Standard precautions and infection control, medical students' knowledge and behavior at a Saudi university: the need for change

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.

A multi-institute, follow-up, observational study measuring nursing students' adherence to infection prevention and control protocols in Saudi Arabia

Background

Nursing students learn principles of infection prevention and control (IPC) and hand hygiene (HH) in clinical courses, and their learning is reflected in their practice.

Objectives

The knowledge, attitude, and practice of principles of IPC and HH of the students were measured prior to and after attending an educational workshop. The adherence of the students to the IPC and HH protocols at the hospital was also observed.

Methods

This study included a pretest-posttest time series follow-up and an observational part. During the first part of the study, students attended a workshop, which was preceded by a pretest. It was then followed by a posttest directly after finishing the workshop and in 12 weeks. Participants were submitted to an observational part by a trained observer to document certain skills taught earlier during the workshop.

Settings

Students from three nursing schools in Saudi Arabia participated in the study.

Participants

A total number of 130 completed the study protocol, and 100 completed the observation part.

Results

Students were found to experience an improvement in their knowledge, beliefs, and commitment scales after the workshop. The attitude scale remained relatively unchanged over different tests. Most students performed the skills properly and adequately, but some failed to perform certain skills, like hand rub, and the proper use of disinfectants.

Knowledge, Attitude, Practice, and Perceived Barriers for the Compliance of Standard Precautions among Medical and Nursing Students in Central India

OBJECTIVES

The aim of this study was to assess and compare (a) the knowledge, attitude, and practice of standard precautions (SPs), (b) the knowledge of post-exposure management, and (c) the perceived barriers underlying the noncompliance with SPs among future healthcare professionals (HCPs), i.e., students of medical and nursing courses in Central India.

SETTING AND PARTICIPANTS

A cross-sectional study was conducted in 2017-2018 among students of a medical and a nursing college using a pretested and modified questionnaire. Data were collected during 23 face-to-face sessions. Responses were scored according to standard guidelines of the Centers for Disease Control and Prevention and WHO, where each correct response was given a score of 1.

RESULTS

Among 600 participants, 51% of medical students and 75% of nursing students could not select the correct definition of SPs from the given options. Sixty-five percent of medical students (275/423) and 82% of nursing students (145/177) were unaware of the term post-exposure prophylaxis. Overall, knowledge about personal protective equipment and hazard symbols was poor (<25%). Furthermore, although theoretical knowledge about hand hygiene was good (510/600; 85%), its implementation was poor (<30%). Sixty-four percent of participants believed that the use of hand rub replaced the need for handwashing, even for visibly soiled hands. Some of the participants believed that the use of PPE might offend patients (16%). High workload and poor knowledge were other significant barriers underlying the noncompliance with SPs.

CONCLUSIONS

A suboptimal translation of participants' knowledge into practice is evident and signifies the presence of the know-do gap. Poor knowledge and inappropriate presumptions about the use of SPs discourage the practice of SPs. This results in increased healthcare-associated infections, increased treatment costs, and a suppressed social economy. The inclusion of a dedicated curriculum with repeated hands-on and practice-based training on SPs is suggested to minimize this know-do gap among future healthcare workers.

Infection control knowledge and practices among radiographers at government hospitals in the Gaza Strip-Palestine: A cross-sectional study

INTRODUCTION

Infections acquired in hospitals are a major concern for patients, professionals and policymakers. They have an impact on the morbidity and mortality rates, length of stay, and microbial resistance. Radiology departments are at high risk for nosocomial infections, and radiographers must adhere to infection control protocols to avoid contracting illnesses and the spread of pathogens. The purpose of this study was to assess radiographers' knowledge and practise of infection control and standard precautions in the Gaza Strip-Palestine government hospitals and to identify the factors that impede radiographers' implementation of infection control.

METHODS

A hospital-based descriptive cross-sectional study design was applied. A self-administered questionnaire survey with 24 items was developed and distributed to examine radiographers' knowledge and practise of nosocomial infections control and standard precautions from September 2019 to February 2020. Descriptive and inferential statistics were generated using SPSS version 20.

RESULTS

With a response rate of 86.6%, 73 males and 37 females out of a total of 127 radiographers participated in this study. The vast majority of radiographers, 86 (78.2%), have never been trained in infection control. Total levels of knowledge and practise were 74.4% and 65.2%, respectively which corresponded to moderate levels. Age had a statistically significant impact on both knowledge and practise scores (P = 0.002 and p = 0.019, respectively). In addition, the differences between radiographers' years of work experience and their ratings on knowledge and practise were statistically significant (P = 0.001 and p = 0.011, respectively). A heavy workload, insufficient time, and a lack of training were the main barriers to implementing infection control measures in hospitals.

CONCLUSION

Palestinian radiographers reported a moderate level of knowledge and practise of infection control. The majority of radiographers have never had formal infection control training.

IMPLICATIONS FOR PRACTICE

This paper has highlighted the need for a continuing education and training programme for practising radiographers to improve their performance in infection control measures.

A Simulation-based PPE orientation training curriculum for novice physicians

Background

Personal protective equipment (PPE) is effective in preventing coronavirus disease (COVID-19) infection. Resident knowledge of proper use and effective training methods is unknown. We hypothesise that contamination decreases and knowledge increases after a formalised PPE educational session.

Methods

Participants included first year interns during their residency orientation in June 2020. Before training, participants took a knowledge test, donned PPE, performed a simulated resuscitation, and doffed. A standardised simulation-based PPE training of the donning and doffing protocol was conducted, and the process repeated. Topical non-toxic highlighter tracing fluid was applied to manikins prior to each simulation. After doffing, areas of contamination, defined as discrete fluorescent areas on participants' body, was evaluated by ultraviolet light. Donning and doffing were video recorded and asynchronously rated by two emergency medicine (EM) physicians using a modified Centers for Disease Control and Prevention (CDC) protocol. The primary outcome was PPE training effectiveness defined by contamination and adherence to CDC sequence.

Results

Forty-eight residents participated: 24 internal medicine, 12 general surgery, 6 EM, 3 neurology, and 3 psychiatry. Before training, 81% of residents were contaminated after doffing; 17% were contaminated after training (P<0.001). The most common contamination area was the wrist (50% pre-training vs. 10% post-training, P<0.001). Donning sequence adherence improved (52% vs. 98%, P<0.001), as did doffing (46% vs. 85%, P<0.001). Participant knowledge improved (62%-87%, P <0.001). Participant confidence (P<0.001) and preparedness (P<0.001) regarding using PPE increased with training.

Conclusion

A simulation-based training improved resident knowledge and performance using PPE.

Promotion of knowledge, attitude, and practice among medical undergraduates regarding infection control measures during COVID-19 pandemic

Background

Medical students are exposed to many serious healthcare-associated infections throughout their learning and training time particularly during a pandemic like COVID-19. Therefore, promotion of their knowledge, attitude, and practice regarding infection control measures is a mandatory action.

Objective

This study was executed to evaluate the knowledge, attitude, and practice of medical undergraduates toward infection control measures before and after the implementation of practical infection control training for them.

Methods

A quasi-experimental prospective study was conducted on a simple random sample of medical undergraduates at Al-Qunfudah College of Medicine, Umm Al-Qura University, KSA. A total of 177 medical undergraduates were recruited for this study and completed a predesigned survey on their knowledge regarding infection control measures. Moreover, their practice of infection control measures was evaluated through a checklist before and 6 months after receiving practical infection control training during their academic year 2020-2021.

Results

A total of 177 and 176 responses were obtained at the pre-test and post-test, respectively. The mean ages of students who participated in pre-training and post-training assessments were (22.50 ± 1.02 and 22.03 ± 1.34), respectively with female sex predominance (62.1 and 61.9%). Mean knowledge and practice scores among them were enhanced from (7.79 ± 2.10 and 4.56 ± 2.58) at their pre-test to (11.06 ± 1.27 and 15.68 ± 1.90) at post-test (P-value 0.001 and <0.001), respectively. After training, almost all of them recommended infection control training for all medical students due to its great value.

Conclusion

The training course has shown its capability in the promotion of medical undergraduates' knowledge, attitude, and practice toward infection control measures.

Testing the efficacy and acceptability of video-reflexive methods in personal protective equipment training for medical interns: a mixed methods study

OBJECTIVES

To test the efficacy and acceptability of video-reflexive methods for training medical interns in the use of personal protective equipment (PPE).

DESIGN

Mixed methods study.

SETTING

A tertiary-care teaching hospital, Sydney, January 2018-February 2019.

PARTICIPANTS

72 of 90 medical interns consented to participate. Of these, 39 completed all three time points.

INTERVENTIONS

Participants received a standard infection prevention and control (IPC) education module during their hospital orientation. They were then allocated alternately to a control or video group. At three time points (TPs) over the year, participants were asked to don/doff PPE items based on hospital protocol. At the first two TPs, all participants also participated in a reflexive discussion. At the second and third TPs, all participants were audited on their performance. The only difference between groups was that the video group was videoed while donning/doffing PPE, and they watched this footage as a stimulus for reflexive discussion.

PRIMARY AND SECONDARY OUTCOME MEASURES

The efficacy and acceptability of the intervention were assessed using: (1) comparisons of audit performance between and within groups over time, (2) comparisons between groups on survey responses for evaluation of training and self-efficacy and (3) thematic analysis of reflexive discussions.

RESULTS

Both groups improved in their PPE competence over time, although there was no consistent pattern of significant differences within and between groups. No significant differences were found between groups on reported acceptability of training, or self-efficacy for PPE use. However, analysis of reflexive discussions shows that the effects of the video-reflexive intervention were tangible and different in important respects from standard training.

CONCLUSIONS

Video reflexivity in group-based training can assist new clinicians in engagement with, and better understanding of, IPC in their clinical practice. Our study also highlights the need for ongoing and targeted IPC training during medical undergraduate studies as well as regular workplace refresher training.

Knowledge And Judgments About Standard Precautions For Nosocomial Infection: Comparative Analysis Of Medical Vs. Non-Medical Students

Background — Nosocomial infection (NI) is among the most common and serious challenges in a healthcare system. Health workers and medical students play an important role in prevention of NI. Despite advances in the field of medicine in Kazakhstan, low detection rate of NIs remains unchanged, which could be due to a lack of awareness of the standard precautions for infection control among medical students and health workers. This study is aimed at examining knowledge and judgments on NIs among medical and non-medical students. Material and Methods — We conducted a cross-sectional paper-based survey to examine the knowledge and judgments about the standard precautions for NI among medical and non-medical students. Data collection took place between September 21 and December 20, 2017. Results — The study enrolled 2,817 students. The mean overall score (±SD) was 2.045±1.29. Medical students had a better mean overall score (2.113) than non-medical students (1.785; p<0.001). Awareness of the standard preventive measures was increasing with a year of study, but still just one-third of year 5 medical students were aware of standard prevention (36.3% vs. 17.4% for non-medical students; p<0.001). Conclusion — The overall score of our survey indicated inadequate knowledge and awareness of the guidelines on infection prevention and control among both medical and non-medical students. In order to improve patient safety and welfare, the courses on infection control should be introduced into the curricular of medical universities in Kazakhstan.

Hand hygiene education of Greek medical and nursing students: A cross-sectional study

AIM

To investigate medical and nursing students' education on hand hygiene, their attitude on hand hygiene education and how this education influences their hand hygiene knowledge and practices.

BACKGROUND

Hospital-acquired infections are associated with prolonged hospitalisation and mortality. The most effective measure for their control is healthcare workers' hand hygiene compliance. Since medical and nursing students constitute the future healthcare workers, our study focuses on them.

DESIGN

Cross-sectional study METHODS: This study was conducted during the academic year 2016-2017, using a modified World Health Organisation questionnaire. Our sample consisted of 132 medical and 111 nursing students from National and Kapodistrian University of Athens, Greece. In data analysis, the Mann-Whitney and Fisher's exact tests were applied to compare differences in continuous variables and proportions in categorical variables, respectively. Knowledge and practices overall scores were calculated per student group. Multiple linear regression analyses were performed to assess the influence of potential confounders on these scores.

RESULTS

We found that 73.1% of medical and 98.2% of nursing students had received relevant education, which was reported as "only theoretical" by 77.4% of the former and as "hands-on and theoretical" by 88.1% of the latter group. Besides the risk of infection, knowledge acquired in lectures and trainer's behaviour were also considered very influential factors shaping hand hygiene attitude in both groups. Overall, medical students reported better hand hygiene practices than nursing ones (69.9% and 59.7%, respectively; p < 0.001). The opposite finding was observed regarding their overall knowledge on hand hygiene (57.2% of medical versus 60.4% of nursing students, p = 0.04). The majority of students (86.6% of all participants; p < 0.001) supported the inclusion of compulsory hand hygiene education in their curriculum. Compulsory education and seminars were assessed as the most effective measures to increase hand hygiene compliance (71.4% of all students).

CONCLUSION

In our study, medical students scored better in practices questions than nursing students; this did not apply for the knowledge score. The majority of students supported the inclusion of compulsory education on hand hygiene principles in their Departments' curricula, highlighting compulsory education and seminars as the most effective measures to increase compliance with hand hygiene.

Personal protective equipment and infection prevention and control: a national survey of UK medical students and interim foundation doctors during the COVID-19 pandemic

BACKGROUND

The adequacy of personal protective equipment (PPE) and infection prevention and control (IPC) training in UK medical students and interim Foundation Year 1 (FiY1) doctors during the COVID-19 pandemic is unknown, as is its impact on COVID-19-related anxiety.

METHODS

Cross-sectional, multi-centre study analysing self-reported adequacy of PPE and IPC training and correlation to a modified pandemic anxiety scale. Participants were current medical students and FiY1 doctors in the UK. Data were collected by an online survey.

RESULTS

Participants reported that they received insufficient PPE information (43%) and IPC training (56%). Significantly, fewer participants identifying as women or BAME/mixed ethnicity reported receiving sufficient PPE information, compared with those identifying as men and White British/White Other, respectively. COVID-19-related anxiety was significantly higher in those without sufficient reported PPE or IPC training, in women compared with men, and in FiY1 doctors compared with medical students.

CONCLUSIONS

With medical students currently volunteering in and imminently returning to hospitals in an educational capacity, levels of self-reported PPE and IPC training are sub-optimal. Better training is paramount to avoid harm to patients and healthcare professionals and to reduce COVID-19-related anxiety among medical students and FiY1 doctors.

First year medical students' and standard precautions: The need for change

BACKGROUND

Standard Precaution (SPs) practices protect health-care workers prevent hospital-acquired infections. With Competency Based Medical Education (CBME) and early clinical exposure (ECE) implemented in the new curriculum, the first year medical students need to be aware of SPs, so as to protect themselves and the patients from these hazards.

AIMS & OBJECTIVE

To assess the knowledge of standard precautions among the medical students and find out association of knowledge with selected demographic variables.

METHODS AND MATERIAL

This cross-sectional study was done among first year medical undergraduate students of a medical college.Data was collected through google form with researcher-made questionnaire including questions on knowledge about SPs and socio-demographic variables of the study participant and their parents.

RESULTS

Response rate was 97.9%. Mean age of the participants was 19.13 ± 0.858 years; 57.7% were girls.Although 80.3% had heard of SPs but as high as 83.1% were of the opinion that "SPs were only for protection of the health-care team", 23.2% felt that it should "only be used in patients diagnosed with infection". 96.5% knew that "hand hygiene should be performed while providing care to patients", 97.2% had knowledge about respiratory and cough hygiene practices, 14.1% of them felt that "PPE can be shared". 57% of the respondents answered that "needle should be recapped after giving injections".

CONCLUSIONS

Students in early clinical years were found to have a varied level of knowledge of SPs and a lot of gaps in correct understanding of required facts. Continued medical education and skill-assessment to test their knowledge, must be incorporated into their teaching curriculum before ECE, so as to minimize the risk of preventable infections.

Medical interns' reflections on their training in use of personal protective equipment

BACKGROUND

The current COVID-19 pandemic has demonstrated that personal protective equipment (PPE) is essential, to prevent the acquisition and transmission of infectious diseases, yet its use is often sub-optimal in the clinical setting. Training and education are important to ensure and sustain the safe and effective use of PPE by medical interns, but current methods are often inadequate in providing the relevant knowledge and skills. The purpose of this study was to explore medical graduates' experiences of the use of PPE and identify opportunities for improvement in education and training programmes, to improve occupational and patient safety.

METHODS

This study was undertaken in 2018 in a large tertiary-care teaching hospital in Sydney, Australia, to explore medical interns' self-reported experiences of PPE use, at the beginning of their internship. Reflexive groups were conducted immediately after theoretical and practical PPE training, during hospital orientation. Transcripts of recorded discussions were analysed, using a thematic approach that drew on the COM-B (capability, opportunity, motivation - behaviour) framework for behaviour.

RESULTS

80% of 90 eligible graduates participated. Many interns had not previously received formal training in the specific skills required for optimal PPE use and had developed potentially unsafe habits. Their experiences as medical students in clinical areas contrasted sharply with recommended practice taught at hospital orientation and impacted on their ability to cultivate correct PPE use.

CONCLUSIONS

Undergraduate teaching should be consistent with best practice PPE use, and include practical training that embeds correct and safe practices.

Willingness and Self-Perceived Competence of Final-Year Medical Students to Work as Part of the Healthcare Workforce During the COVID-19 Pandemic

Purpose

The coronavirus disease 2019 (COVID-19) pandemic may increase demand for healthcare professionals (HCPs), either because of a HCP shortage due to illness or because of the need to increase surge capacity. Final-year medical students are one of the resources potentially available to expand the workforce. There is a need to explore the willingness of final-year medical students to meet this demand, examine their perceived competence, and determine how their overall perceived competence correlates with their willingness.

Methods

A cross-sectional study using a self-administered electronic questionnaire was used. The questionnaire included demographic data, students’ self-perceived competence derived from the patient care theme of the Saudi Medical Education Directives (SaudiMED) framework, and their willingness to be measured on a 5-point Likert scale. The study targeted final-year medical students at King Saud University, Riyadh, Saudi Arabia.

Results

The number of participants was 134 (56.1% response rate), of whom 47 students (34.3%) were willing to work, while 31 (23.1%) were somewhat willing. The mean total self-perceived-competence score was 58.36/88 (66.3%). Demonstration of essential clinical skills had the highest mean score 11.48/16 (71.8%) among learning outcomes. There was a positive moderate correlation between willingness and mean perceived-competence score (Spearman correlation coefficient=0.45, p<0.001).

Conclusion

Fifty-seven percent of medical students were willing to work as part of the healthcare workforce during the COVID-19 pandemic. Better overall self-perceived competence appeared to correlate with more willingness. Students perceive themselves to be more competent in essential clinical skills. Appropriate training and supervision are suggested in all tasks assigned to them, with additional care required in areas with a lower perceived competence, such as prescription writing and essential clinical procedures.

Knowledge, Attitude, and Practice Towards Leptospirosis among Undergraduate and Postgraduate Medical Students in India

Background: Students of medicine in India tend to follow textbooks from western authors for rural pathologies, zoonosis, and this geographical disconnect leads to gaps in familiarity with local diseases.Aim: This study aims to assess knowledge, practices, and attitudes on leptospirosis among undergraduate and postgraduate medical students.Methods: A cross-sectional, self-administered questionnaire study was performed from June 2018 to May 2019 among 778 undergraduate students from six medical colleges of Tamil Nadu and 446 postgraduate students from two postgraduate institutions.Results: The survey of 1224 medical students revealed that the postgraduate medical students' knowledge of leptospirosis was better than undergraduates; however, there were important knowledge gaps in risk factors and management of leptospiral infection.Conclusions: Although the results of the study are encouraging, poor knowledge of risk factors and of diagnosis of leptospirosis can significantly affect the quality of patient care. This calls for multifaceted interventions to improve the medical curriculum.

Conocimiento sobre infecciones asociadas a la atención de la salud en estudiantes de Medicina, Licenciatura en Bioanálisis y Licenciatura en Enfermería de una universidad venezolana

Introducción. El conocimiento acerca de las infecciones asociadas a la atención de la salud (IAAS) en profesionales en salud es fundamental para disminuir las tasas de morbimortalidad causadas por estas infecciones.Objetivo. Evaluar el nivel de conocimiento sobre las IAAS en estudiantes del último año de la Escuela de Ciencias de la Salud de la Universidad de Oriente, Venezuela.Materiales y métodos. Estudio descriptivo realizado en una muestra aleatoria estratificada (n=98). Se aplicó una encuesta para determinar los conocimientos de los participantes sobre 3 áreas específicas: generalidades sobre IAAS, precauciones universales e higiene de las manos. Se consideró que los estudiantes tenían un conocimiento adecuado si obtenían un puntaje promedio de 17.5.Resultados. La edad promedio de los encuestados fue 24.9 años y el 74.9% fueron mujeres. En promedio, los estudiantes de Licenciatura en Enfermería, los de Medicina y los de Licenciatura en Bioanálisis obtuvieron 18, 18.04 y 17.25 puntos, respectivamente; el 59.2% de los respondientes aprobó la encuesta y el puntaje promedio total fue 17.87 puntos. En cuanto a las tres áreas de conocimiento evaluadas, la mayoría de estudiantes reprobó Generalidades sobre IAAS (n=78) e Higiene de las manos (n=76), mientras que la mayoría (n=91) aprobó Precauciones universales.Conclusiones. En general, los estudiantes encuestados tienen un conocimiento adecuado de las IAAS y su prevención; sin embargo, independiente del programa académico, se evidenciaron deficiencias en aspectos puntuales del tema, tales como la fuente de los microorganismos causantes de las IAAS y el uso adecuado de guantes, por lo que es necesario que los currículos de estos programas profundicen más al respecto.

Hand hygiene knowledge and attitude of medical students in western Saudi Arabia

Background

The practice of hand hygiene (HH) has prime importance among Health Care Professionals (HCPs) and non-compliance could cause adverse consequences. By keeping the importance of HH in mind, this study aims at investigating the knowledge and attitudes towards HH among medical students and interns at King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA).

Methods

The study includes 453 medical students and interns (189 males & 264 females). This study was completed in three months; from September to November 2017. The World Health Organization (WHO) HH questionnaire was used and data were analyzed on SPSS-21.

Results

Two-third of the participants 292 (64.2%) had formal training in HH in the last three years. Almost half of the participants 254 (56.1%) had correct knowledge regarding the major course of transmission of potentially detrimental microbes among patients in the healthcare premises. Just 124 (27.4%) of the respondents had the correct knowledge about the most common basis of germs accountable for healthcare-related infections. Females had significantly better knowledge than males regarding the type of HH technique needed before palpation of the abdomen (177(54%) Vs. 151(46%); P < 0.002), before an injection (175(54.5%) Vs. 146(45.5%); P < 0.007), after emptying a bedpan (207(64.7%) Vs. 113(35.3%); P < 0.001), following discarding examination gloves (256(60.4% Vs. 168(39.6%); P < 0.001] and after exposure to blood (200(64.1%) Vs. 112(35.%); P < 0.001). Female participants had better knowledge than males regarding the type of HH actions. Females also had a significantly better attitude towards the importance of HH than males (240(62.5%) Vs. 144(37.5%); P < 0.001).

Conclusion

The majority of the participants' knowledge regarding HH was not up to the mark; however, female students had better knowledge compared to male students. The medical students and interns' knowledge and positive attitude towards HH can play a pivotal role in preventing HCPs associated infections and it would overall decrease the infection-related burden on the hospital and governmental budgets. It is suggested that multi-dimensional plans are required to change this low compliance to a higher rate.

Effects of a multi-component educational intervention on nurses' knowledge and adherence to standard precautions in intensive care units

Background

The standard precautions (SPs) should be disseminated and implemented by healthcare providers. This study aimed to examine the effects of a multi-component educational intervention on nurses' knowledge and adherence to the SP guidelines in intensive care units (ICUs).

Methods

This small-scale study consisted of a cluster randomised trial. Two ICUs, located in different hospitals, participated in the study. Nurses (n = 15) in one ICU received the multi-component educational intervention. The intervention involved an educational (with multiple instructional media) and a behavioural (with hands-on practice) component. Nurses' knowledge and adherence were assessed at pre-test and two and six weeks after the intervention.

Results

Results showed significant group by time interaction effects for both outcomes: a large improvement was found in the experimental group over time, but not in the control group. The experimental nurses' knowledge improved from 15 ± 2.47 at pre-test to 19 ± 2.65 and 19.53 ± 0.92 at follow-ups. Similarly, their adherence increased from 19.87 ± 4.44 at pre-test to 29.20 ± 5.00 and 28.40 ± 4.37 at two and six weeks post-test, respectively.

Conclusions

The multi-component educational interventions had demonstrated initial effectiveness in enhancing ICU nurses' knowledge and adherence to the SPs guidelines. The intervention is a promising approach for designing effective continuing education initiatives aimed to improve nurses' practice.

Compliance of Nurses and Hospitals With Ventilator-Associated Pneumonia Prevention Guidelines: A Middle Eastern Survey

This study was a self-reported cross-sectional survey that investigated nurses' and hospitals' compliance with ventilator-associated pneumonia prevention guidelines and the barriers and factors that affect their level of compliance. A questionnaire was completed by 471 intensive care unit nurses from 16 medical centers in 3 Middle Eastern countries: Jordan, Egypt, and Saudi Arabia. The results show that both nurses and hospitals have insufficient compliance. Previous education, experience, and academic degree were all found to affect nurses' compliance.

Knowledge, attitudes, and practices of health-care workers regarding hand hygiene guidelines in Al-Qassim, Saudi Arabia: A multicenter study

INTRODUCTION

Hand hygiene is one of the most important ways to reduce the prevalence of nosocomial infections, morbidity, mortality, and health-care costs among hospitalized patients worldwide.

OBJECTIVES

We addressed this study to assess knowledge, attitudes, and practices regarding hand hygiene guidelines among health-care workers.

METHODS

A multicenter cross-sectional study conducted from October to December 2015 including three hospitals in Al-Qassim, Saudi Arabia. A total of 354 participants completed a self-administered survey on knowledge, attitudes, and practices of hand hygiene. Analysis of variance was used to compare knowledge level across age, gender, profession, and hospitals. All analyses were performed with SPSS, version 21.

RESULTS

Overall, the average knowledge score was 63%. There were significant differences in knowledge level across groups. Health-care workers over the age of 30 had higher scores than those younger than 30. Health-care workers at the tertiary hospital had higher scores than those at the secondary hospitals. Nearly, all reported positive attitudes toward hand hygiene as well as adhering to the guidelines regularly. Further, they reported that soap and water were the most common agents for cleaning hands.

CONCLUSION

The study findings indicate that there are gaps in the knowledge, which could be addressed with brief and more frequent training sessions, particularly in the secondary hospitals. However, the hand hygiene guidelines are well-known by the staff and well promoted in the hospitals reflected by the positive attitudes. Further improvements in adherence to the hand hygiene guidelines will continue to decrease the likelihood of nosocomial infections.

Standard precaution knowledge and adherence: Do Doctors differ from Medical Laboratory Scientists?

Background

Doctors and laboratory scientists are at risk of infection from blood borne pathogens during routine clinical duties. After over 20 years of standard precautions, health care workers knowledge and compliance is not adequate.

Aim

This study is aimed at comparing adherence and knowledge of standard precautions (SP) among Medical Laboratory Scientists (MLSs) and doctors.

Methods

It was a cross sectional study done at University of Nigeria Teaching Hospital, ItukuOzalla. A semi structured pre-tested questionnaire was the study instrument.

Results

General knowledge of SP was high,76.2% in doctors and 67.6% in MLSs although there were differences between the two groups on the knowledge of components of SP. Safe injection practices, use of personal protective equipment as well as safe handling of contaminated equipment or surfaces was higher amongst doctors. Even though more than half of respondents in both groups, 53.1 % among doctors and 58.1% among MLSs had received training on standard precautions, this did not reflect in the practice. MLS reported more use of personal protective equipment such as gloves and coveralls (100% in MLS and 35% of doctors), P<0.001. Recapping of syringes was higher amongst doctors (63.6%) than MLS (55.1%).The doctors practiced better hand hygiene than MLS (P<0.001). Constraints that affected SP included non-availability of PPEs and emergency situations for both groups.

Conclusion

SP knowledge and practice are still low, and as such, there is a need to train doctors and MLS on the components of SP. Policies on SP need to be enforced and facilities for practice regularly supplied.

Knowledge and information sources on standard precautions and infection control of health sciences students at King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia, Riyadh

Background

Only one study has been conducted in Saudi Arabia to assess medical students’ knowledge of standard precautions (SPs) and infection control (IC). In this study, we examined knowledge of SPs and IC among clinical students attending the King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Methods

In this cross-sectional study, we targeted clinical students from the following five colleges: Medicine (fifth and sixth years); Dentistry (second semester of the third, fourth, fifth, and sixth years); Applied Medical Sciences (third and fourth years); Nursing (third and fourth years); and Pharmacy (third, fourth, and fifth years). The data collection instrument was an adopted 41-item questionnaire that measured knowledge of SPs and IC in five domains. A score of ≥24 (60%) indicated sufficient knowledge.

Results

The participants comprised 129 students (67 men). The proportions of participants from each college were: Medicine, 58.1% (n = 75); Dentistry, 14% (n = 18); Applied Medical Sciences, 13.2% (n = 17); Nursing, 10.9% (n = 14); and Pharmacy, 3.9% (n = 5). Most students (73.6%) demonstrated sufficient knowledge (men, 67.2% and women, 80.6%). The highest scores were obtained for the domains “general concept of SPs”, “hand hygiene”, and “personal protective equipment”, whereas the lowest scores were obtained for “disposal of and injuries from sharp objects” and “health-care providers’ care”. The main information source was formal curricular teaching.

Conclusions

In Saudi Arabia, students’ knowledge of SPs and IC is satisfactory, with no significant differences between the sexes or between colleges. Thus, formal curricular teaching is an effective way to increase students’ knowledge of SPs and IC.

Hand hygiene knowledge of primary health care workers in Abha city, South Western Saudi Arabia

Purpose:

The aim of this is to find out the hand hygiene (HH) knowledge among primary health care workers (PHCWs) in Abha health district, southwestern Saudi Arabia.

Methods:

Data were collected through an anonymous self-administered questionnaire. The questionnaire was based on a WHO “Knowledge Questionnaire for Health Care Workers.”

Results:

The study included 478 PHCWs (239 males and 239 females). The sample included 186 physicians, 212 nurses, and 80 technicians. The highest proportion receiving formal training was nurses (82.1%). Females (77.4%) received significantly more training than males (70.3%). Only 59.2% (283) of the HCWs properly identified unclean hands of HCWs as the main route of the cross. Only 26.4% (126) of the HCWs properly identified germs already present on or within the patient as the most frequent source of pathogens in a health-care facility. Only 54.8% (262) of HCWs properly identified 20 s as the minimal time needed for alcohol-based hand rub to kill most germs on hands.

Conclusion:

The study revealed gaps in the knowledge regarding HH. To promote HH at primary health care setting, WHO bundle of multimodal strategies should be adopted including system change; training/education; evaluation and feedback; reminders in the workplace; and institutional safety climate.

Knowledge of nosocomial infection control practices among radiographers in Jordan

INTRODUCTION

Nosocomial infections add health-related and financial burdens on health systems. This study aims to evaluate the radiographers' knowledge of nosocomial infection control practices in Jordan.

METHODS

A cross-sectional questionnaire-based assessment was conducted. The main domains of the knowledge based test were the nature of nosocomial infections, standard precautions, and infection control practices specific to the radiology department. Comparison of knowledge among radiographers was assessed using the Student t-test and ANOVA. Multiple linear regression was used to find predictors of the knowledge score.

RESULTS

The final analysis included 100 radiographers from educational, private, and public hospitals. Mean knowledge score was 66.2% (SD: 20.3%, range: 25.0-100%). Questions with the lowest correctly scored were about the main source of infections (17%), recapping used needles (27%), gloves use (27%), the necessity of using overshoes (26%) and a cap (26%) when there is a risk of biological fluid splashes, the necessity of using sterile gloves (7%) and protective masks (5%) during all invasive procedures, the manoeuvrability around a sterile field (54%), and the safety of passing the imaging plate to the scrub nurse in order to place it under the radiographer's direction (37%). Predictors of knowledge score were the academic degree and training status (R² = 0.21, P < 0.001).

CONCLUSION

Knowledge of infection control practices among Jordanian radiographers was moderate. Future training should focus on handling used needles, the use of protective barriers, and the manoeuvrability around sterile fields. Improved academic curriculum and on-site training could enhance knowledge in infection control practices.

Do medical students receive training in correct use of personal protective equipment?

BACKGROUND

Healthcare personnel often use incorrect technique for donning and doffing of personal protective equipment (PPE).

OBJECTIVE

We tested the hypothesis that medical students receive insufficient training on correct methods for donning and doffing PPE.

METHODS

We conducted a cross-sectional survey of medical students on clinical rotations at two teaching hospitals to determine the type of training they received in PPE technique. The students performed simulations of contaminated PPE removal with fluorescent lotion on gloves and were assessed for correct PPE technique and skin and/or clothing contamination. To obtain additional information on PPE training during medical education, residents, fellows, and attending physicians completed written questionnaires on PPE training received during medical school and on knowledge of PPE protocols recommended by the Centers for Disease Control and Prevention.

RESULTS

Of 27 medical students surveyed, only 11 (41%) reported receiving PPE training, and none had received training requiring demonstration of proficiency. During simulations, 25 of 27 (92.5%) students had one or more lapses in technique and 12 (44%) contaminated their skin with fluorescent lotion. For 100 residents, fellows and attending physicians representing 67 different medical schools, only 53% reported receiving training in use of PPE and only 39% selected correct donning and doffing sequence.

CONCLUSIONS

Our findings suggest that there is a need for development of effective strategies to train medical students in correct use of PPE.

ABBREVIATIONS

PPE: Personal protective equipment; MRSA: Methicillin-resistant Staphylococcus aureus; SARS: Severe acute respiratory syndrome; MERS: Middle East respiratory syndrome; WHO: World Health Organization; CDC: Centers for Disease Control and Prevention; OSCE: Objective structured clinical examination.

Knowledge, source of information, and perception of Portuguese medical students and junior doctors of infection control precautions

Medical education should include infection control precautions (ICPs). Portuguese medical students showed reasonable knowledge in ICPs; however, contact isolation and glove and mask use should be reinforced. Only 25% referred to the curriculum as the most important information source. There was a positive association between academic year (P = .032), previous training in ICPs (P = .016), and knowledge. Main strategies proposed to acquire competences in ICPs were bedside teaching (26.9%) and curriculum and bedside teaching (20.2%).

Knowledge, awareness, and attitude regarding infection prevention and control among medical students: a call for educational intervention

BACKGROUND

Medical students can be exposed to serious health care-associated infections, if they are not following infection prevention and control (IPC) measures. There is limited information regarding the knowledge, awareness, and practices of medical students regarding IPC and the educational approaches used to teach them these practices.

AIM

To evaluate the knowledge, awareness, and attitude of medical students toward IPC guidelines, and the learning approaches to help improve their knowledge.

METHODS

A cross-sectional, interview-based survey included 73 medical students from Weill Cornell Medical College, Qatar. Students completed a questionnaire concerning awareness, knowledge, and attitude regarding IPC practices. Students' knowledge was assessed by their correct answers to the survey questions.

FINDINGS

A total of 48.44% of the respondents were aware of standard isolation precautions, 61.90% were satisfied with their training in IPC, 66.13% were exposed to hand hygiene training, while 85.48% had sufficient knowledge about hand hygiene and practiced it on a routine basis, but only 33.87% knew the duration of the hand hygiene procedure.

CONCLUSION

Knowledge, attitude, and awareness of IPC measures among Weill Cornell Medical Students in Qatar were found to be inadequate. Multifaceted training programs may have to target newly graduated medical practitioners or the training has to be included in the graduate medical curriculum to enable them to adopt and adhere to IPC guidelines.

Compliance with standard precautions among baccalaureate nursing students in a Saudi university: A self-report study

Meticulous observance of standard infection control precautions by health care providers is strongly recommended for every patient encounter. Assessment of nursing students' compliance should be carried out regularly in order to ensure adherence to protocols. Thus, this study was conducted to assess self-reported compliance with standard precautions among baccalaureates in nursing students in a Saudi university. A convenience sample of 236 nursing students was surveyed in this cross-sectional, self-reported study, using the Compliance with Standard Precaution Scale Arabic version (CSPS-A). Independent t-test and one-way analyses of variance (ANOVA) were performed to examine the differences on compliance. A multiple regression analysis was performed to identify the factors affecting compliance. The overall compliance rate was 61.0%. The students reported highest compliance in disposing used sharp instruments and other sharp objects into sharps-only boxes, while the lowest compliance rate in using water only for hand washing. Significant differences in compliance were observed when respondents were grouped according to their demographic characteristics. Cultivating a supportive culture of adherence to infection control precautions among nursing students is of paramount importance. The clinical environment should be supportive of a culture where strict compliance with the control and prevention of infection is of prime importance.

Hand Hygiene: Knowledge and Attitudes of Fourth-Year Clerkship Medical Students at Alfaisal University, College of Medicine, Riyadh, Saudi Arabia

Introduction: Little is known about the clerkship (clinical) medical students’ knowledge of hand hygiene as the single most important precautionary measure to reduce nosocomial healthcare-associated infections. The aim of this study is to explore the knowledge of, and attitudes towards, hand hygiene practices among fourth-year clerkship medical students at Alfaisal University, College of Medicine, Riyadh, Saudi Arabia.

Materials and Methods: A cross-sectional, paper-based, Yes/No formatted questionnaire was administered to explore the students’ knowledge of, and attitudes towards, hand hygiene practices. Data were decoded in Microsoft Excel sheet and presented as numbers and percentages.

Results: One hundred and eleven students (n=111/147) participated in the questionnaire (response rate: 76%). Although the majority of students had a fair knowledge of hand hygiene practices, a number of them had some misconceptions. Only 14% of students correctly agreed to the statement: "Traditional hand washing (water, plus regular soap) decreases the number of germs." Furthermore, only 32% of students correctly answered that "hand washing with a regular soap, instead of an antiseptic soap, is better in limiting the transmission of clostridium difficile infections". Almost all students (93%) agreed to the importance of hand hygiene education in medical curricula and its awareness in healthcare centers. Despite the importance of hand hygiene, only 13% of students reviewed the respective WHO and CDC guidelines before starting their clinical training in the teaching hospital.

Discussion: The students’ inadequate knowledge about hand hygiene needs to be enriched by well-structured curricular and extra-curricular programs as well as more positive attitudes by healthcare workers.