Sundal Jorun Saetre, Aune Anne Grethe, Storvig Eline, Aasland Jenny Kristin, Fjeldsaeter Kaja Linn, Torjuul Kirsti
Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Department of Infection Control, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
J Clin Nurs. 2017 Dec;26(23-24):4646-4653. doi: 10.1111/jocn.13811. Epub 2017 Jun 22.
To observe student nurses' overall and moment-specific hand hygiene compliance during clinical placement.
Hand hygiene is the single most important measure to prevent healthcare-associated infections. However, research has shown low compliance among healthcare workers. During clinical placements, student nurses perform various nursing tasks and procedures to a large number of patients, requiring extensive patient contact. It is crucial that they practice correct hand hygiene to prevent healthcare-associated infections.
Open, standardised and nonparticipating observations.
Twenty-nine student nurses were observed three times for 20 ± 10 min during clinical placement in a Norwegian university hospital. To measure compliance, we used WHO's Hand Hygiene Observation tool, based on the model "My five moments for hand hygiene".
Overall hand hygiene compliance in the student group was 83.5%. Highest moment-specific compliance was after touching patient surroundings, after touching patients and after body fluid exposure risk. Lowest moment-specific compliance was recorded before touching patients or patient surroundings, and before clean/aseptic procedures.
Nurse education needs to be improved both theoretically and during clinical placements in order to advance and sustain compliance among student nurses.
Increasing healthcare workers' compliance with hand hygiene guidelines remains a challenge to the clinical community. In order to reduce healthcare-associated infections, it is important to educate student nurses to comply with the guidelines during clinical placements. Identifying student nurses' hand hygiene performance is the first step towards developing teaching methods to improve and sustain their overall and moment-specific compliance. As a measure to ensure student compliance during clinical placements, mentors should be aware of their influence on students' performance, act as hand hygiene ambassadors, encourage students to comply with established guidelines and provide regular feedback.
观察实习护士在临床实习期间的总体手卫生依从性以及特定时刻的手卫生依从情况。
手卫生是预防医疗相关感染的最重要单项措施。然而，研究表明医护人员的依从性较低。在临床实习期间，实习护士要为大量患者执行各种护理任务和操作，需要与患者进行广泛接触。他们正确实施手卫生对于预防医疗相关感染至关重要。
开放式、标准化且非参与性观察。
在挪威一家大学医院对29名实习护士在临床实习期间进行了3次观察，每次观察20±10分钟。为衡量依从性，我们使用了基于“手卫生的五个时刻”模型的世界卫生组织手卫生观察工具。
学生组的总体手卫生依从率为83.5%。特定时刻依从率最高的是接触患者周围环境后、接触患者后以及有体液暴露风险后。特定时刻依从率最低的是在接触患者或患者周围环境之前以及进行清洁/无菌操作之前。
为提高并维持实习护士的依从性，护士教育在理论和临床实习期间都需要改进。
提高医护人员对手卫生指南的依从性仍然是临床领域面临的一项挑战。为减少医疗相关感染，在临床实习期间教育实习护士遵守指南很重要。识别实习护士的手卫生表现是开发教学方法以提高并维持其总体和特定时刻依从性的第一步。作为确保实习护士在临床实习期间依从性的一项措施，带教老师应意识到自己对学生表现的影响，充当手卫生大使，鼓励学生遵守既定指南并定期提供反馈。
