved and sustainable hygiene care to reduce the rate of surgical site infections after vascular surgery. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06097-5.
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Affiliation(s)
- Francis Rezk
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden. .,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. .,Unit of Vascular Surgery, Department of Surgery, Region Jönköping County, Jönköping, Sweden.
| | - Margaretha Stenmarker
- Unit of Vascular Surgery, Department of Surgery, Region Jönköping County, Jönköping, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Department of Paediatrics, Institute of Clinical Sciences, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Stefan Acosta
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Karoline Johansson
- Unit of Vascular Surgery, Department of Surgery, Region Jönköping County, Jönköping, Sweden.,Department of Health, Medicine and Caring, Linköping University, Linköping, Sweden
| | - Malin Bengnér
- Unit of Vascular Surgery, Department of Surgery, Region Jönköping County, Jönköping, Sweden.,Department of Health, Medicine and Caring, Linköping University, Linköping, Sweden
| | - Håkan Åstrand
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Unit of Vascular Surgery, Department of Surgery, Region Jönköping County, Jönköping, Sweden
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Hand Areas Which Are Commonly Missed during Hand Disinfection by Nursing Students Who Completed a Basic Educational Course in Hand Hygiene. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052590. [PMID: 33807595 PMCID: PMC7967523 DOI: 10.3390/ijerph18052590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 11/16/2022]
Abstract
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.
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