Abstract
Background The high prevalence of hand dermatitis in nurses is attributed to frequent hand washing with soap and infrequent use of hand moisturisers Aim To test the hypothesis that a bespoke, web-based behavioural change programme (BCP) coupled with provision of hand moisturisers, can produce a clinically useful reduction in the prevalence of hand dermatitis after one year, when compared to standard care, in at-risk nurses. Methods 35 Trusts/Health Boards have been recruited as participating sites. Sites will be the unit of randomisation. There are two groups of participants per site: a) student nurses (n > 40/site) who are about to start their first clinical placements, and who are at increased risk of hand dermatitis because of a past history of atopic disease or hand dermatitis; b) nurses working in intensive care units (n > 40/site) who are at increased risk of hand dermatitis because of the nature of their work. The intervention centres on the BCP, which will include information on: when and when not to use gloves, antibacterial hand gels and moisturising cream. Participants will be asked to form implementation intentions for performing each behaviour. Facilities will be provided to encourage adherence, including personal supplies of moisturising cream for student nurses, and provision of optimal equipment for washing and moisturising hands on the wards for intensive care nurses. The impact of the interventions will be evaluated from information collected by questionnaires and standardised photographs of hands/wrists. In addition, we will undertake a cost/benefit analysis. Statistical analysis will be by multi-level regression modelling to allow for clustering by site, and will take account of the paired nature of before and after comparisons in individuals. Primary outcome The difference between intervention and control sites in the change in point prevalence of visible hand dermatitis from baseline to 12 months after the intervention.
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