Oyapero Afolabi, Oyapero Oyejoke
Department of Preventive Dentistry, Lagos State University College of Medicine, Ikeja, Nigeria.
Department of Paediatrics, Alimosho General Hospital, Lagos State, Nigeria.
J Educ Health Promot. 2018 Nov 27;7:150. doi: 10.4103/jehp.jehp_56_17. eCollection 2018.
The contaminated hands of health-care professionals (HCPs) is an implicated vector in the transmission of potentially pathogenic organisms to vulnerable patients. The aim of this study was to derive baseline data on hand hygiene (HH) practices among a cohort of students at the Lagos State School of Nursing and to determine their perception about the adequacy of instructions they receive.
A descriptive, cross-sectional study was conducted on a probability random sample of 69 nursing students at the Lagos State School of Nursing at the Alimosho Igando General Hospital. The knowledge, attitude, and practice as well as the perception of the respondents on the adequacy of their infection control instructions were obtained using an interviewer-administered questionnaire. Data entry and analysis were done using SPSS software version 20 (IBM Corp., Armonk, NY, USA), < 0.05 was considered statistically significant. Multivariate linear and logistic regressions were done to assess which factors were truly significant predictors, with odds ratios (ORs) and 95% confidence intervals (CIs) specified as the measures of association between predictors and outcome variables.
Majority of participants were ≤20 years old (50.7%, = 35) and were in their second year of study (44.9%, = 31). Participants were least knowledgeable about the importance of discarding gloves and not washing or reusing them (16 [23.1%]). The mean score on the Hand Hygiene Beliefs Scale was 86.2 ± 9.0, with scores ranging from 23 to 88 out of a possible high score of 115. The most positive health beliefs were associated with being a role model for HH (3.57 ± 0.52), while the worst was associated with imitating bad HH practices performed by senior colleagues (1.29 ± 1.20). Caring for a wound (60 [87.0%]) was most associated with the need for HH, while demonstration and clinical practice were rated as the most effective teaching methods. Results of the multivariate logistic regression analysis, with the outcome variable of good self-reported HH practices, revealed that the odds of appropriate behavior were higher if the student nurses were in their third year of study (OR = 1.59; 95% CI: 1.01-2.45). An appropriate behavior was also more likely in student nurses with a higher risk perception (OR = 1.54; 95% CI: 1.03-2.51).
Despite the overwhelming evidence that HH is effective in the prevention of hospital-acquired infections, its performance among HCPs remains far less than optimal. Since students will someday be influencing future HH compliance behaviors of other health-care workers, the importance of HH should be adequately incorporated into their school curriculum.
医护人员受污染的双手是将潜在致病微生物传播给易感染患者的一个相关传播媒介。本研究的目的是获取拉各斯州护理学校一批学生手部卫生（HH）习惯的基线数据，并确定他们对所接受指导充分性的看法。
对阿利莫肖伊甘多综合医院拉各斯州护理学校69名护理专业学生的概率随机样本进行了一项描述性横断面研究。通过访谈员管理的问卷获取受访者的知识、态度和实践情况，以及他们对感染控制指导充分性的看法。使用SPSS软件20版（美国纽约州阿蒙克市IBM公司）进行数据录入和分析，P<0.05被认为具有统计学意义。进行多变量线性和逻辑回归分析以评估哪些因素是真正重要的预测因素，将比值比（OR）和95%置信区间（CI）指定为预测因素与结果变量之间关联的度量指标。
大多数参与者年龄≤20岁（50.7%，n = 35），处于学习的第二年（44.9%，n = 31）。参与者对丢弃手套以及不清洗或重复使用手套的重要性了解最少（16人[23.1%]）。手部卫生信念量表的平均得分为86.2±9.0，在可能的115分高分中，得分范围为23至88分。最积极的健康信念与成为手部卫生的榜样相关（3.57±0.52），而最消极的与模仿资深同事不良的手部卫生习惯相关（1.29±1.20）。护理伤口（60人[87.0%]）与手部卫生需求关联最大，而示范和临床实践被评为最有效的教学方法。多变量逻辑回归分析结果以自我报告的良好手部卫生习惯为结果变量，显示如果学生护士处于学习的第三年，适当行为的几率更高（OR = 1.59；95%CI：1.01 - 2.45）。风险认知较高的学生护士也更有可能有适当行为（OR = 1.54；95%CI：1.03 - 2.51）。
尽管有压倒性证据表明手部卫生在预防医院获得性感染方面有效，但其在医护人员中的执行情况仍远未达到最佳。由于学生总有一天会影响其他医护人员未来的手部卫生合规行为，手部卫生的重要性应充分纳入他们的学校课程。
