A novel approach to improve hand hygiene compliance of student nurses

Siu Yin Lee,Xiao Bei Wang,Theresa Seetoh,Dale A Fisher,Sharon Salmon

doi:10.1186/2047-2994-2-16

Abstract

BackgroundThe National University Hospital, Singapore routinely undertakes standardized Hand Hygiene auditing with results produced by ward and by staff type. In 2010 concern was raised over consistently low compliance by nursing students averaging 45% (95% CI 42%–48%) prompting us to explore novel approaches to educating our next generation of nurses to improve their hand hygiene practice.We introduced an experiential learning assignment to final year student nurses on attachment to NUH inclusive of hand hygiene auditor training followed by a period of hand hygiene observation. The training was based on the World Health Organisation (WHO) “My 5 moments for hand hygiene” approach. Upon completion students completed an anonymous questionnaire to evaluate their learning experience.FindingsBy 2012, nursing students were 40% (RR: 1.4, 95% CI 1.3–1.5, p<0.001) more likely to comply with hand hygiene practices. 97.5% (359/368) of nursing students felt that the experience would enhance their own hand hygiene practice and would recommend participating in audits as a learning instrument.ConclusionsWith consideration of all stakeholders a sustainable, flexible, programme was implemented. Experiential learning of hand hygiene was a highly valued educational tool and in our project was directly associated with improved hand hygiene compliance. Feedback demonstrated popularity amongst participants and success in achieving its program objectives. While this does not guarantee long term behavioural change it is intuitive that instilling good habits and messages at the early stages of a career will potentially have significant long-term impact.

Highlights

The National University Hospital, Singapore routinely undertakes standardized Hand Hygiene auditing with results produced by ward and by staff type
Experiential learning of hand hygiene was a highly valued educational tool and in our project was directly associated with improved hand hygiene compliance
A hand hygiene auditor training programme was incorporated into the orientation programme for final year nursing students as part of their pre-registration consolidation placement (PRCP) for diploma students and transition to practice (TTP) for degree students

Summary

Introduction

The National University Hospital, Singapore routinely undertakes standardized Hand Hygiene auditing with results produced by ward and by staff type. In 2010 concern was raised over consistently low compliance by nursing students averaging 45% (95% CI 42%–48%) prompting us to explore novel approaches to educating our generation of nurses to improve their hand hygiene practice. The importance of hand hygiene in the prevention of healthcare-associated infections (HCAIs) is not disputed. Hand hygiene is recognized as the single most important element of strategies to prevent HCAIs [1,2]. Essential components for improving hand hygiene compliance rates are monitoring and providing timely performance feedback to health care workers [3,4,5,6]. In 2008, NUH escalated its hand hygiene efforts with respect to education and institution of standardised auditing.

Objectives

Methods

Results

Discussion

Conclusion