Major Article
Mentor's hand hygiene practices influence student's hand hygiene rates

https://doi.org/10.1016/j.ajic.2005.05.009Get rights and content

Background

There were 3 objectives for this prospective quasiexperimental study. The first was to determine the effect of mentor's hand hygiene practices on student's hand hygiene rates during clinical rotations. The second was to assess the difference in hand hygiene rates for students with and without prior medical experience. The third was to assess the student's opinion and beliefs regarding hand hygiene.

Methods

Sixty students enrolled in a certified nursing program were selected to participate in the study. Each study group was observed twice during the 30-day span. The first observational period was conducted on day 1 of clinical rotation. The second observational period was conducted on day 30 of clinical rotation. Students were observed for hand hygiene. Also assessed were medical experience, sex, gloving, age, and mentor's hand hygiene practices. After observational period 2, a brief questionnaire was given to students to determine their opinion and beliefs regarding hand hygiene. The questionnaire was divided into 5 sections: student's commitment to hand hygiene, their perception of hand hygiene inconvenience, the necessity of hand hygiene, the student's ability to perform hand hygiene, and their opinion on the frequency of medical staff's hand hygiene.

Results

The mentor's practice of hand hygiene was the strongest predictor of the student's rate of hand hygiene for both observational periods (P < .01). Furthermore, students without prior medical experience had a significant increase in hand hygiene rates when comparing observational period 1 to observational period 2 (P < .01). Glove usage was associated with increased hand hygiene rates by 50% during observational period 1 (P = .01) and 44% during observational period 2 (P < .01). Male students during observational period 1 practiced hand hygiene 30% less often than female students (P < .01); however, during observational period 2, there was no significant difference between hand hygiene rates for males and females (P = .82). Questionnaires were completed by 47 students, who reported a strong commitment to hand hygiene, belief in its necessity, and ability to perform hand hygiene (with scores in the high 90s on a 10 to 100 rating scale).

Conclusion

Mentor's use of hand hygiene and glove usage was associated with increased hand hygiene among students. Even though students reported strongly positive attitudes toward hand hygiene, students had a low overall rate of hand hygiene.

Section snippets

Cohort definition

This was a prospective quasiexperimental study with single blinding of the participants. There were 2 study groups. Study group 1 consisted of 30 student nursing assistants, of which 22 were females, and 8 were males between the ages of 18 and 44 years, without prior medical employment, medical volunteer service, or medical education. Study group 2 consisted of 30 student nursing assistants consisting of 24 females and 6 males between the ages of 19 and 42, with prior medical employment,

Results

During observational period 1, student HH opportunities were 391, with 192 HH attempts and 199 HH failures. Mentor HH opportunities were 483, with 214 attempts and 269 failures. During observational period 2, student HH opportunities were 420, with 222 HH attempts and 198 HH failures. Mentor HH opportunities were 415, with 221 HH attempts and 194 HH failures (See Table 1).

Discussion

Observation and handwashing practices of Ingnaz Semmelweis32 and Oliver Wendell Holmes33 historically aided in establishing HH as one of the key elements for reducing nosocomial infection rates. Gallo reports that CNAs provide more of the hands-on direct patient care than any other HCP.34 HH is a critical behavior in preventing nosocomial infections for all HCP and especially for CNAs because of their staffing numbers, the large number of patients cared for, and their job tasks requiring

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