Hand Areas Which Are Commonly Missed during Hand Disinfection by Nursing Students Who Completed a Basic Educational Course in Hand Hygiene

Abstract

Background: Teaching nursing students how to correctly perform hand hygiene procedures may guarantee a reduction in transmitting pathogens through direct contact and, thus, it may lead to a decrease in the number of hospital infections. The aim of the study, which was conducted in low fidelity simulation conditions, was to assess the performance and the efficiency of a hand-rubbing disinfection technique among nursing students on the last day of their course. Materials and methods: The study was conducted in a group of 190 nursing students studying at the Jagiellonian University and it focused on the performed hand-rubbing disinfection procedure. The accuracy of the task performance was assessed by measuring the percentage of the amount of Fluo-Rub (B. Braun) fluorescent alcohol-based gel remaining on students’ hands after disinfection. The gel was rubbed into particular hand parts including four surfaces (left palm, right palm, left back and right back) divided into thirteen areas (I–XIII) and each surface was examined separately. The results were then dichotomized based on the cut-off point of 10% and two categories: “clean” and “dirty” were established. Additionally, the range of negligence in the disinfection procedure was assessed by counting the total number of the areas classified as “dirty”. The comparison of continuous and categorical variables was conducted by means of Friedman’s and Cochrane’s tests, respectively. Results: It was found out that the palm surfaces that were commonly missed during hand disinfection included the whole thumb (I and VI), the fingertip of the little finger (V) and the midpalm (XIII), whereas in the case of back surfaces (on both right and left hand) the most commonly missed areas were the fingertips and the whole thumb I–VI. Only 30 students (13%) had all 52 areas of both hands completely clean, whereas more than one third—66 students (33%)—failed to disinfect properly more than 10 areas out of all assessed ones on the surfaces of both hands. Conclusions: In the examined group of nursing students, a significant lack of compliance with hand disinfection procedures was observed and it was related mainly to thumbs and back parts of both hands. Therefore, it is essential to conduct systematic training sessions and assessment of hand hygiene procedures for nursing students at the end of every educational stage as it can lead to their developing these skills properly.

Medical Students’ and Radiology Technician Trainees’ eHealth Literacy and Hygiene Awareness—Asynchronous and Synchronous Digital Hand Hygiene Training in a Single-Center Trial

“…A cognitive visual link of the mistakes made during the performance, which are individually shown by ad hoc animations in the selftraining, could therefore still be a possible reason for the improvement from cohort A to cohort B2, a subgroup of the same participants (see Figure 3). Every second participant had ≤2.0 wetting gaps, which is slightly better but still comparable Gniadek et al's results, where 42% of the nursing students achieved a maximum of 2.0 wetting gaps out of the defined 52 [55]. Conventional training was previously often practiced only by looking at the moisture film or a third-party observation.…”

“…The heat maps of all cohorts (Figure 4) show clear wetting gaps in the thumb and wrist area, which have also been identified as problem areas in former studies [55]. Even over the period between the procedures of cohort A to those of cohort B2, no significant improvement in these areas could be achieved.…”

Learning practical nursing skills in simulation centers – A narrative review

“… Germain et al., 2018 USA To evaluate the effect of simulation on confidence levels of a group of diverse nursing students. Quantitative descriptive Pre / post / transfer 61 Third year Obstetric skills LF Manikin + Task trainer Confidence Overall confidence level increased significantly from pre to post and pre to follow-up after clinical practice Gniadek et al., 2021 Poland To assess the performance and the efficiency of a hand-rubbing disinfection technique among nursing students Observational study Post 190 First year Hand disinfection Skill perf. Problems in performing the procedure were observed, mostly connected with thumbs and back of both hands.…”

Nurses’ Perceptions of Patient Safety and Errors in Nursing Practice: A Qualitative Study

“…The results of a study conducted to assess the performance and effectiveness of handwashing among nursing students confirm the seriousness of the situation, as issues such as incomplete hand hygiene were identified during the process. 27 Promoting understanding among nurses about the essential nature of thorough hand hygiene and instilling in them the perception that lapses in this procedure signify negligence are inherent challenges within the healthcare domain.…”