Gniadek Agnieszka, Ogórek-Tęcza Beata, Inglot Anna, Nowacka Anna, Micek Agnieszka
Department of Nursing Management and Epidemiological Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Kraków, Poland.
Postgraduate Student at the Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Kraków, Poland.
Int J Environ Res Public Health. 2021 Mar 5;18(5):2590. doi: 10.3390/ijerph18052590.
Teaching nursing students how to correctly perform hand hygiene procedures may guarantee a reduction in transmitting pathogens through direct contact and, thus, it may lead to a decrease in the number of hospital infections. The aim of the study, which was conducted in low fidelity simulation conditions, was to assess the performance and the efficiency of a hand-rubbing disinfection technique among nursing students on the last day of their course.
The study was conducted in a group of 190 nursing students studying at the Jagiellonian University and it focused on the performed hand-rubbing disinfection procedure. The accuracy of the task performance was assessed by measuring the percentage of the amount of Fluo-Rub (B. Braun) fluorescent alcohol-based gel remaining on students' hands after disinfection. The gel was rubbed into particular hand parts including four surfaces (left palm, right palm, left back and right back) divided into thirteen areas (I-XIII) and each surface was examined separately. The results were then dichotomized based on the cut-off point of 10% and two categories: "clean" and "dirty" were established. Additionally, the range of negligence in the disinfection procedure was assessed by counting the total number of the areas classified as "dirty". The comparison of continuous and categorical variables was conducted by means of Friedman's and Cochrane's tests, respectively.
It was found out that the palm surfaces that were commonly missed during hand disinfection included the whole thumb (I and VI), the fingertip of the little finger (V) and the midpalm (XIII), whereas in the case of back surfaces (on both right and left hand) the most commonly missed areas were the fingertips and the whole thumb I-VI. Only 30 students (13%) had all 52 areas of both hands completely clean, whereas more than one third-66 students (33%)-failed to disinfect properly more than 10 areas out of all assessed ones on the surfaces of both hands.
In the examined group of nursing students, a significant lack of compliance with hand disinfection procedures was observed and it was related mainly to thumbs and back parts of both hands. Therefore, it is essential to conduct systematic training sessions and assessment of hand hygiene procedures for nursing students at the end of every educational stage as it can lead to their developing these skills properly.
教导护理专业学生如何正确执行手部卫生程序，可确保减少通过直接接触传播病原体，从而可能降低医院感染的数量。本研究在低保真模拟条件下进行，目的是评估护理专业学生课程最后一天手部揉搓消毒技术的操作情况和效率。
本研究针对190名在雅盖隆大学学习的护理专业学生展开，重点关注手部揉搓消毒程序。通过测量消毒后学生手上残留的Fluo - Rub（贝朗公司）荧光酒精基凝胶量的百分比，评估任务执行的准确性。将凝胶揉搓到特定的手部部位，包括四个表面（左手掌、右手掌、左手背和右手背），每个表面再细分为13个区域（I - XIII），并分别检查每个表面。然后根据10%的临界点将结果二分法化，确定“清洁”和“脏污”两类。此外，通过计算被归类为“脏污”的区域总数，评估消毒程序中的疏忽范围。连续变量和分类变量的比较分别采用弗里德曼检验和 Cochr ane检验。
发现手部消毒时通常遗漏的手掌表面包括整个拇指（I和VI）、小指指尖（V）和手掌中部（XIII），而对于手背表面（左右手皆是），最常遗漏的区域是指尖和整个拇指I - VI。只有30名学生（13%）双手的所有52个区域完全清洁，而超过三分之一——66名学生（33%）——双手表面所有评估区域中未正确消毒的区域超过10个。
在所检查的护理专业学生群体中，观察到明显缺乏对手部消毒程序的依从性，且主要与双手的拇指和背部有关。因此，在每个教育阶段结束时，对护理专业学生进行手部卫生程序的系统培训和评估至关重要，因为这有助于他们正确掌握这些技能。
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