Self-efficacy of health professionals in hand hygiene practice: is it possible to measure?

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.

Development of Respiratory Infection Prevention and Control Self-Efficacy Scale for Adults

Purpose

This study aimed to develop a scale for respiratory infection prevention and control self-efficacy (R-PACS) to measure self-efficacy in the prevention and control of the spread of respiratory infections among adults and to confirm the applicability of the developed scale by testing its validity and reliability.

Methods

This methodological study was conducted in two phases. During the first phase, the R-PACS scale was developed after conducting a thorough literature review, content validity, and a pilot test. In the second phase, its validity and reliability were verified against 210 university students in Korea. The criterion validity of the developed R-PACS scale was tested using the correlation with resilience scale. Item analysis, explanatory factor analysis, and convergent and discriminant validity analyses were conducted in order to verify construct validity. Furthermore, Cronbach's α was used to verify internal consistency reliability.

Results

The final version of the R-PACS scale comprises 4 factors and 16 items rated on a 5-point Likert scale. Higher scores are interpreted as higher levels of self-efficacy in the prevention and control of respiratory infection. The R-PACS scale exhibited good content validity, construct validity, criterion validity, and reliability. The correlation coefficient of the four factors was ≥.4, confirming the validity of item convergence; meanwhile, the Cronbach's α coefficient for the final 16 items of the developed scale was 0.923, verifying reliability. This scale consists of four factors: "environmental management", "contact restrictions", "general infection prevention and control", and "early detection".

Conclusion

The applicability of the R-PACS scale exhibited acceptable validity and reliability. This scale can be utilized to assess and evaluate the degree of self-efficacy in the prevention and control of respiratory infections among adults. Data obtained using this scale can be utilized for preparing health behavior change and health promotion programs, and practical policies for preventing respiratory infections.

Navigating a Pandemic: Leadership Dynamics and Challenges within Infection Prevention and Control Units in Israel

This study investigates the impact of the coronavirus disease 2019 (COVID-19) pandemic on leadership within infection prevention and control (IPC) units across public hospitals in Israel. Through qualitative interviews with ten IPC managers from nine hospitals, equivalent to 30% of the country's acute care facilities, the research uncovers significant changes in managerial approaches due to the health crisis. The results reveal four main themes: (1) Enhanced managerial autonomy and leadership skills, with a noted rise in self-efficacy against the pandemic's backdrop; (2) Shifted perceptions of IPC units by upper management, recognizing their strategic value while identifying the need for a more profound understanding of IPC operations; (3) The increased emphasis on adaptability and rapid decision-making for effective crisis management; (4) The dual effect on job satisfaction and well-being, where greater commitment coincides with risks of burnout. The study underscores the essential nature of effective IPC leadership during emergencies, highlighting the need for clear communication, prompt action, and empathetic leadership. The conclusions point to the necessity for continuous research into IPC leadership, promoting strategic advancements in management to bolster IPC units against future health threats.

Development and Validation of the Infection Prevention Appraisal Scale

It has been emphasized that future studies aimed at improving adherence to infection prevention guidelines should focus on beliefs in, e.g., self-efficacy. Reliable situation specific measures are needed to measure the phenomenon of self-efficacy, but there seems to be few valid scales available that are suitable for measuring one's belief in self-efficacy regarding infection prevention measures. The purpose of the study was to develop a unidimensional appraisal scale to capture nurses' beliefs in their abilities to practice medical asepsis in care situations. When creating the items, evidence-based guidelines for preventing healthcare-associated infections were used together with Bandura's guide for constructing self-efficacy scales. Face validity, content validity, and concurrent validity were tested in various samples of the target population. Furthermore, dimensionality was evaluated on data collected from 525 registered nurses and licensed practical nurses recruited from the medical, surgical, and orthopaedic wards of 22 Swedish hospitals. The Infection Prevention Appraisal Scale (IPAS) consists of 14 items. Face and content validity were endorsed by target population representatives. The exploratory factor analysis suggested unidimensionality, and the internal consistency was good (Cronbach's alpha 0.83). The total scale score correlated with the General Self-Efficacy Scale, as expected, and supported concurrent validity. The Infection Prevention Appraisal Scale demonstrates sound psychometric properties supporting a unidimensional measure of self-efficacy to medical asepsis in care situations.

Measuring the Self-Efficacy of Health Professionals for Practicing Hand Hygiene and Using Gloves: Development and Validation of an Instrument

Adherence to hand hygiene procedures and the use of gloves is a problem that deserves to be analyzed from an individual and organizational point of view. For this, we aim to develop and validate an instrument for measuring the self-efficacy of health professionals for practicing hand hygiene and using gloves. We evaluated the metric properties of validity and reliability for measuring the self-efficacy of health professionals for practicing hand hygiene and using gloves. Fifteen health and education professionals formed the judges committee to construct the instrument for measuring the self-efficacy of health professionals for practicing hand hygiene and using gloves. Moreover, 362 nursing professionals participated in this study that was carried out from 2017 to 2020. The construct validity by known groups was confirmed by comparing the means of self-efficacy of the self-efficacy of health professionals for practicing hand hygiene and using gloves with the variables sex and unit of activity. The convergent construct validity showed a weak correlation between the scores of the self-efficacy of health professionals for practicing hand hygiene and using gloves instrument, and the perceived general self-efficacy scale. This instrument is easy to apply and can be used in the assessment of behavioral determinants, regarding hand hygiene and the use of gloves, in other health professionals, considering the generalization and scope of the items.

Hygiene-related knowledge, attitude and practice: An imperative study among primary caregivers of the under three aboriginal children in Malaysia

BACKGROUND

Parental and caregivers' hygiene-related knowledge, attitude and practice are compelling factors in the prevention of stunting and malnutrition among the aboriginal children in Malaysia, which are highly modifiable. This study was conducted to explore the knowledge, attitude and practice related to hygiene among primary caregivers of the under three aboriginal (known as Orang Asli) children community in Malaysia.

METHODS

A total of 166 primary caregivers of the under three children of the aboriginal community in Kuala Langat district, Selangor were recruited. Data related to caregivers', child's and environmental factors were collected using a validated and reliable questionnaire, with knowledge, attitude and practice being the dependent variables. IBM Statistical Package for Social Science (SPSS) version 25.0 was used to analyse the data. Pearson's correlation was conducted to identify the relationship between continuous data. Multiple linear regression analysis was performed to determine the relationship between knowledge, attitude and practice related to hygiene, as well as the predictors.

RESULTS

The mean scores for knowledge, attitude and practice related to hygiene were 6.91 (2.12), 23.67 (3.16), 29.97 (3.55) and 43.05 (4.41), respectively. Significant moderate positive correlations were found between attitude and hygiene practice (r = 0.445, P < 0.001). Self-efficacy was significantly correlated with attitude (r = 0.442, P < 0.001) and practice (r = 0.557, P < 0.001), with every unit increase in self-efficacy will predict 0.281 and 0.536 increase in attitude (B = 0.281, 95% CI: 0.126-0.435) and practice (B = 0.536, 95% CI: 0.348-0.725) scores respectively.

CONCLUSION

Moderate mean scores for hygiene related knowledge, attitude and practice were observed in this study, with self-efficacy being a significant predictor for both hygiene-related attitude and practice but not knowledge. The self-efficacy of the caregivers should be sustained through continuous health education and counselling, to ensure improved hygiene practice. Future related research should consider the mediating role of self-efficacy on attitude and practice.