Exploring the Relationship between Knowledge and Attitudes, Adherence and Confidence on Hand Hygiene Practices Among Thai Nursing Students
Article Sidebar
Main Article Content
Abstract
Background: Hand hygiene plays a crucial role in infection control in healthcare settings, but there is a concerning gap in compliance rates among healthcare workers globally. Nursing students, who will form a substantial part of the future healthcare workforce, are key to effective hand hygiene practices. A significant educational gap in hand hygiene exists globally, especially in Asia, including Thailand. Research on nursing students’ knowledge, attitude, adherence to, and confidence in hand hygiene is still limited, despite their frequent non-compliance with standard protocols. Therefore, this study aimed to examine the correlations and associated factors between knowledge, attitudes, adherence to, and confidence in hand hygiene practices among first-year nursing students at a Thai nursing college.
Methods: A cross-sectional study was conducted with all 116 first-year nursing students from Boromarajonani College of Nursing, Thailand. Data were collected through a self-administered questionnaire and analyzed using Pearson’s correlation and multiple logistic regression analysis.
Results: The results show that only 46.6% of students demonstrated good knowledge of hand hygiene, but a higher percentage showed positive attitudes (51.7%) and adherence (55.2%). A majority (76.7%) had good confidence in their hand hygiene practices. Positive correlations were observed between knowledge and attitude, attitude and adherence, and adherence and confidence. Male students generally had better knowledge, while those with lower GPAs tended to have higher confidence in hand hygiene. The findings of this study are in line with previous studies, indicating that knowledge does not always lead to positive attitudes or adherence to hand hygiene. Also, confidence is necessary for effective hand hygiene practices.
Conclusions: This study highlights the factors related to hand hygiene practices among Thai nursing students and emphasizes the need for comprehensive, culturally sensitive educational strategies. Future research should consider various contextual factors, such as gender differences and academic performance, to enhance hand hygiene practices among nursing students.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
References
World Health Organization. Hand hygiene for all initiative: Improving access and behaviour in health care facilities [Internet]. 2020 [updated 2020 Oct 12; cited 2023 May 12]. Available from: https://www.who.int/publications/i/item/9789240011618
World Health Organization. Key facts and figures World Hand Hygiene Day 2021 [Internet]. 2021 [cited 2022 May 12]; Available from: https://www.who.int/campaigns/world-hand-hygiene-day/2021
Fox C, Wavra T, Drake DA, Mulligan D, Bennett YP, Nelson C, Kirkwood P, Jones L, Bader MK. Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses’ hand washing. American Journal of Critical Care. 2015 May 1;24(3):216-24.
Kampf G, Löffler H, Gastmeier P. Hand hygiene for the prevention of nosocomial infections. Deutsches Ärzteblatt International. 2009 Oct;106(40):649.
Nair SS, Hanumantappa R, Hiremath SG, Siraj MA, Raghunath P. Knowledge, attitude, and practice of hand hygiene among medical and nursing students at a tertiary health care centre in Raichur, India. International Scholarly Research Notices. 2014;2014.
Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. The Lancet. 2000 Oct 14;356(9238):1307-12.
Labrague LJ, McEnroe-Petitte DM, Van de Mortel T, Nasirudeen AM. A systematic review on hand hygiene knowledge and compliance in student nurses. International nursing review. 2018 Sep;65(3):336-48.
Green EC, Murphy EM, Gryboski K. The health belief model. The Wiley encyclopedia of health psychology. 2020 Sep 2:211-4.
Purssell E, Gould D. Teaching health care students hand hygiene theory and skills: a systematic review. International Journal of Environmental Health Research. 2022 Sep 2;32(9):2065-73.
Grover E, Hossain MK, Uddin S, Venkatesh M, Ram PK, Dreibelbis R. Comparing the behavioural impact of a nudge-based handwashing intervention to high-intensity hygiene education: a cluster-randomised trial in rural Bangladesh. Tropical medicine & international health. 2018 Jan;23(1):10-25.
Sundal JS, Aune AG, Storvig E, Aasland JK, Fjeldsaeter KL, Torjuul K. The hand hygiene compliance of student nurses during clinical placements. Journal of clinical nursing. 2017 Dec;26(23-24):4646-53.
Safety WP, World Health Organization. WHO guidelines on hand hygiene in health care. World Health Organization; 2009.
World Health Organization. WHO guidelines on hand hygiene in health care. InWHO guidelines on hand hygiene in health care 2009 (pp. 270-270).
Nguyen HT, Duong TT, Lu DT, Ngo DT, Nguyen TT, Tudpor K. Assessment of knowledge, attitude, and practices of hand hygiene among nursing students in the south of Vietnam. 2022 Sep 28; 6(S6):11145-11153
Jeong SY, Kim KM. Influencing factors on hand hygiene behavior of nursing students based on theory of planned behavior: A descriptive survey study. Nurse education today. 2016 Jan 1;36:159-64.
Santangelo OE, Provenzano S, Armetta F, Pesco G, Allegro A, Lampasona M, Terranova A, D’ANNA GI, Firenze A. Knowledge, attitudes and practices towards COVID-19 among nursing students of the University of Palermo: results from an online survey. Journal of preventive medicine and hygiene. 2021 Jun;62(2):E270.
Cambil-Martin J, Fernandez-Prada M, Gonzalez-Cabrera J, Rodriguez-Lopez C, Almaraz-Gomez A, LANA-PEREZ A, Bueno-Cavanillas A. Comparison of knowledge, attitudes and hand hygiene behavioral intention in medical and nursing students. Journal of preventive medicine and hygiene. 2020 Mar;61(1):E9.
Al Kadi A, Salati SA. Hand hygiene practices among medical students. Interdisciplinary perspectives on infectious diseases. 2012 Sep 16;2012.
Sakihama T, Honda H, Saint S, Fowler KE, Shimizu T, Kamiya T, Sato Y, Arakawa S, Lee JJ, Iwata K, Mihashi M. Hand Hygiene Adherence Among Health Care Workers at Japanese Hospitals. Journal of patient safety. 2016 Mar 1;12(1):11-7.
Moralejo D, El Dib R, Prata RA, Barretti P, Corrêa I. Improving adherence to Standard Precautions for the control of health care‐associated infections. Cochrane Database of Systematic Reviews. 2018(2).
Larson EL, Bryan JL, Adler LM, Blane C. A multifaceted approach to changing handwashing behavior. American journal of infection control. 1997 Feb 1;25(1):3-10.
Gould DJ, Moralejo D, Drey N, Chudleigh JH, Taljaard M. Interventions to improve hand hygiene compliance in patient care. Cochrane database of systematic reviews. 2017(9).
Whitby M, Pessoa-Silva CL, McLaws ML, Allegranzi B, Sax H, Larson E, Seto WH, Donaldson L, Pittet D. Behavioural considerations for hand hygiene practices: the basic building blocks. Journal of Hospital Infection. 2007 Jan 1;65(1):1-8.
Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments. Journal of personality and social psychology. 1999 Dec;77(6):1121.
Kim HW, Kim MG. The relationship among academic achievement, clinical competence, and confidence in clinical performance of nursing students. The Journal of Korean Academic Society of Nursing Education. 2021;27(1):49-58.
Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC, van Beeck EF. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infection Control & Hospital Epidemiology. 2010 Mar;31(3):283-94.
Al-Khawaldeh OA, Al-Hussami M, Darawad M. Influence of nursing students handwashing knowledge, beliefs, and attitudes on their handwashing compliance. Health. 2015 May 5;7(05):572.
Paudel IS, Ghosh V, Adhikari P. Knowledge, Attitude and Practice of nursing students regarding hand hygiene in Western region of Nepal. Journal of College of Medical Sciences-Nepal. 2016;12(4):169-73.
Humran MB, Alahmary K. Assessment of knowledge, attitude, and practice of hand hygiene among medical and health profession students at King Saud Bin Abdulaziz University for Health Sciences in Saudi Arabia. Saudi Critical Care Journal. 2018 Oct 1;2(4):66-72.