Current hand hygiene education is suboptimal

Abstract

SUMMARY Background To address the low levels of hand hygiene compliance (HHC) at our academic medical centre, we developed an annual patient safety course required for all incoming third‐year medical students. Based on previous observations of medical students, it was determined that hand hygiene (HH) would be a central component of the course. Methods Over a 1‐year period (2015/16), we observed third‐ and fourth‐year medical students who had participated in the annual patient safety course entering three intensive care units (ICUs) at two teaching hospitals. A total of 150 medical students failed to perform HH on entry and were subsequently asked why they did not comply. Results Of the 150 medical students observed entering an ICU without performing HH, 74.7% were male and 25.3% were female. Males cited inadequate time (21.4%), lack of role models (10.7%) and provided incorrect information regarding HH requirements (58.9%). Females cited concerns about dry or cracked skin (34.2%) and forgetting (23.7%). Discussion Our study demonstrates that even when medical students receive intensive HH education, compliance remains low. Of note, males and females offered different reasons for why they failed to perform HH. To address the suboptimal HHC, we developed an annual patient safety course required for all third‐year medical students immediately prior to beginning clinical rotations. In this study, we sought to understand why medical students’ HH remains suboptimal even after an intensive course.

Assessment of medical staff’s knowledge concerning the “five moments for hand hygiene”

“…In this study, men and women presented various reasons why they did not comply with HH: men pointed to setbacks in performing HH, i.e. lack of time, lack of role models, and unclear requirements, while women pointed to dry or cracked skin and forgetfulness [22].…”

“…Similarly, in a study by Wałaszek [12], the average age of the respondents and higher education were associated with greater knowledge of hand hygiene. A study by Birnbach [22] carried out an observation of 150 medical students (third and fourth year of study) who, after undergoing HH training, completed internships in the intensive care unit; in this study 75% of men and 25% of women did not perform HH in the required situations. This study showed that even if medical students received intensive HH education, compliance remained low [22].…”

“…A study by Birnbach [22] carried out an observation of 150 medical students (third and fourth year of study) who, after undergoing HH training, completed internships in the intensive care unit; in this study 75% of men and 25% of women did not perform HH in the required situations. This study showed that even if medical students received intensive HH education, compliance remained low [22]. In this study, men and women presented various reasons why they did not comply with HH: men pointed to setbacks in performing HH, i.e.…”

Hand hygiene compliance: student perspectives

“…W e read with interest the article by Birnbach et al regarding the poor hand hygiene compliance (HHC) of medical students despite a 5-day course. 1 As fifth-year medical students at Imperial College London, we propose improving HHC amongst medical students through quality improvement projects (QIPs).…”

“…4 In our opinion, students fail at HHC because of a lack of exposure to the complications and severity of poor HHC, namely hospital-acquired infections. 1 By undertaking projects, students can experience first-hand the importance of HHC, and identify reasons for failure as they improve their own compliance. 3 As HHC is a theme applicable to most areas of care, groups can be further challenged to relate their QIP to a chosen specialty, to enhance student engagement and indicate relevance.…”