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.

Development of an infection control competency scale for clinical nurses: an instrument design study

BACKGROUND

Nurses work in close proximity to patients, and as such, they can have a direct impact on the control of infections; thus, it is important for nurses to be competent in infection control. However, the scales used to measure infection control performance in nurses are not suitable for measuring infection control competencies that reflect nurses' expertise, clinical environment, and work. Thus, this study aimed to develop a valid and reliable measure to assess infection control competency of clinical nurses.

METHODS

A concept analysis, using a hybrid model, was performed on the infection control competency of clinical nurses to confirm the components and develop 67 initial items. Ten experts evaluated the content validity of these items, and a Korean language expert and a Doctor of Nursing reviewed the questions to consolidate them into 59 items. Subsequently, 267 nurses working at a certified tertiary hospital in D City were surveyed to confirm the validity and reliability of the scale.

RESULTS

As a result of the study, the final scale comprising seven factors and 33 questions was derived, and the cumulative explanatory power of these factors was 60.8%. To verify convergent and discriminant validity, confirmatory factor analysis was conducted, and the average variance extraction index, composite reliability values, and confidence interval of the correlation coefficient between factors were confirmed. Convergent and discriminant validities were verified by comparison with standard values. The Cronbach's α for the entire scale in this study was 0.93. Consequently, the validity and reliability of the clinical nurses' infection control competency measurement scale were verified.

CONCLUSIONS

The validity and reliability of the infection control competency measurement scale for clinical nurses (ICCS-CN) developed in this study was verified, and the scale can be effectively used to measure the infection control competency of clinical nurses. Measuring the infection control competency of clinical nurses will help reduce the harm caused by infection and ensure patient safety by decreasing infection rates in medical institutions.

Hand hygiene knowledge, perception, and self-reported performance among nurses in Kelantan, Malaysia: a cross-sectional study

Background

Nurses interact with patients 24 hours a day, and this connection has the potential to raise the risk of infection transmission to patients. Nursing plays a vital role in pre-venting healthcare-associated infections (HCAIs) by ensuring that hand hygiene (HH) practises are followed and maintained. The purpose of this study was to evaluate nurses’ knowledge, perceptions, and self-reported HH performance scores, as well as their correlation, in tertiary care hospitals in Kelantan, Malaysia.

Methods

A cross-sectional study was undertaken in all four Kelantan tertiary care hospitals from December 2019 to February 2020. A stratified random selection method was used to obtain a sample of 438 registered nurses. A validated WHO self-administered HH knowledge and perception questionnaire for healthcare personnel was used to measure HH knowledge, perception, and self-reported HH performance.

Results

The mean (SD) score of knowledge was 15.08 (1.96) out of the total 25. The score of perception participants towards HH was 68.02 (10.14) out of the total 81 and the average self-reported HH performance was 87.58 (12.03) out of 100. Pearson’s correlation analysis showed significant positive correlations between perception and knowledge scores; r (436) =0.17, p<0.001 and Perception and self-reported HH performance scores; r (436) =0.27, p<0.001.

Conclusions

There is a strong link between knowledge and perception scores. Lack of understanding of HH during patient care might lead to a negative perception, which can affect overall self-reported HH performance. The need of monitoring and maintaining HH knowledge among nurses was established in this study.

Predictors of Self-Reported Hand Hygiene Performance among Nurses at Tertiary Care Hospitals in East Coast Malaysia

Background: Hand hygiene (HH) is the simplest and most effective way to reduce the incidence of healthcare-associated infections (HCAIs). Methods: This cross-sectional study aimed to determine factors associated with self-reported HH performance among nurses at Kelantan tertiary care hospitals. A sample of 438 registered nurses was selected through a stratified random sampling method. Self-reported HH performance was assessed using a validated WHO self-administered HH knowledge and perception questionnaire for healthcare workers. Results: A multiple linear regression analysis was performed to identify the predictors. The factors that significantly predicted self-reported HH performance among nurses included perception score (beta coefficient (β) = 0.260; 95% CI: 0.200, 0.417; p < 0.001), pediatric department (β = −0.104; 95% CI: −9.335, −2.467; p < 0.001), and orthopedic department (β = −5.957; 95% CI: −9.539, −0.720; p < 0.023), adjusted R² = 0.102; p < 0.001. Nurses with a strong perception and belief in HH were more likely to have better HH performance. Compared to pediatric and orthopedic, surgical departments were associated with better self-reported HH performance. Conclusions: This study showed the importance of factors that could improve the intervention’s performance in HH strategy. Lack of perception and HH program intervention in departments engaged in patient care could lead to poor HH practices, thus increasing HCAIs and antimicrobial resistance (AMR).

Knowledge, perception, performance, and attitude regarding hand hygiene and related factors among infection control nurses in South Korea: A cross-sectional study

BACKGROUND

We assessed the current status of knowledge, perception, attitude, and role model regarding hand hygiene (HH) among infection control nurses (ICNs) and identified the factors influencing these variables.

METHODS

A structured questionnaire was adapted from a World Health Organization survey. Data were collected from November 8, 2017, to February 2, 2018.

RESULTS

ICNs showed the following scores (mean ± SD): knowledge (19.5 ± 2.3), perception (69.9 ± 8.9), attitude (46.9 ± 5.8), and role model (39.2 ± 6.0). HH performance of health care workers (HCWs) was 75.2 ± 15.5. Mean HH performance scores of HCWs (P = .007) differed significantly according to infection control experience (3 groups: ≤12 months, 13-24 months, >24 months). Perception, attitude, and role model scores showed positive correlations with each other (P < .01). The regression model for HH performance of HCWs was calculated as follows: Y₁ = 31.638 + 0.067X₁ (perception of ICNs) + 0.133X₂ (attitude of ICNs) + 0.825X₃ (role model of ICNs) (P < .001; adjusted R² = 0.115).

DISCUSSION

Perception, attitude, and role model scores of ICNs were significant predictors of HH performance of HCWs.

CONCLUSIONS

Specialized well-structured HH education programs should be developed for ICNs that will help improve HH performance of HCWs.

Knowledge, Perceptions, and Self-reported Performance of Hand Hygiene Among Registered Nurses at Community-based Hospitals in the Republic of Korea: A Cross-sectional Multi-center Study

Objectives

To assess the nurses’ hand hygiene (HH) knowledge, perception, attitude, and self-reported performance in small- and medium-sized hospitals after Middle East Respiratory Syndrome outbreak.

Methods

The structured questionnaire was adapted from the World Health Organization’s survey. Data were collected between June 26 and July 14, 2017.

Results

Nurses showed scores on knowledge (17.6±2.5), perception (69.3±0.8), self-reported HH performance of non-self (86.0±11.0), self-reported performance of self (88.2±11.0), and attitude (50.5±5.5). HH performance rate of non-self was Y₁=36.678+ 0.555X1 (HH performance rate of self) (adjusted R²=0.280, p<0.001). The regression model for performance was Y₄=18.302+0.247X₄₁ (peception)+0.232X₄₂ (attitude)+0.875X₄₂ (role model); coefficients were significant statistically except attitude, and this model significant statistically (adjusted R²=0.191, p<0.001).

Conclusions

Advanced HH education program would be developed and operated continuously. Perception, attitude, role model was found to be a significant predictors of HH performance of self. So these findings could be used in future HH promotion strategies for nurses.

A systematic review on hand hygiene knowledge and compliance in student nurses

BACKGROUND

Hand hygiene competence is one of the critical outcomes in nursing education. Ensuring nursing students recognize the what, when and how of hand hygiene is critical in the light of the increasing rates of healthcare-associated infections.

AIM

To systematically appraise and synthesize articles on hand hygiene knowledge and compliance among nursing students.

METHODS

This is a systematic review of scientific articles published from 2006 to 2016. The primary databases used were as follows: PubMed, Embase, Cumulative Index to Nursing & Allied Health Literature, Proquest and PsychINFO. Key search terms utilized were as follows: 'handwashing', 'hand hygiene', 'compliance', 'knowledge', 'practice' and 'nursing students'.

FINDINGS

Nineteen studies met the review criteria. The findings revealed a low-to-moderate knowledge of and compliance with hand hygiene among nursing students. In addition, there were significantly higher rates of hand hygiene compliance in nursing students when compared to medical students. Relatively few studies attempted to identify predictors of hand hygiene knowledge and compliance.

CONCLUSION

This review demonstrated suboptimal knowledge and compliance to hand hygiene among student nurses. In addition, this review also highlighted the paucity of studies that examined individual and organizational factors, which influence nursing students hand hygiene knowledge and compliance.

IMPLICATIONS FOR NURSING AND POLICY

The findings of this review emphasized the role of nurse educators in enhancing hand hygiene competence in nursing students. Implementation of empirically tested strategies such as utilizing multidimensional interventions, scenario-based hand hygiene simulation activities and hand hygiene education programmes that would enhance nursing students' hand hygiene knowledge and compliance is an asset. Hospital and nursing administrators should ensure continuous support and monitoring to guarantee that hand hygiene programmes are institutionalized in every healthcare setting by every healthcare worker.

Influencing factors on hand hygiene behavior of nursing students based on theory of planned behavior: A descriptive survey study

BACKGROUND

Hand hygiene is the single most important measure to prevent transmission of infection, but the compliance rate of healthcare workers is relatively low.

OBJECTIVES

This study was conducted to identify the knowledge, beliefs, behavior, and affecting factors about hand hygiene among nursing students.

DESIGN

A descriptive survey study.

SETTINGS

The study was carried out in two South Korean nursing schools.

PARTICIPANTS

A total 208 nursing students participated in this study.

METHODS

Questionnaires were used to collect data.

RESULTS

The percentage of correct answers in the survey section concerning hand hygiene knowledge was 68.1%. No significant difference in the knowledge, behavioral beliefs, normative beliefs, or control beliefs data was found related to general characteristics. Behavioral beliefs correlated with normative beliefs (r=.25, p<.001) and hand hygiene behavior (r=.17, p=.017), and control beliefs correlated with hand hygiene behavior (r=.18, p=.010).

CONCLUSION

The results suggest that knowledge is not enough to change the beliefs related to hand hygiene; positive behavioral beliefs and strong control beliefs are also needed to increase hand hygiene compliance.