Examining the hand hygiene beliefs and practices of nursing students and the effectiveness of their handwashing behaviour

Hand Hygiene Compliance and Its Associated Factors Among Health Care Workers at Mogadishu Somali Turkiye Recep Tayyip Erdoğan Training and Research in a Tertiary Care Hospital

Background

Hand hygiene is a critical preventive measure for controlling infections, particularly in underdeveloped nations.

Materials and Methods

A cross-sectional study was conducted in a hospital in Mogadishu, Somalia, from January to March 2024. This study aimed to assess compliance with hand hygiene practices and related factors among healthcare professionals.

Results

The study population comprised 52% men and 47.3% women. Most participants held bachelor's degrees, with the majority being nurses or midwives. A significant proportion had over five years of work experience. Almost all participants were knowledgeable about hand hygiene. Most reported cleaning and drying their hands before, during, and after contact with bodily fluids during aseptic procedures. Age, gender, educational status, marriage, working experience, type of occupation, receiving hand hygiene training and knowledge, and having the availability of water, soap, alcohol, and gloves significantly affected the overall uptake of infection control measures in Mogadishu (p<0.05).

Conclusion

The findings highlight an urgent need for targeted interventions to enhance hand hygiene practices in Somalia. Addressing training gaps and resource shortages is crucial for reducing infection rates and safeguarding patient health in this high-risk setting.

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.

The behaviours identified and the behaviour change techniques planned in health partnerships for antimicrobial stewardship

Antimicrobial stewardship (AMS) interventions promote optimised use of antimicrobials by healthcare professionals. In 2019-2020, the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) supported 12 global health partnerships in low- and middle-income countries to co-develop education and training interventions to improve AMS practices amongst hospital staff. This study aimed to describe six of the CwPAMS health partnerships' target behaviours and behaviour change techniques (BCTs) within their planned AMS interventions. Content analysis extracted behaviours and BCTs from partnership materials. Techniques used by partnerships with (n = 2) and without (n = 4) an embedded behavioural scientist were compared, to understand their added value. Nineteen AMS related behaviours for hospital staff were targeted; most commonly hand hygiene and antibiotic prescribing behaviours. Twenty-three BCTs were coded, with instructing participants on how to perform the behaviours the most prominent across all, including partnerships with a behavioural scientist. Intervention materials did not always report the context of the intervention being delivered, including who was delivering it and the target. Behaviours for change were also often not specified. Partnerships varied in reporting their content and specific behaviours, impacting replicability of their interventions, and limiting knowledge exchange. An AMS behaviour change intervention resource is recommended to support clear specification of prospective AMS interventions.

Use of ultraviolet light in graduate medical education to assess confidence among residents and fellows in handwashing instruction

BACKGROUND

Coronavirus disease 2019 (COVID-19) has made it imperative to focus on strategies to improve hand hygiene to minimize threats of viral transmission in hospitals.

OBJECTIVE

We investigated the potential of using ultraviolet (UV) light as a visual tool in hand-hygiene education to bring awareness of individual handwashing effectiveness to healthcare workers.

METHODS

In 2020, 117 individuals participated in the simulation and completed surveys on proper handwashing technique. Of these, 114 were first-year residents and fellows. Surveys of confidence in hand hygiene were obtained before and after formal hand-hygiene education utilizing UV light with Glo Germ lotion. The UV light and Glo Germ lotion were used to identify deficiencies in individual handwashing technique.

RESULTS

With a total response rate of 97.4%, first-year residents and fellows demonstrated a significant decrease in handwashing confidence in pre- and posteducation surveys. Study participants who had had formal hand-hygiene training in the previous 3 years also indicated confidence in hand hygiene similar to those who had not had previous hand-hygiene training. Conclusions: Overall, resident interns and fellows may have falsely elevated their hand-hygiene confidence levels. However, conclusions regarding the confidence of residents and fellows individually could not be made due to sample size. Many healthcare personnel practice improper handwashing techniques, which may be improved with education and training that includes UV light.

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.

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

BACKGROUND

Hand hygiene is the most effective and simplest infection control method but there is a considerable amount of evidence that shows hand hygiene skills of nursing students should be improved. Nursing education plays an important role in giving nursing students the necessary knowledge, beliefs and teaching and improving basic hand hygiene skills. An effective learning method that enables students to understand both the practical skills and the underlying theoretical principles should be used in teaching hand hygiene.

OBJECTIVES

The aim of this study was to compare the effects of a fluorescent concretization intervention and conventional education on improving the hand hygiene beliefs and skills of nursing students.

DESIGN AND SETTING

This double blinded pretest-posttest randomized controlled trial was carried out from January 1 to June 1, 2019 with the participation of 126 nursing students in a faculty of health science in a state university in Turkey.

METHODS

The participants were randomly assigned to an intervention group (n = 63), receiving education with a fluorescent concretization intervention, and a control group (n = 63) receiving conventional education.

RESULTS

There was a significant difference between the intervention and control groups in terms of the total post-test hand hygiene belief score (p = .016 effect size(r) = 0.214). The final handwashing skill score of the students in the intervention group increased significantly for the seven regions of hands (p < .001 effect size(r) = 0.863). In addition, final handwashing skill score in the intervention group (20.62 ± 4.07) was found to be significantly higher than that of the students in the control group (12.57 ± 2.85) (p < .001 effect size(r) = 0.805).

CONCLUSION

Hand hygiene training which includes visual concretization intervention with glo germ can be used as a useful strategy to improve nursing students' negative beliefs about hand hygiene and to gain students to effective handwashing behaviors.