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      Knowledge, Attitude, and Practice of Hand Hygiene among Medical and Nursing Students at a Tertiary Health Care Centre in Raichur, India

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          Abstract

          Background. Hand hygiene is recognized as the leading measure to prevent cross-transmission of microorganisms. Regarding hospital acquired infections, the compliance of nurses with hand washing guidelines seems to be vital in preventing the disease transmission among patients. There is a paucity of studies exploring this subject in Asia. Especially medical and nursing student's knowledge of standard hand hygiene precautions is rarely compared. Methods. A cross-sectional study was conducted among 98 medical and 46 nursing students in a tertiary medical college in India. Knowledge was assessed using WHO hand hygiene questionnaire. Attitude and practices were evaluated by using another self-structured questionnaire. Z test was used to compare the percentage of correct responses between medical and nursing students. A P value less than 0.05 was considered significant. Results. Only 9% of participants (13 out of 144) had good knowledge regarding hand hygiene. Nursing students knowledge ( P = 0.023) , attitude ( P = 0.023), and practices ( P < 0.05) were significantly better than medical students.

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          Compliance with handwashing in a teaching hospital. Infection Control Program.

          T Perneger, P Mourouga, Didier Pittet (1999)
          Transmission of microorganisms from the hands of health care workers is the main source of cross-infection in hospitals and can be prevented by handwashing. To identify predictors of noncompliance with handwashing during routine patient care. Observational study. Teaching hospital in Geneva, Switzerland. Nurses (66%), physicians (10%), nursing assistants (13%), and other health care workers (11%). Compliance with handwashing. In 2834 observed opportunities for handwashing, average compliance was 48%. In multivariate analysis, noncompliance was higher among physicians (odds ratio [OR], 2.8 [95% CI, 1.9 to 4.1]), nursing assistants (OR, 1.3 [CI, 1.0 to 1.6]), and other health care workers (OR, 2.1 [CI, 1.4 to 3.2]) than among nurses and was lowest on weekends (OR, 0.6 [CI, 0.4 to 0.8]). Noncompliance was higher in intensive care than in internal medicine units (OR, 2.0 [CI, 1.3 to 3.1]), during procedures that carry a high risk for contamination (OR, 1.8 [CI, 1.4 to 2.4]), and when intensity of patient care was high (compared with 60 opportunities: OR, 2.1 [CI, 1.3 to 3.5]). Compliance with handwashing was moderate. Variation across hospital ward and type of health care worker suggests that targeted educational programs may be useful. Even though observational data cannot prove causality, the association between noncompliance and intensity of care suggests that understaffing may decrease quality of patient care.
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            'Now please wash your hands': the handwashing behaviour of final MBBS candidates.

            S. Stone, Keith Feather, Stephen C. Pratt … (2000)
            The Handwashing Liaison Group has pointed out that "The failure of healthcare workers to decontaminate their hands reflects fundamentals of attitudes, beliefs and behaviours". Doctors are known to be poor at handwashing. This poor compliance may have its roots in a failure to learn this behaviour at medical college, where the influence of consultants and other role models may be critical. The handwashing behaviour of modern day medical students has not been previously studied. The Final MBBS Objective Structured Clinical Examination (OSCE) reflects learnt behaviours and attitudes of final year medical students 'absorbed' from role models within their training. We observed the handwashing behaviour of 187 candidates during the 1998 Final MBBS OSCE, at one clinical station, neurological examination of the lower limbs. Only 8.5% of candidates washed their hands after patient contact, although this figure rose to 18.3% with the aid of handwashing signs. These findings suggest that handwashing should become an educational priority. As student learning is highly focused by assessment (in-course or examination), we sug-gest that compliance with handwashing be built into undergraduate and Teaching Quality assessments with, for example, 'Hygiene marks' incorporated into OSCE or observed long case checklists. This study re-emphasizes the need for good clinical practice whenever teaching medical students. Copyright 2000 The Hospital Infection Society.
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              Teaching hospital medical staff to handwash.

              J Tibballs (1996)
              To increase the frequency of handwashing by medical staff. a prospective study of handwashing before and after patient contact. A paediatric intensive care unit in a tertiary hospital. 61 intensive care unit medical staff and visiting medical staff. A five-phase behaviour modification program:(i) unobtrusive observation for four weeks to obtain a baseline handwashing rate (ii) overt observation for five weeks (preceded by written advice); (iii) overt observation continued for four weeks with performance feedback; (iv) all observation and feedback discontinued for seven weeks; and (v) unobtrusive observation for five weeks to obtain a residual rate. 939 patient contacts were observed. The baseline handwashing rates before and after patient contact were 12.4% and 10.6%, respectively. During overt observation, the respective rates increased and plateaued at 32.7% and 33.3%, but increased further (to 68.3% and 64.8%) during the period of performance feedback. The residual handwashing rates, observed unobtrusively seven weeks after the cessation of performance feedback, were 54.6% before and 54.9% after patient contact.
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                Author and article information

                Journal
                Journal ID (nlm-ta): ISRN Preventive Med
                Journal ID (iso-abbrev): ISRN Preventive Med
                Journal ID (publisher-id): ISRN.PREVENTIVE.MEDICINE
                Title: ISRN Preventive Medicine
                Publisher: Hindawi Publishing Corporation
                ISSN (Electronic): 2090-8784
                Publication date Collection: 2014
                Publication date (Electronic): 6 February 2014
                Volume: 2014
                Electronic Location Identifier: 608927
                Affiliations
                1Navodaya Medical College, Raichur, Karnataka 584103, India
                2Department of Community Medicine, Navodaya Medical College, Raichur, Karnataka 584103, India
                3Department of Microbiology, Pushpagiri Institute of Medical Science and Research Center, Tiruvalla, Kottayam, Kerala, India
                Author notes
                *Sreejith Sasidharan Nair: dr.sreejithn@ 123456gmail.com

                Academic Editors: Z. Fatmi, P. Parneix, A. Trajman, and V. Usonis

                Article
                DOI: 10.1155/2014/608927
                PMC ID: 4045463
                PubMed ID: 24967144
                SO-VID: 8a113053-319c-4027-b1a7-5a9ea8fdfc66
                Copyright © Copyright © 2014 Sreejith Sasidharan Nair et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 9 October 2013
                Date accepted : 30 December 2013
                Categories
                Subject: Research Article

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