Students' observations of hand hygiene in nursing homes using the five moments of hand hygiene

Abstract

Aims and objectives To use nursing students to observe hand hygiene adherence in nursing homes and to explore whether the students' reflections after observing hand hygiene practices gives them a deeper understanding of the subject matter. Background Residents in nursing homes worldwide have low tolerance for healthcare‐associated infections that require antibiotics, and hand hygiene is the single most effective action to reduce infections. Design Observational study using (a) World Health Organization's (WHO) “Five moments for hand hygiene” validated tool to record indications and adherence and (b) an exploratory study of individual reflection notes from students conducted during and after observations. Methods From February 12–15, 2018, 26 nursing students in their second semester of a 3‐year bachelor programme participated as observers in five wards in four nursing homes in the Oslo metropolitan area. This study was performed according to the STROBE statement. Results Hand hygiene was performed for 57.2% of the 2,393 indications observed and recorded. Adherence differed significantly by type of personnel and by location. Four thematic categories emerged from the reflection notes: (a) practical awareness and introspection; (b) visualisation and enhancement of understanding of practice learning; (c) incorrect hand hygiene practices; and (d) stimulation to increase essential knowledge. Conclusion Hand hygiene adherence was too low to prevent healthcare‐associated infections and to reduce the use of antibiotics. The students' reflection notes indicated more “insight and understanding of the complexity of hand hygiene.” We suggest using nursing students in clinical placement as a means of incorporating different interventions as part of their learning skills and become “living reminders” of the importance of hygiene and infection prevention. Relevance for clinical practice Improving the student's activity about hygiene and infection prevention in clinical placement may help to raise awareness by healthcare workers in nursing homes.

Infection prevention and control in nursing homes during COVID-19: An environmental scan

“…Their reflections on real-world scenarios have increased their awareness of their own and others’ hand hygiene habits and other IPC competencies. 27 , 37 , 38 Students reported insights into the value of moving from theoretical concepts to real-life situations as well as observing which clinical scenarios present critical IPC challenges. They also reported that employees became more conscious of their hand hygiene and their IPC actions in the presence of an observer.…”

Posters as a Tool to Improve Hand Hygiene among Health Science Students: Case—Control Study

“…Overall, nursing students’ attitudes towards HH are favourable [ 7 , 10 , 16 , 17 ], but conventional teaching methods do not seem to provide a proper understanding of HH [ 7 , 18 , 19 ]. Additionally, Løyland et al (2020) [ 20 ] confirmed that the adhesion to HH in the medical personnel, including nursing students, had a negative balance, which affected to the prevention of nosocomial infections and even prevented the reduction of the instructions of the antibiotic treatment in patients. In studies such as the one developed by Sundal et al [ 19 ], the degree of general compliance in HH in nursing students was estimated to be 83.5% during their clinical internship.…”

“…In studies such as the one developed by Sundal et al [ 19 ], the degree of general compliance in HH in nursing students was estimated to be 83.5% during their clinical internship. In these studies, the five moments of the HH of the WHO were evaluated: firstly, before touching the patient; secondly, before the cleaning/washing procedure; thirdly, after exposure to body fluids; fourthly, after touching the patient; and finally, after touching a patient in the environment [ 19 , 20 ]. Elola-Vicente et al [ 21 ] evaluated the effectiveness of the HH technique in medical personnel.…”

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