Citing articles

International Journal of Nursing Education, April-June, 2015, Vol.7, No. 2 213

Hand Hygiene Practices of Nursing Students

Shams Ul Hua1, Kiran Qaisar Ali2

1MSc N Year I, 2Senior Instructor, Aga Khan University School of Nursing and Midwifery Karachi, Pakistan

ABSTRACT

This descriptive study was done to determine compliance, and knowledge of BSc Nursing year II students regarding hand hygiene. Data were collected using questionnaire as well students’ observation clinical for 15 days. Poor compliance to hand hygiene is the most important source of hospital acquired infection. We determined that students Hand hygine practices are different at different times and movements. At most 80% times student practice hand hygine after contact with blood body fluid, and only 31% time after contact with paitent surroundings. Moreover, 67% times student do hand hygine before any procedure, 35% time before contact with patient and 50% times after contact with patient. Only 56% students were aware about effectiveness of hand hygiene.

Keywords: Hand hygine, Infection, Nursing students.

INTRODUCTION

Nosocomial infections are the major reason of prolong hospital stay and complication of patient in developing as well developed countries. Hands of health care workers are the frequent source of hospital acquired infections. Patients in developing countries usually come across with nosocomial infection more as compared to developed countries (1, 2). European studies show the prevalence of nosocomial infections to vary between 6.1% and 10.7% (1); on other hand in Pakistan the prevalence is about 31% (3). The main reason of nosocomial infection is poor compliance of health care professionals towards hand hygiene. According to a study on trainee physician in tertiary care hospital only 4.7% of the physicians reported to cleanse their hands before having direct contact with their patients (4). The burden of infectious disease account for 13 million deaths annually and majority of death occur in developing countries (5). Student nurses do hand hygiene 80.2% in Turkey (6). There is substantial evidence that hand antisepsis reduces the incidence of Hospital acquired infections. Health care workers hands are the most effective method of preventing transmission of infection (3). However, unacceptably low compliance with hand hygiene is universal in health care. This contributes to the transmission of microbes capable of causing avoidable Hospital acquired infections.

PURPOSE

The purpose of this research project was to determine compliance, current practices and knowledge of BSc Nursing year II students regarding hand hygiene. Moreover, we will find some barriers related to low compliance of hand hygiene.

SIGNIFICANCE

This study is significant to nursing field. This will help the stake holder to develop policies, and train their student to provide safe and effective care to patient.

Method: Quantitative survey method along with observation was used to conduct the study. Data were collected using questionnaire and direct observation. Twenty students were randomly selected from year II BSc Nursing. In first phase their Practices were observed using “Hand Hygiene Five Moments Model for two weeks”. In second phase questionnaire were distributed among student to assess their knowledge and practices. The questionnaires were derived from WHO- frame work of 2010 on hand Hygiene. The se�ing for study was private sector tertiary care hospital.

RESULTS

The result form suvery as well observation are follow.

DOI Number: 10.5958/0974-9357.2015.00106.3

International Journal of Nursing Education, April-June, 2015, Vol.7, No. 2 213

Table 1: Self reported result of student knowledge and awarness

The result from survey questionnaire was as follow. Only 56%students were aware about effectiveness of hand hygine, 64.3% of students were knowledgable regarding Hospital acquired infections and only 56.2% correctly list indicaiton of hand washig or hand rubbing. Moreover, some barriers were identified by the participant such as work load, time limitation, lack of resources, practice of of seniour collegues and nurses, and lack of awarness. Moreover, the students reported that over all they do hand hygiene 75%; this was not related with students observation.

Through observation follwing results were obtained

Table 2: Observation of studens Practices at different movements

Hand hygine Practice varies in different time and movements. At most 80% time student practice hand hygine after contact with blood body fluid, and only 31% time after contact with paitent surroundings. Moreover, 67% times student do hand hygine before any procedure, 35% time before contact with patient and 50% times after contact with patient.

DISCUSSION

In turkey students wash their hands 80% times (6), where we observed 51% time. They further

mention that students are using soap more than hands sanitizer and similar findings were drawn from our studies. Students usually exaggerate their practice of hand hygiene. Contrary to students nurses do hand hygiene 74% time (7). Some studies concluded that students over-estimated their knowledge and skills (8). Students self-report in turkey that they their hands 96% time (6), while in this study student report 76% time. Some studies concluded that main barriers to hand hygiene are high work load, limited resources, and time limitation are some of the barriers to hand hygiene (6); where we also find lack of resources, high work load, limited time and lack of proper knowledge as barriers to hand hygiene. Their results showed that the nursing students can be a source of infection owing to the colonized pathogens in their hands acquired as a result of their insufficient hand hygiene during clinical procedures. Barre� (2007) find that lack of education and training decreases compliance of hand hygiene (10); so training and education are very important to increase the compliance of students.

RECOMMENDATIONS AND CONCLUSION

In conclusion the issue is very important and pertinent to nurses. Nurses’ academia should incorporate content related to infection control and hand hygiene practices. Further researches should be conducted to explore the issue in detail. I have arranged a workshop of three hours for students and shared results of this research project with them.

Following are some recommendations

1) Training and educational session of student on infection control especially on hand hygiene in each semester before clinical, for recap information and update their knowledge.

2) Faculties observe the student practices related to hand hygiene on clinical and evaluate the student on the basis of their safe practices of infection control.

3) The concept of coach and coacher are very useful to monitor the student’s practices, the coach observe the coacher practice and give feedback accordingly, as faculty was not there with students all the time.

4) The students going outside for clinical the institute provides hand sanitizer, tissues and soap,

214 International Journal of Nursing Education, April-June, 2015, Vol.7, No. 2

because in some areas there are not enough facilities of hand hygiene.

5) A card should be provided to each student with slogan of hand hygiene, so that this reminds about hand hygiene.

LIMITATION OF STUDY

The study was done only in private sector hospital and with small sample size; so, finding cannot be generalized to whole country.

Acknowledgment: BSc Nursing year II students.

Conflict of Interest: I do not have any financial or other conflict of interest with this project.

Support: The study was self-supported by the Co-authors and no financial support is taken from any person or organization.

REFERENCES

1. Van der Kooi, T. I. I., Mannien, J., Wille, J. C., & Van Benthem, B. H. B. (2010). Prevalence of nosocomial infections in The Netherlands, 2007– 2008: results of the first four national studies. Journal of Hospital Infection, 75(3), 168-172.

2. Girou, E., Loyeau, S., Legrand, P., Oppein, F., & Brun-Buisson, C. (2002).Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: Randomised clinical trial. British Medical Journal, 17, 325–362.

3. Shaikh, J., Devrajani, B. R., Ali Shah, S. Z., Akhund, T. , & Bini, I. (2008). Frequency, Pa�ern and Etiology OF Nosocomial. Journal of Ayub Medical College Abbpabad, 20(4),

4. Anwar, M. A., Rabbi, S., Masroor, M., Majeed, F., Andrades, M., & Baqi, S. (2009). Self-reported practices of hand hygiene among the trainees of a teaching hospital in a resource limited country

5. Bloomfield, S. F., Aiello, A. E., Cookson, B., O’Boyle, C., & Larson, E. L. (2007). The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community se�ings including handwashing and alcohol-based hand sanitizers. American Journal of Infection Control, 35(10), S27-S64.

6. Celik, S., & KocaYlV, S. (2008). Hygienic hand washing among nursing students in Turkey. Applied Nursing Research, 21, 207-211.

7. Randle, J., Arthur, A., & Vaughan, N. (2010). Twenty-four-hour observational study of hospital hand hygiene compliance. Journal of Hospital Infection, 76, 252-255.

8. Cole, M. (2009). Exploring the hand hygiene competence of student. Nurse Education, 29, 380-388.

9. Barre�, R., & Randle, J. (2008). Hand hygiene practices: nursing students’ perceptions. Journal of Clinical Nursing, 17(14), 1851-1857.

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