A comparative study of hand hygiene and alcohol-based hand rub use among Irish nursing and medical students
Introduction
The burden of health care-associated infection (HCAI) is well documented by the World Health Organization (WHO) and European Centre for Disease Control (ECDC) (WHO, 2013; ECDC, 2013). HCAI results in prolonged hospital stay, increased morbidity and mortality, high healthcare costs, financial burden and increased resistance of microorganisms to antimicrobials, leading to a sharp rise in multi-drug resistant organisms (MDROs) (WHO, 2013; ECDC, 2013). According to the WHO hundreds of millions of patients are affected by HCAI worldwide each year and the ECDC estimates that 25,000 people die in the European Union (EU) annually from infections caused by MDROs with an associated cost of €1.5 billion (WHO, 2013; ECDC, 2013). In Ireland, the setting for this study, the national prevalence rate of HCAI in acute-care facilities is 5.2% (Health Protection Surveillance Centre, 2012). Hand hygiene is considered the most effective measure a healthcare professional can take to prevent the transmission of HCAI (Health Protection Surveillance Centre, 2012). Yet, even though hand hygiene is simple, cost-effective and highly efficacious in controlling the spread of HCAI, evidence suggests that compliance among healthcare professionals is sub-optimal (Kingston et al., 2016; Erasmus et al., 2010).
Section snippets
Background
Hand hygiene is a general term that refers to various actions of hand cleansing suited to different clinical situations, including the action of hand rubbing. Hand rubbing with alcohol-based hand rub (ABHR) is globally advocated as the ‘gold standard’ approach to hand hygiene in most routine patient encounters, except those for which handwashing with soap and water is recommended, for example, when nursing patients with Clostridium difficile infections (WHO, 2009). Despite this, the literature
Methods
This observational study employed a cross-sectional, self-report design and aimed to explore nursing students' and medical students' perceptions of their hand hygiene and hand rubbing practices. All students of a Bachelor of Science Nursing (Honours) degree programme (n = 342) and of a Graduate Entry Bachelor of Medicine and Surgery degree programme (n = 530) within blinded for review, were invited via student email addresses to participate, between March and April 2015. They were provided a
Results
A response rate of 37% (323/872) was achieved. Of the 323 respondents 70% (n = 225) were nursing students and 30% (n = 98) were medical students. Ninety-four percent (n = 212) of the nursing student respondents were female and 58% (n = 57) of the medical student respondents were female.
Discussion
Previous studies suggest that nurses are more compliant with hand hygiene than doctors (Randle et al., 2010; McLaws et al., 2009; Pittet, 2000). However, fewer cross-disciplinary studies comparing hand hygiene behaviour among healthcare students are available (van de Mortel et al., 2010), despite direct patient contact during internships and clinical placements, which increases students' risk of becoming mediators of HCAI or contracting a HCAI (Al-Khawaldeh et al., 2015; Bargellini et al., 2014
Conclusion
Despite reported improvements in patient safety education (Patey et al., 2011) results of this study suggest that a challenge persists. Channelling the reported positive attitudes towards ABHR use among healthcare students to achieving improvements in hand hygiene practice is required and reviewing infection prevention and control curricula and pedagogical approaches seems warranted. Underpinning nursing and medical curricula with national and international evidence-based hand hygiene
Funding
This work was supported in part by the Infection Prevention Society Novice Investigator Grant 2015. The contents of this paper are solely the work of the individual authors and do not reflect the views of the funding body.
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