Effectiveness of Hygienic Hand Washing Training on Hand Washing Practices and Knowledge

Effectiveness of Hygienic Hand Washing Training on Hand Washing Practices and Knowledge: A Nonrandomized Quasi-Experimental Design Mete Kagan Karaoglu, BSc, RN, MSc; and Semiha Akin, BSc, RN, MSc, PhD

Hygiene is considered as an integral part of hospital infection control. Hygiene refers to hand washing using antiseptic hand wash, antiseptic hand rub, or surgical hand antiseptics to reduce the spread of micro- organisms and infection. Hygiene includes the practices and precautions to prevent the spread of infectious diseases and microorganisms from one environment to another (World Health Organization [WHO], 2009). Although the hospital-acquired infection rate for inpatients is 5% to

10%, that rate exceeds 20% to 25% in intensive care units (Yurttaş, Kaya, & Engin, 2017). Compliance with hygiene practices and infection control precautions such as hand hy- giene reduces the incidence of hospital-acquired infections and financial burdens and prevents long-term disability (Koşucu, Göktaş, & Yıldız, 2015; WHO, 2009).

the Centers for Disease Con- trol and Prevention (CDC) in 2002

Guidelines published by the Centers for Disease Con- trol and Prevention (CDC) in 2002 and the WHO in 2009 emphasized that multidisciplinary hand hygiene promotion programs and alcohol-based hand rubs have been reported to improve hand hygiene practices of health care staff (CDC, 2002; WHO, 2009). Hospital workers’ hands are one of the most important sources of infections among patients (Yurttaş, Kaya, & Engin, 2017). With simple hygienic applications such as washing the hands with soap and water or alcohol-based hand rubs, many in- fectious diseases could be prevented (Deveci, Açık, Ercan, Ferdane, & Oğuzöncül, 2010). Although the importance of washing hands for infection prevention is well known, compliance with hand hygiene practices among health care staff continues to be a frequently encountered prob- lem (Sadeghi-Moghaddam, Arjmandnia, Shokrollahi, & Aghaali, 2015; WHO, 2009).

The WHO (2009) states that the assessment of hand hygiene indications and actions should be monitored to

Nurses undertake important responsibilities in patient care and the prevention of hospital-acquired infections. However, adherence to hand hygiene practices among nurses has been reported to be low. This study aims to evaluate the effectiveness of hygienic hand washing training on hand washing practices and knowledge. The study design was a nonrandomized, quasi-experimental study, with pretest–posttest for one group. Pre- and postobservations were also conducted using an observa- tion form on any 5 workdays to evaluate the effective- ness of hygienic hand washing training on hand washing practices. The study was conducted with 63 nurses work- ing at a hospital in Istanbul. Hand Hygiene Knowledge Form scores after hygienic hand washing training were higher than the pretraining scores. The number of the nurses’ hand hygiene actions after hand hygiene train- ing increased significantly compared with that before training. The results indicate that training in proper hand washing techniques and hygienic hand washing practices positively affects the knowledge level of nurses and their hand washing behavior. J Contin Educ Nurs. 2018;49(8):360-371.

important responsibilities in patient care and the prevention of hospital-acquired infections

abstract

Mr. Karaoglu is Faculty, Hematology/Oncology Ward, Florence Night- ingale Hospital, and Dr. Akin is Associate Professor, Faculty of Nursing, University of Health Sciences, Istanbul, Turkey.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Semiha Akin, BSc, RN, MSc, PhD, Associ- ate Professor, Faculty of Nursing, University of Health Sciences, Mekteb-i Tıbbiye-i Sahane (Haydarpasa) Kulliyesi Selimiye Mahallesi, Tibbiye Cad. No:38, 34668 Uskudar, Istanbul, Turkey; e-mail: semihaakin@yahoo.com.

Received: August 1, 2017; Accepted: April 12, 2018 doi:10.3928/00220124-20180718-07

361The Journal of Continuing Education in Nursing · Vol 49, No 8, 2018

improve approaches for the prevention of health care- associated infections and the transmission of microorgan- isms. Direct observation is still considered the gold stan- dard for monitoring compliance with hand hygiene and is a widely used assessment technique, providing more accu- rate and reliable data (CDC, 2002; WHO, 2009). Hand hygiene actions that health care staff should follow include washing hands (a) before patient contact, (b) before asep- tic tasks, (c) after body fluid exposure risk, (d) after patient contact, and (e) after contact with patient surroundings. Observational studies reported poor adherence to hand hygiene procedures among health care staff (CDC, 2002).

Effectiveness of Hygienic Hand Washing Training on Hand Washing Practices and Knowledge