Efficacy of a handwashing teaching program to enhance knowledge, attitude, behaviour and compliance to handwashing protocol among nurses & minor staff in a rehabilitation hospital

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Efficacy of a handwashing teaching program to enhance knowledge, attitude, behaviour and compliance to handwashing protocol among nurses & minor staff in a rehabilitation hospital

 

Author: Law, Wai-ha Dorothy
Title: Efficacy of a handwashing teaching program to enhance knowledge, attitude, behaviour and compliance to handwashing protocol among nurses & minor staff in a rehabilitation hospital
Degree: M.Sc.
Year: 2006
Subject: Hong Kong Polytechnic University -- Dissertations
Hand washing
Nurses -- Training of
Nurses' aides -- Training of
Department: School of Nursing
Pages: vii, 97 leaves ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1893944
URI: http://theses.lib.polyu.edu.hk/handle/200/925
Abstract: Background: Handwashing is widely accepted as being a key point to the prevention of hospital-acquired infection but the compliance of handwashing by the health care staff was found to be low. Despite numerous studies on handwashing practices, very little investigated on how to increase handwashing compliance. In Hong Kong, there are also few local studies concerning the knowledge, attitude, behaviour and compliance of handwashing among nurses and minor staff who are in close contact with patient in their routine work. Purpose: This study aimed to examine nurses' and minor staff's knowledge, attitude, behaviour and compliance towards handwashing in a local health care setting. It also attempted to develop, implement and evaluate a handwashing educational program designed to promote knowledge, attitude and behaviour of handwashing as well as the compliance of handwashing practices among the nurses and the minor staff. Method: An interventional study, using pre and post design, was conducted to compare the knowledge, attitude, behaviour and compliance towards handwashing among the nurses and the minor staff before and after a handwashing educational program in a rehabilitation hospital. A self-administered structured questionnaire was used to collect data of handwashing knowledge, attitude and behaviour. In addition, observations on handwashing compliance i.e. handwashing frequency and technique were conducted. Wilcoxon signed ranks test was used to compare the data collected for the knowledge, attitude and behaviour of handwashing at the pre and post intervention phases. Kruskal-Wallis test was used to compare the difference among knowledge, attitude, behaviour and the demographic data such as rank, age, educational level, the years of working experience and different units. For observations, McNemar test was used to compare the handwashing compliance, i.e. the frequency and Mann-Whitney test for handwashing technique. Descriptive statistics were used to organize and summarize the collected data as stated above. Results: Data analysis showed that a multifaceted educational program could lead to a significant increase in the total score on the handwashing knowledge, attitude, behaviour and compliance. Majority of the staff viewed prevention of infection as the most motivating factor for handwashing. It was found that they washed their hands more frequently for those activities more likely to result in contamination of hands. However, the study showed that most of the staff could not practise proper handwashing technique and have mis-understanding of gloves usage. They perceived gloves were their "second" skin. They might not change gloves and practiced handwashing between patients. Besides, many clinical staff perceived that the alcoholic hand-rubs could replace handwashing. It was evidenced that nurses and the minor staff did not really understand the proper usage of gloves and the alcoholic hand-rubs. Recommendation: Further re-enforcement and continuous education on proper handwashing technique, gloving and usage of alcoholic hand-rubs should be implemented to acquaint staff with the correct concept of them as well as to enhance the handwashing compliance. Conclusion: Multifaceted approaches that included focus group sharing, training, education and reminders were successful in achieving optimal improvement in handwashing. Through the study, an in-depth understanding about nurses and minor staff's knowledge, attitude and behaviour towards handwashing was gained. It helped to facilitate for future planning by the infection control team to enhance staff's awareness on the importance of handwashing and to improve the efficacy of prevention strategies for hospital acquired infection.

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