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Hand Hygiene Practices among Medical Students
Interdisciplinary Perspectives on Infectious Diseases
Abstract and Figures
Background. Hand hygiene is a cost-effective method in preventing infection transmission. Hand hygiene practices have been found to be faulty in most healthcare settings. We conducted a study to evaluate the awareness, and compliance of hand hygiene among undergraduate medical students during their clinical phase in Qassim College of Medicine, Saudi Arabia. Methods. A questionnaire based on World Health Organization's concept of "Five Moments for Hand Hygiene" was used to evaluate the awareness of the indications for hand hygiene and compliance was observed during Objective Structured Clinical Examination (OSCE) sessions. Sixty students including thirty-six males (60%) and twenty-four females (40%) participated voluntarily in the study. Results. The average awareness regarding the positive indications of hand hygiene was 56%. Rest of the 44% of students were either not sure or unaware of the indications of hygiene. Only 29% of students were able to identify all the five indications for hand hygiene in the questionnaire. Compliance as assessed during OSCE sessions was only 17% with no significant difference between the genders. Conclusion. It was concluded that serious efforts are needed to improve the hand hygiene practices among medical students.
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... Further research is essential to validate and adapt the survey culturally for use in Arab nations. Previous study has shown that the burden of nosocomial infections is disproportionately higher in developing countries (Al Kadi & Salati, 2012). In light of this, we sought to assess the elements and reasons of missed infection control measures in Jordanian hospitals. ...
Background
Missed infection control practices may negatively impact quality healthcare and patient safety in acute health care settings. Hence, more research is urgently needed especially in Arab countries. To investigate the elements and reasons of missed infection control activities among nurses in Jordan. The sociodemographic correlates with missed infection control activities were also examined.
Methods
A cross sectional design was utilized in this study. A convenience sample of 960 nurses from seven hospitals in the North of Jordan was used. The Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey was employed to collect the data. Data were analyzed using descriptive inferential, and multivariate regression analysis.
Findings
The majority of the participants worked as registered nurses (78.4%). The highest missed infection control activities were: screening new admissions for Multi Resistant Organisms (MRO), wearing gloves for both preparing and administration of all antibiotics, and informing staff and visitors for the need for transmission-based precautions (when managing a patient with a MRO). The least missed infection control activities reported by nurses were performing hand hygiene after touching patients, and before drug administration. The reasons of missed infection control measures most frequently reported by nurses were: urgent patient situation, followed by inadequate number of clerical staff, and unexpected rise in patient volume and or acuity.
Conclusion
This research suggests that interventions to reduce missed infection control measures should focus on the education and training of nursing staff as well as a adopting nurse: patient ratio in managing nursing workload, which should not exceed 1:4.
... The results were marginally better than the other studies done in Saudi Arabia. [14,15] Similarly, another study done among medical and nursing students also found moderate knowledge in the majority of them. [16] Some other researchers have also reported knowledge to be moderate among medical and nursing students. ...
... Further research is necessary to inform current and future healthcare workers in the country about the importance of complying with hand hygiene. Studies have found that healthcare providers, including certified healthcare providers and health science students, have low awareness of hand hygiene [25,26]. ...
Hand hygiene serves as a critical preventative measure against the spread of acquired
infections in healthcare facilities and is an integral component of patient safety programs. While
healthcare students in training are typically introduced to the principles underlying hand hygiene,
the translation of this understanding into practice is often lacking, and compliance has remained low.
This study aimed to evaluate health science students’ in biomedical sciences, chiropractic and emergency
medical care, environmental health, complementary medicine, medical imaging and radiation
sciences, nursing, optometry, podiatry, and sports and movement studies perceptions regarding hand
hygiene education (knowledge and attitude) and practice at a university in South Africa. Consenting
students were asked to complete an online questionnaire that tested their knowledge, practices,
and skills in handwashing. The ANOVA analysis results suggested significant differences in hand
hygiene scores across departments and years of study. The multiple regression analyses confirmed
these findings, suggesting that the department of study significantly influenced all aspects of hand
hygiene, while the year of study affected hand hygiene skills, and age group influenced hand hygiene
practices. Based on these findings, a conceptual model, the University Hand Hygiene Improvement
Model (UHHIM), was proposed to enhance the teaching and learning of hand hygiene at the university
level. The model underscores the necessity of targeted education, continuous monitoring, and
feedback, and the pivotal roles of hand hygiene facilitators and student participation in enhancing
hand hygiene behaviors.
... In addition, a study in Malaysia reported that around 61% of healthcare workers had good hand hygiene knowledge (19). However, the 53.7% of good hand hygiene knowledge in this study was much higher than 29%, 14% and 9% reported in Saudi Arabia and India, respectively (9,20,21). The difference in results reported might be due to the variety of the hospital's education curriculum or training courses. ...
Background:
Hands are the most common vehicle of pathogen transmission in a healthcare setting. Therefore, hand hygiene is the leading method of reducing healthcare-associated infections. This study aimed to determine the knowledge, attitude and practice (KAP) of hand hygiene and predictors for poor hand hygiene practice among healthcare workers who care for children with leukaemia in the paediatric oncology ward of King Saud Medical City (KSMC) in Saudi Arabia.
Methods:
One hundred and ninety medical doctors and nurses, who were registered with the Saudi Commission for Health Specialities, were selected to participate in this cross-sectional study using a simple sampling technique. Their KAP of hand hygiene was assessed using a self-structured questionnaire and the collected data was analysed using IBM® SPSS® version 26.0.
Results:
Of the 190 healthcare workers, 74.7% were nurses and 25.3% were medical doctors. Among the participants, 53.7% (102) had good knowledge of hand hygiene, 51.6% (98) had positive attitudes towards hand hygiene and 55.8% (106) practised satisfactory hand hygiene. Bachelor education level (adjusted OR = 2.736; 95% CI = 1.101, 6.799; P = 0.030), postgraduate education level (adjusted OR = 6.256; 95% CI = 2.171, 18.028; P = 0.001), poor knowledge (adjusted OR =2.575; 95% CI = 1.263, 5.246; P = 0.009) and negative attitude (adjusted OR = 4.702; 95% CI = 1.263, 5.246; P < 0.001) were the significant predictor variables of unsatisfactory hand hygiene practice among healthcare workers.
Conclusion:
The performance of hand hygiene among healthcare workers is still far less than optimal, particularly in settings like oncology units. Effective programmes are needed to increase their awareness of hand hygiene KAP, while strict guidelines are needed to reduce nosocomial infections.
... Infections are the most frequent adverse effects following a hospital stay, affecting 5-10% of hospitalized patients in developed countries. Even though practicing good hand hygiene is a pretty basic habit, only about 40% of healthcare professionals follow it [4][5][6][7]. The "Time strokes method" refers to the vigorous scrubbing of the nail beds on the palm resulting in foam [8]. ...
Background
The most critical factors in the satisfactory recovery of a patient post-surgery are obedience to sterilization and aseptic protocol. Using aseptic principles, the standard hand scrubbing and gloving procedure prevents contamination of the surgical site and aids in infection control.
Methods
Eighty dental interns were observed during minor oral surgical procedures for hand scrubbing and donning sterile surgical gloves, following the steps and guidelines provided by World Health Organization (WHO). The dental interns were evaluated, and in order to enhance their understanding of hand scrubbing and donning surgical gloves, desensitization programs were conducted through lectures using PowerPoint presentations. After one week, the participants were observed and evaluated again. This program made the participants aware of asepsis and infection control in clinical practice.
Results
Prior to intervention, only 37.14% of young dental surgeons performed proper conventional hand hygiene practices. After the intervention, this percentage increased to 62.142%, indicating a significant improvement. Regarding the donning of sterile surgical gloves, 43.75% of participants followed the standard steps before the intervention. After the intervention, the percentage raised to 86.25% indicating substantial growth.
Conclusion
Observations before and after the evaluation demonstrated significant changes in the acceptance rates for the fundamental criteria of hand hygiene and donning sterile surgical gloves. Adhering to both procedures according to WHO guidelines will help to reduce the risk of infections and raise awareness about asepsis in the practice among young dental surgeons.
... But both doctors and nurses showed positive attitude towards hand hygiene when compared to the ward staff (table 3). The response of the participants to attitude based questions is given in table 3. [12,13] In our study analysis of the responses showed that health care workers had moderate knowledge on hand hygiene, similar to findings in study done by MHJD Ariyaratne. [14] Though this was a positive finding, major gaps in the knowledge were identified which should be addressed during the future training sessions. ...
Background: Health-care-associated infection (HCAI) is one of the most important and pervasive problems in the medical field. When the healthcare system first began, maintaining clean hands was thought to play a critical part in reducing hospital acquired illnesses. It has become more important for healthcare professionals to practice good hand hygiene at the outset of the Covid pandemic. Methods:-A cross-sectional observational research conducted at Teerthanker Mahaveer Medical College & Research Center Hospital in Moradabad by using a convenience sequential sampling method 360 professionals were enrolled then divided into 3 groups for comparison and assess knowledge, attitude, practices (behavior) the WHO knowledge questionnaire, attitude and self-perceived practices via Likert scale. Results: Of the 360 participants were involved in the study, we found that majority (doctors-60.4%, nurses-70.8%, ward staff-74.8%) had received knowledge on hand hygiene in last three years but the overall most participants had positive attitude of the respondents towards hand hygiene and more than 70 % of participants considered it as an essential part of their role during practice but still practices lagged situationally. Conclusion: We concluded that there is lacunae in training leading to differences in attitude and practices when compared to knowledge of the health care worker even after a pandemic. Laying importance on the training of staff of all strata.
Introduction
For more than a century, Hand hygiene (HH) has been known to be the most cost-effective hygienic method to minimize infection transmission and risk in healthcare settings. Even though 50% of healthcare-associated infections (HAIs) can be prevented with proper HH, globally 7 per 100 patients from acute-care hospitals in high-income countries (HIC) and 15 per 100 patients in low and middle-income countries (LMIC) acquire at least one HAI during their hospital stay. Even though medical healthcare students do not have the primary responsibility of providing patient care, it is necessary to train, assess, and monitor HH as their interaction with patients could lead to an increased number of HAIs. By conducting this global scoping review, we aim to summarize the global trends surrounding the knowledge, attitude, and practice (KAP) of medical healthcare students regarding HH, and how it affects patient safety.
Methods
We followed the five stages of Arksey and O’Malley’s Scoping Review Methodology. The literature search was done in three databases, specifically, EMBASE, Web of Science, and PubMed. Original published research in credible journals in English conducted between 2012 and 2023 discussing HH amongst medical healthcare students all over the world were included.
Results
Twenty-three studies were included in the final analysis. The overall knowledge of medical students regarding HH was low, with some studies reporting scores as low as 10.1%. However, the attitude towards HH was generally positive, with mean scores ranging from 55% to 93%. Notably, nursing students and females exhibited better attitudes and self-reported HH practices. Furthermore, studies indicated that providing training on HH resulted in an increase in positive attitudes towards and improved practices of HH.
Conclusion
By focusing on training and facilitating improved HH practices, future generations of doctors and nurses can contribute to minimizing HAIs and enhancing patient safety. Standardized approaches and comprehensive data collection are crucial for implementing effective HH interventions.
Background
Maintaining effective surface hygiene and preventing contamination is of paramount importance. Our study introduces Glo Germ, a versatile product available in various forms, which possesses the unique ability to reveal hidden truths under ultraviolet light, enhance understanding of hygiene, and spread awareness of COVID-19 transmission and preventive measures.
Materials and Methods
A comprehensive study was conducted to assess different surface cleaning techniques’ effectiveness. Glo Germ, containing a fluorescent dye activated by ultraviolet light, was used to visualize germ spread and compare disinfectant cleaners’ efficacy. The study encompassed diverse surfaces and materials, aiming to identify optimal cleaning techniques for each context. Furthermore, a small illustrative study was conducted during a COVID-19 awareness presentation involving students. Glo Germ was applied to hands, revealing its subsequent spread to faces and surfaces. This visual experiment effectively emphasized hand hygiene and mask-wearing importance.
Results
Results indicated that while water alone achieved satisfactory cleaning results, using detergent and the appropriate cleaning tools further improved efficacy. Notably, adhering to consistent patterns and applying pressure during cleaning proved essential. The student demonstration showed how contaminants spread quickly, highlighting hand hygiene’s significance and the potential extent of contamination through sneezing.
Conclusion
Glo Germ inclusion in these experiments highlights its potential in educating about surface cleaning and microbial transmission, offering an interactive and engaging approach to promoting personal hygiene and fostering illness prevention awareness.
The aim of this study was to determine the level of personal hygiene knowledge in university students and assess the level of health perception. This cross-sectional study was conducted with 946 students studying at a state university in Ankara. A questionnaire which included the Perception of Health Scale and questions to determine socio-demographic characteristics and level of personal hygiene knowledge of students was used to collect data. Data were collected by face-to-face survey method. The students ages ranged from 16 to 39 with years. Median score of the students obtained from the questions on personal hygiene knowledge and from the Perception of Health Scale was 24.0 (Min-Max= 0.0-30.0)and 48.5 (Min-Max=22.0-75.0), respectively. While the most accurately answered question on personal hygiene was “Hands should be washed with generous amounts of soap and water after using the toilet” (95%), the least accurately answered question was “It is beneficial to walk around barefoot at home” (37.2%). In this study, the level of personal hygiene knowledge was determined to be higher in students of medical faculty, women, non-smokers, non-drinkers and those who had previous information on personal hygiene before (p< 0.05).A weak positive relationship was determined between the level of personal hygiene level and health perception (r=0.397; p=0.001).It was determined in the study that the students had a good level of personal hygiene knowledge and medium level of health perception.
Pelaksanaan hand hygiene dapat mengurangi peningkatan kejadian Hospital Associated Infections (HAIs). Peserta program studi profesi dokter merupakan salah satu perantara patogen kepada pasien untuk mengurangi kejadian HAIs diperlukan kepatuhan terhadap hand hygiene. Hand hygiene adalah suatu tindakan untuk mengurangi peningkatan angka kejadian. Tujuan dari penelitian ini adalah untuk melihat gambaran kepatuhan hand hygiene pada peserta program studi profesi dokter di RSUD Ulin Banjarmasin berdasarkan jenis kelamin, lama pendidikan, protokol five moments dan cuci tangan 6 langkah. Penelitian ini menggunakan metode observasional deskriptif dengan pengamatan langsung dengan populasi peserta program studi profesi dokter. Penelitian dilakukan pada bulan November – Desember 2022 dengan pengambilan secara consecutive sampling. Hasil penelitian ini menunjukkan angka kepatuhan hand hygiene 33,33% dan melakukan sesuai prosedur 25%. Kepatuhan hand hygiene pada perempuan 35,48% dan laki – laki 31,03%; pada angkatan 31 sebanyak 42,86% dan angkatan 32 sebanyak 25%. Kepatuhan pada tiap momen seelum menyentuh pasien 22,73%, sebelum tindakan aseptis 25%, setelah terpapar cairan tubuh 50%, setelah menyentuh pasien 45,45%, setelah menyentuh lingkungan sekitar pasien 25%. Hasil penelitian kepatuhan hand hygiene ini didapatkan jenis kelamin perempuan dan angkatan 31 lebih patuh. Kepatuhan momen tertinggi saat setelah terpapar cairan tubuh pasien. Subjek penelitian diharapkan dapat meningkatkan kepatuhan hand hygiene.
Objectives: To motivate healthcare professionals, with a focus on improving hand hygiene compliance. Methods: An observational, prospective, longitudinal study was conducted on the evaluation of hand hygiene compliance at Hera General Hospital, Makkah, Kingdom of Saudi Arabia from May 2009 to May 2010. Four components to improve hand hygiene compliance were implied; daily audit, monthly staff education; quarterly workshops of hand hygiene, and education material distribution. The compliance rate was calculated by its adherence with number of opportunities. Results: Of total 163 healthcare professionals were surveyed for hand hygiene compliance; 57)35%(were doctors, 92)56.4%(nurses, and 14)8.6%(patient care technicians. The overall compliance rate was 50.3%, and its distribution among staff was as follows; doctors 49.1%, nurses 52.2%, and technicians 42.8%. The highest compliance rate among doctors and nurses was found in surgical units. A low compliance in high intensity patient care area was observed such as in the Emergency Room and out patient department. The patient care technicians showed highly variable results, as their compliance rate was 100% in medical units while 0% in various other clinical areas. Conclusion: The overall hand hygiene compliance rate of healthcare professionals reached 50% after a long education campaign, and was highest among the nurses. Further study is needed to explore the reasons for non-compliance.
Health care associated infections are drawing increasing attention from patients, insurers, governments and regulatory bodies. This is not only because of the magnitude of the problem in terms of the associated morbidity, mortality and cost of treatment, but also due to the growing recognition that most of these are preventable. The medical community is witnessing in tandem unprecedented advancements in the understanding of pathophysiology of infectious diseases and the global spread of multi-drug resistant infections in health care set-ups. These factors, compounded by the paucity of availability of new antimicrobials have necessitated a re-look into the role of basic practices of infection prevention in modern day health care. There is now undisputed evidence that strict adherence to hand hygiene reduces the risk of cross-transmission of infections. With "Clean Care is Safer Care" as a prime agenda of the global initiative of WHO on patient safety programmes, it is time for developing countries to formulate the much-needed policies for implementation of basic infection prevention practices in health care set-ups. This review focuses on one of the simplest, low cost but least accepted from infection prevention: hand hygiene.
Wearing of gloves reduces transmission of organisms by healthcare workers' hands but is not a substitute for hand hygiene. Results of previous studies have varied as to whether hand hygiene is worse when gloves are worn. Most studies have been small and used nonstandardized assessments of glove use and hand hygiene. We sought to observe whether gloves were worn when appropriate and whether hand hygiene compliance differed when gloves were worn.
Observational study.
Healthcare workers in 56 medical or care of the elderly wards and intensive care units in 15 hospitals across England and Wales.
We observed hand hygiene and glove usage (7,578 moments for hand hygiene) during 249 one-hour sessions. Observers also recorded whether gloves were or were not worn for individual contacts.
Gloves were used in 1,983 (26.2%) of the 7,578 moments for hand hygiene and in 551 (16.7%) of 3,292 low-risk contacts; gloves were not used in 141 (21.1%) of 669 high-risk contacts. The rate of hand hygiene compliance with glove use was 41.4% (415 of 1,002 moments), and the rate without glove use was 50.0% (1,344 of 2,686 moments). After adjusting for ward, healthcare worker type, contact risk level, and whether the hand hygiene opportunity occurred before or after a patient contact, glove use was strongly associated with lower levels of hand hygiene (adjusted odds ratio, 0.65 [95% confidence interval, 0.54-0.79]; P < .0001).
The rate of glove usage is lower than previously reported. Gloves are often worn when not indicated and vice versa. The rate of compliance with hand hygiene was significantly lower when gloves were worn. Hand hygiene campaigns should consider placing greater emphasis on the World Health Organization indications for gloving and associated hand hygiene.
National Research Register N0256159318.
The World Health Organization (WHO) launched the first Global Patient Safety Challenge in 2005 and introduced the ‘5 moments of hand hygiene’ in 2009 in an attempt to reduce the burden of health care associated infections. Many NHS trusts in England adopted this model of hand hygiene, which prompts health care workers to clean their hands at five distinct stages of caring for the patient. Our review analyses the scientific foundation for the five moments of hand hygiene and explores the evidence, as referenced by WHO, to support these recommendations. We found no strong scientific support for this regime of hand hygiene as a means of reducing health care associated infections. Consensus-based guidelines based on weak scientific foundations should be assessed carefully to prevent shifting the clinical focus from more important issues and to direct limited resources more effectively.
We recommend caution in the universal adoption of the WHO ‘5 moments of hand hygiene’ by orthopaedic surgeons and other health care workers and emphasise the need for evidence-based principles when adopting hospital guidelines aimed at promoting excellence in clinical practice.
Although hand hygiene (HH) is the cheapest and simplest tool for the prevention of hospital-acquired infections, poor HH compliance has been reported among health care professionals. A variety of factors influence the compliance with HH guidelines, the most important being the quality of the basic nursing education. The aims of this study were to analyze the effectiveness of the basic nursing education in relation to HH, and to explore the skills and attitudes toward HH among nursing students in praxis.
A mixed-method approach using a cross-sectional survey combined with observation and curricular analysis was used. A total of 188 nursing students participated in the study.
Content analysis revealed significant deficits in the quality of HH-related information in basic nursing educational programs. Our results correlate directly with the reported insufficient levels of HH knowledge and the associated poor HH compliance by students during their training in clinical settings; as shown in observation and questionnaire-based surveys.
The lack of compliance with HH standards among students lead to poor compliance among health care professionals in praxis. Consequently, the role of educational institutions in the prevention of hospital-acquired infections is significant, if the effectiveness of HH education is to be improved.
To evaluate the compliance on hand-hygiene and related factors among healthcare providers working at secondary and tertiary hospitals in Chengdu.
On-site observations regarding hand-hygiene compliance and facilities were conducted in 6 hospitals in Chengdu. Doctors and nurses were asked and recorded about their knowledge regarding hand-hygiene.
Of 1535 activities where hand-hygiene was deemed necessary, under observating healthcare providers would perform hand-hygiene procedures 17.8% of the time (12.8% of the time before touching a patient, 21.0% of the time before touching objects around a patient, 27.3% of the time after touching a patient, and 31.5% of the time after removing gloves). Only 2.2% of the treating rooms were equipped with foot-operated or automatic faucets;of these only 24.5% had soap or alcohol-based hand-sanitizer, and 6.3% had paper towel or other hand-drying equipment. 92.8% of the healthcare providers knew of the six-step method on hand-washing. More than 90.0% of the healthcare providers knew that both palm and back of the hands as well as the front and back of the fingers should be washed. However, only 22.8% knew that the hand-washing procedure should last ≥ 15 seconds. Rates on hand hygiene among chief or more senior physicians (14.6%), attending physicians (9.2%) and junior doctors (15.6%), nurses in chief (25.0%), senior nurses (26.3%) and junior nurses (20.5%) showed no significant differences (P > 0.05). Similarly, scores on related knowledge between chief or senior physicians (12.4 ± 3.2), attending physicians (13.6 ± 3.3) and junior doctors (13.4 ± 2.9), nurses in charge (15.2 ± 2.0), senior nurses (14.8 ± 2.1) and junior nurses (14.3 ± 2.6) also showed no significant differences (P > 0.05). Rate on hand hygiene among nurses (22.7%) was significantly higher than that of the doctors (13.6%). Rate of hand hygiene among 50 - 59 years old healthcare providers (7.4%) was significantly lower than those of all the other age groups (17.1% - 25.0%); rate of female health care providers (19.5%) was significantly higher than that of males (13.8%). Similarly, the nurse's knowledge score (14.7 ± 2.3) was significantly higher than that of the doctors (13.2 ± 3.1). Among 50 - 59 years old healthcare providers, the rate was (12.2 ± 3.8) significantly lower than that of 20 - 29 (14.0 ± 2.6), 30 - 39 (14.3 ± 2.9) and 40 - 49 year olds (13.8 ± 2.7). Again, the knowledge score of females (14.5 ± 2.5) was significantly higher than that of males (12.7 ± 3.2) (P < 0.05).
The high-level knowledge on hand-hygiene among healthcare providers in this area did not translate into good practices. Also, most of the hospitals had poor hand-hygiene equipment. We recommend that training and periodic monitoring be conducted, and hand-hygiene equipment be improved to facilitate hand-hygiene practices among healthcare providers.
Despite several guidelines on hand hygiene (HH), compliance especially in physicians is reported to be low which has huge implications for healthcare-associated infections. To evaluate performance of HH, influence of teaching and influence of monitoring the results in medical students, we conducted an observational study.
Performance of hand disinfection was evaluated in first (N=28), third (N=193) and fifth (N=45) year medical students using fluorescent hand disinfectant. The influence of teaching and information about result control was assessed. The students perception of the impact of HH was also evaluated by a questionnaire.
Presence of disinfectant gaps was observed significantly more often in first year medical students compared to third year ones (82% vs, 60%; p=0.02). In additional, > 3 gaps were seen significantly more often in first year medical students compared to fifth year students (36% vs. 9%; p=0.007). Both information about teaching and monitoring the results improved outcome significantly. For example, gaps were present in 92% without information and without teaching, in 70% (RR: 1.3 (1.0-1.6); p=0.003) with information about result control only, and in only 18% (5.1 (3.0-8.5); p=0.0001) after teaching. Notably, the medical students ascribed HH to be of a great importance regardless of their level of education.
Performance of HH could be improved by practical training as evidenced by best HH performance being documented immediately after teaching and a training effect during the course of medical studies was also observed. Thus, we suggest implementing regular education and practical training on HH from early on in the medical studies curricula to improve overall quality of patient care. regular education and practical training on HH from early on in the medical studies curricula to improve overall quality of patient care.
Medical students were asked regarding knowledge and beliefs on hand hygiene before entering the clinical phase of education. By this, we noticed a lack of knowledge concerning the correct indications for hand disinfection. Regardless of previous experience in hospitals, the medical students expected that the compliance towards hand hygiene would be worse in more experienced physicians and senior consultants - who are often considered to be role models for medical students. © 2011 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
This paper reports a study examining the hand hygiene knowledge, beliefs and practices of Italian nursing and medical students with the aim of informing undergraduate curricula.
In comparison with registered nurses, physician status is a risk factor for non-compliance with hand hygiene guidelines. Little research has been conducted to determine if differences between the professions in relation to hand hygiene are apparent at the undergraduate level. Cross-disciplinary studies that may provide an insight into this topic are lacking.
A questionnaire was administered to a convenience sample of 117 nursing and 119 medical students in a large university in Rome, Italy, to determine their hand hygiene knowledge, beliefs and practices. The data were collected in 2007-2008.
Nursing students' hand hygiene knowledge (F = 9·03(1,230); P = 0·003), percentage compliance (Z = 6·197; P < 0·001) and self-reported hand hygiene practices (F = 34·54(1,230); P < 0·001) were significantly higher than that of medical students. There were no statistically significant differences between hand hygiene beliefs. Mean scores on the knowledge questions were low for both groups, reflecting primarily a knowledge deficit in relation to the use of alcohol-based hand rubs to decontaminate hands in the healthcare setting.
Statistically significant disciplinary differences in hand hygiene knowledge and self-reported practices were apparent among undergraduate Italian healthcare students. Further research is needed to determine the causative factors. The overall low scores on the knowledge items indicate that these students require further education on hand hygiene, particularly in relation to the use of alcohol-based hand rubs.