Knowledge, acceptability and practices towards alcohol-based handrub among Hong Kong special schools staff

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Knowledge, acceptability and practices towards alcohol-based handrub among Hong Kong special schools staff

 

Author: Ho, Ka Yee
Title: Knowledge, acceptability and practices towards alcohol-based handrub among Hong Kong special schools staff
Degree: M.Sc.
Year: 2014
Subject: Hand washing -- China -- Hong Kong.
Hygiene.
Special education -- China -- Hong Kong.
Hong Kong Polytechnic University -- Dissertations
Department: School of Nursing
Pages: xv, 133 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2743464
URI: http://theses.lib.polyu.edu.hk/handle/200/7438
Abstract: Background: School children in Hong Kong with multiple physical or mental disabilities are accommodated in special schools to continue their studies. As of 2013, there were 7,946 disabled school children studying in 60 local special schools and one non-local special school. Between August 2009 and October 2012, several outbreaks of human swine influenza (HSI), respiratory syncytial virus (RSV) and influenza-liked illnesses had affected 13 local special schools causing suspension of classes. The outbreaks affected 185 students and 35 school staff; 39 of them were found positive for HSI and two were found positive for RSV. As a result, 29 students required hospitalization and 2 fatal cases had occurred. Those communicable diseases can be transmitted through direct or indirect contacts. As hand hygiene is a basic infection prevention minimising the transmission of infective agents, particularity among health care providers, the World Health Organization (WHO) has promoted a global hand hygiene campaign -'Clean Care is Safer Care' since 2005. However, hand hygiene compliance among health care workers has still been low universally. Hence, WHO has urged the use of alcohol-based handrub (ABHR) in clinical settings. To investigate the effectiveness of ABHR, several studies have revealed that hand hygiene compliance among health care workers have improved after the introduction of ABHR. Most studies related to ABHR have mainly focused on hospital settings. However, to date, few empirical studies have documented effectiveness of ABHR among Hong Kong special schools staff. Hence, findings of this study can provide school administrative staff and school health educators with a possible course of action, with which to design or modify hand hygiene educational programmes in a bid to reduce the risk of communicable diseases in Hong Kong special schools. Aim and objectives: The aim of the study was to explore the level of knowledge, acceptability and practices towards ABHR among Hong Kong special schools staff. The objectives of the study were: 1. To determine the level of knowledge, acceptability and practices towards ABHR among Hong Kong special schools staff; 2. To identify the association between demographic characteristics and the level of knowledge, acceptability and practices towards ABHR among Hong Kong special schools staff. Methods: This was a cross-sectional study. Based on WHO health information products, this study designed a questionnaire for data collection and analysis. The questionnaire has five sections namely 1) demographic characteristic of the subjects, 2) facilities and resources of ABHR provided by the participated special schools, 3) subjects’ knowledge on ABHR; 4) acceptability to ABHR and 5) practices in using ABHR.
Results: Staff from a total of 14 local special schools participated in the study, and data from 399 questionnaires were analyzed. This study conducted descriptive statistics, Chi-square test of independence, Fisher's exact test, independent t-test and Analysis of variance (ANOVA) to analyse the data set and produce findings accordingly. With regard to the findings, for resources and facilities, ABHRs were always available in medical inspection rooms (85.5%), therapy rooms (63.7%) and classrooms (56.6%). However, 55.4% of the subjects reported that pocket-sized ABHRs were never available in their schools; and 25.1% claimed that handrubbing technique posters were never displayed close to ABHR dispensers and around the campus. For the knowledge level, nursing staff had the highest marks among others (p<0.000) (Nurse = 8.4211; paramedical staff = 6.9464; teaching staff = 7.0154). Nevertheless, 60.7% of the subjects believed that ABHR could cause more skin dryness than soap and water (i.e. knowledge Q7); 53.6% believed that ABHR was not more effective against germs than soap and water (i.e. knowledge Q8) and 66.9% did not know the minimal time of handrubbing with ABHR to kill most microorganisms on hands and 10.8% without providing an answer (i.e. knowledge Q10). For the acceptability level, there were a highly statistically significant association between knowledge Q7 and 'Irritation' (i.e. opinions) (p<0.005), 'Drying the skin' (i.e. opinions) (p<0.000), 'Damaged skin' (i.e. difficulties) (p<0.000), ‘Irritation on hands' (i.e. difficulties) (p<0.000). The results indicated that subjects' ABHR knowledge affected their acceptability to ABHR. For the practices level, the subjects preferred handwashing to handrubbing in the following situations. 55.5% preferred handwashing before a direct contact with a student, 81.7% used it after a direct contact with a student (81.7%), 36.8% before touching two students sequentially, 67.4% after removing gloves and 46.6% after touching inanimate objects. Further, there were a statistically significant association between knowledge Q7 and practices pertaining to question 1 (p<0.000), question 3 (p<0.05) and question 8 (p<0.005). The results also revealed that subjects' ABHR knowledge affected their practices in using ABHR. Conclusion: This study has provided school administrative staff and school health educators with a possible plan implementing an effective hand hygiene educational programme; and school nurses should take an active role in controlling infection spreading in schools.

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