Knowledge, practices, compliance and beliefs of university nursing students’ toward hand hygiene: A cross-sectional survey

Nursing students can contribute to healthcareassociated infections if having inadequate knowledge and noncompliance of hand hygiene. Effective hand hygiene is considered the most effective measure for preventing healthcare-associated infections. This study investigated the knowledge, practices, compliance, and beliefs of university nursing students toward hand hygiene. By using a well-validated, self-report hand hygiene questionnaire, a cross-sectional survey was performed. In the convenience sampling, 421 out of 506 questionnaires were returned (83.2%). There were 169 (40.14%), 170 (40.38%) and 82 (19.48%) nursing students from Years 1, 2 and 3, respectively. The respondents’ overall mean score for hand hygiene knowledge was 7.33/10 (SD = 1.52) with an increasing trend of knowledge performance along study year was observed. The hand hygiene practice inventory was 4.76/5 (SD = 0.303). The mean scores for respondents from Years 1, 2 and 3 were 4.75 (SD = 0.367), 4.82 (SD = 0.20) and 4.69 (SD = 0.290), respectively. The self-reported hand hygiene compliance rate was 88.17% (SD = 11.922) and the mean score on the health beliefs scale was 4.03/5 (SD = 0.34). The university nursing students demonstrated moderate knowledge, good practices, a high compliance rate and positive beliefs toward hand hygiene. More effort on educating healthcare professionals about alcohol-based hand rubs and the promotion of hand cream usage to prevent hand-hygiene-induced skin irritations are suggested. Regular training workshops or seminars could be arranged to maintain knowledge levels and cultivate a positive attitude toward hand hygiene. DOI: 10.5176/2345-7198_5.1.21 ISSN 2345-7198 ©The Author(s) 2018. This article is published with open access by the GSTF Education and training programs have identified strategies for controlling and preventing HCAIs at the international level [1][10][11]. HH knowledge includes its importance and indications, correct hand-washing and alcohol-rubbing procedures, skin care and glove use [1][2]. As important members of the future professional workforce, nursing and medical students have been provided with HH education to decrease HCAIs [12][13]. Their awareness of personal HH is essential to patient safety and their own well-being. Several international studies have investigated the knowledge, attitudes and practices of such professionals [14][15][16]17][18]. Inadequate HH knowledge among nursing students has been mentioned in previous studies conducted in Turkey and Taiwan [19][20], indicating that nursing students can contribute to HCAIs due to insufficient knowledge and non-compliance. The influence of HH education on undergraduate nursing students and evaluations of HH knowledge, beliefs and practices have received little attention locally. Thus, a cross-sectional survey study investigating Hong Kong nursing students’ HH knowledge, practices, compliance, and beliefs were conducted in a clinical setting. Subsequently, the study results can be used to inform undergraduate nursing curriculum design and compliance strategies. Improving nursing students’ HH compliance could potentially reduce the incidence of HCAIs, which would prevent patients’ suffering and save lives.