Clean hands, safe care: how knowledge, attitude, and practice impact hand hygiene among nurses in Najran, Saudi Arabia

Effects of patient safety education programs on nursing students' knowledge, attitude, and competency with patient safety: A systematic review, meta-analysis, and meta-regression

AIMS

Patient safety is a global concern, and nurses, as the largest group of healthcare professionals, play a critical role in ensuring patient safety. This study aimed to systematically review and analyze the effects of patient safety education programs on nursing students' knowledge, attitudes, and competencies by synthesizing existing research and identifying key factors contributing to program effectiveness.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Ovid-EMBASE, MEDLINE, CINAHL, and PubMed were selected for their comprehensive coverage of healthcare and nursing literature. Articles published between January 2000 and July 2024 were included, as the year 2000 marked the beginning of global efforts to prioritize patient safety in healthcare systems.

REVIEW METHODS

This systematic review and meta-analysis followed PRISMA guidelines. A comprehensive search of Ovid-EMBASE, MEDLINE, CINAHL, and PubMed (2000-2024) identified interventional studies on patient safety education for nursing students. Eligible studies underwent quality appraisal using the weight of evidence framework.

RESULTS

The meta-analysis showed significant improvements in nursing students' knowledge (Z = 5.315, p < .001), attitudes (Z = 2.727, p = .006), and competencies (Z = 4.870, p < .001). Effect sizes ranged from medium to very large (g = 0.684-2.461). Meta-regression analysis indicated that participants' grades (β = -3.29, p < .001) influenced attitudes, while both grades (β = -2.04, p = .007) and education methods (β = 0.85, p = .042) affected competency.

CONCLUSION

Patient safety education programs significantly enhance nursing students' knowledge, attitudes, and competencies. Structured, long-term education and interactive methods, such as simulation and virtual reality, enhance competency development. Integrating these approaches into nursing curricula can help bridge the gap between theory and practice, ultimately improving patient safety.

The effect of an educational program on hand hygiene compliance among nursing students

BACKGROUND

Hand hygiene is one of the most important measures for preventing infections acquired in healthcare settings. Nursing students are at risk of these infections due to their frequent contact with patients and contaminated surfaces. Educational programs can be effective in improving hand hygiene compliance among nursing students.

OBJECTIVE

To determine the effect of an educational program on hand hygiene compliance among nursing students.

METHODS

This study utilized a quasi-experimental two-group pretest-posttest design in 2023 with senior nursing students. All students were included in the study using a census method, and the intervention and control groups were randomly assigned. Data collection tools included a demographic questionnaire, and hand hygiene compliance was monitored through non-participant and non-intrusive observation methods, using the World Health Organization paper-based hand hygiene observation tool. The overall hand hygiene compliance rate was calculated by dividing the number of observed hand hygiene actions by the total number of recorded opportunities, with 100 observations before and after the intervention in both groups for each hand hygiene moment. Three months after the intervention, hand hygiene compliance was reassessed. The educational program was based on Kirkpatrick's learning model and consisted of a three-hour workshop to educate participants on the importance of hand hygiene. Descriptive statistics were used for data analysis, and the chi-square test was applied to assess compliance across the five hand hygiene moments. Data analysis was conducted using SPSS version 22 software.

RESULT

The results showed that hand hygiene compliance rates in the intervention group increased compared to the control group across all five hand hygiene moments, indicating a significant improvement in adherence to hand hygiene practices following the educational intervention.

CONCLUSION

An educational program can be effective in improving hand hygiene compliance among nursing students.

CLINICAL TRIAL NUMBER

Not applicable.

"I Know What I Have to Do, but I Don't Do It": The Relationship Between Knowledge and Adherence to Hand Hygiene in Healthcare Settings

Objective: This study aims to analyze the correlation between healthcare professionals' knowledge of hand hygiene protocols and their actual adherence to these practices. Specifically, we investigate whether higher knowledge levels correspond to better compliance, and we examine potential influencing factors such as professional role, gender, and prior training in infection control. Methods: A non-probabilistic, convenience sample was composed of 51 healthcare professionals working in patient care. Data collection was conducted through a questionnaire to assess knowledge and direct observation to assess adherence to hand hygiene. Results: The results indicate a satisfactory level of knowledge among healthcare professionals. No statistically significant differences were observed between different professional groups regarding knowledge and adherence to hand hygiene. The average adherence rate to hand hygiene was 60.13%. No statistically significant relationship was found between healthcare professionals' knowledge and their adherence to hand hygiene. Statistically significant differences were only found between males and females regarding the adherence rate to hand hygiene, with males showing higher adherence. Conclusions: Although healthcare professionals demonstrate satisfactory knowledge about hand hygiene, adherence to the practice still shows variability. Therefore, implementing continuous training programs and developing institutional policies may contribute to improving hand hygiene practices, thereby reducing the incidence of healthcare-associated infections.

A Cross-Sectional Examination of Missed Infection Control Practices Among Nurses in the Jordanian Hospitals

BACKGROUND

Missed infection control practices may negatively impact quality healthcare and patient safety in acute health care settings. Hence, more research is urgently needed especially in Arab countries. To investigate the elements and reasons of missed infection control activities among nurses in Jordan. The sociodemographic correlates with missed infection control activities were also examined.

METHODS

A cross sectional design was utilized in this study. A convenience sample of 960 nurses from seven hospitals in the North of Jordan was used. The Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey was employed to collect the data. Data were analyzed using descriptive inferential, and multivariate regression analysis.

FINDINGS

The majority of the participants worked as registered nurses (78.4%). The highest missed infection control activities were: screening new admissions for Multi Resistant Organisms (MRO), wearing gloves for both preparing and administration of all antibiotics, and informing staff and visitors for the need for transmission-based precautions (when managing a patient with a MRO). The least missed infection control activities reported by nurses were performing hand hygiene after touching patients, and before drug administration. The reasons of missed infection control measures most frequently reported by nurses were: urgent patient situation, followed by inadequate number of clerical staff, and unexpected rise in patient volume and or acuity.

CONCLUSION

This research suggests that interventions to reduce missed infection control measures should focus on the education and training of nursing staff as well as a adopting nurse: patient ratio in managing nursing workload, which should not exceed 1:4.

Knowledge, attitudes, and practices toward femtosecond laser small incision lenticule extraction surgery and postoperative care among recipients

BACKGROUND

To investigate the knowledge, attitudes, and practices (KAP) of individuals who underwent small incision lenticule extraction (SMILE) surgery and explore the influencing factors.

METHODS

This cross-sectional study was conducted from June 21, 2023, to August 13, 2023, at Xiangyang Central Hospital. The participants were patients who had undergone SMILE surgery. The self-designed questionnaire had a Cronbach's α = 0.849. Multivariable analyses were performed to determine the factors influencing the KAP scores.

RESULTS

Finally, 485 valid questionnaires were analyzed. The median knowledge score was 14 (/17, 82.4%; IQR: 12-15). The median attitude score was 15 (/20, 75.0%; IQR: 14-16). The median practice score was 48 (/60, 80.0%; IQR: 42-54). The knowledge scores correlated to the attitude (r = 0.323, P < 0.001) and practice (r = 0.202, P < 0.001) scores, while the attitude scores correlated to the practice scores (r = 0.065, P < 0.001). College diploma (OR = 0.299, 95%CI: 0.110-0.812, P = 0.018), myopia for < 2 years (OR = 0.177, 95%CI: 0.060-0.526), and not receiving proper eye training (OR = 0.588, 95%CI: 0.402-0.862) were independently associated with knowledge. Being 19-30 years old (OR = 0.421, 95%CI: 0.235-0.756), being ≥ 31 years old (OR = 0.259, 95%CI: 0.111-0.601), myopia for 2-5 years (OR = 0.476, 95%CI: 0.232-0.978), myopia for 5-10 years (OR = 0.480, 95%CI: 0.263-0.875), and moderate myopia in the right eye (OR = 1.745, 95%CI: 1.024-2.974) were independently associated with attitude. Female gender (OR = 1.826, 95%CI: 1.196-2.787), being ≥ 31 years (OR = 2.587, 95%CI: 1.113-6.014), college diploma (OR = 3.436, 95%CI: 1.366-8.641), bachelor's degree (OR = 2.826, 95%CI: 1.214-6.581), and not having proper eye training (OR = 0.458, 95%CI: 0.310-0.677) were independently associated with practice.

CONCLUSIONS

Patients who underwent SMILE had high KAP regarding SMILE. This study identified KAP items that would warrant education.

Hand Hygiene Knowledge and Perception Survey for Healthcare Workers in Government Hospitals (GHs) in Bahrain

Introduction and aim Healthcare-associated infections (HAIs) are a serious concern in all healthcare facilities as they may lead to many serious consequences, like prolonged hospitalization, increased mortality and morbidity, and extra costs. Effective hand hygiene (HH) is the primary proven measure known to be effective in reducing the risk of HAIs in all healthcare settings. This study aimed to measure the healthcare workers' (HCWs) knowledge and perception of HH at government hospitals (GHs) in Bahrain. Subjects and methods This cross-sectional study was conducted among HCWs working in GHs in the Kingdom of Bahrain. A self-administered questionnaire was distributed among the targeted population using a Google survey (Google LLC, California, USA). The questionnaire includes socio-demographic data (e.g., age, gender, nationality, etc.) and a validated WHO questionnaire measuring perceptions and knowledge toward HH. Results Of the 285 HCWs, 75.4% were females, and 48.1% were aged between 31 and 40 years old. The overall mean perception was 35.9 (SD 6.93) out of 42 points, with nearly 80% of HCWs considered to have good perception levels. The overall mean knowledge score was 11.4 (SD 1.37) out of 14 points. Accordingly, 75.4% were considered to have good knowledge levels. Factors associated with increased perception include increasing age, female gender, non-Bahraini, being a nurse with increasing years of working experience, and receiving formal training in HH. Being a nurse was the sole significant predictor of increased knowledge. Conclusion The knowledge and perception of HH among HCWs were sufficient. Being a nurse was a significant predictor of both knowledge and perception. Further, a significant positive correlation was noted between the knowledge and perception scores. Maintaining the level of knowledge and perception of HH could lead to improved HH compliance among HCWs.