Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
School of Nursing & Midwifery & Centre for Quality and Patient Safety Research, Deakin University, Geelong, VIC 3220, Australia.
Nurse Educ Pract. 2021 Nov;57:103232. doi: 10.1016/j.nepr.2021.103232. Epub 2021 Oct 18.
This study explored nursing students' compliance with standard precautions (SPs) and attitudes to SPs in Thailand, to identify factors that may increase adherence to SPs and infection prevention and control best practice.
In the context of high rates of healthcare associated infections as in Thailand, effective strategies to promote high levels of clinician adherence to SPs is a priority. Nursing students are one group of healthcare workers who play a vital role in caring for patients and constitute the future nursing workforce.
A cross-sectional survey design was used.
A self-reported survey comprising the Compliance with Standard Precautions Scale and the Factors Influencing Adherence to Standard Precautions Scale were distributed to nursing students as a Thai paper-based survey.
A total of '533 second' to fourth year nursing students from a tertiary nursing school in Bangkok, Thailand completed the survey. The average nursing student compliance to SPs was 68.5%. Most (91.2%) reported only using water for handwashing and 57.2% reported reuse of surgical masks. The fourth-year students had higher compliance (M=3.90, SD=1.12) on the 'prevention of cross infection from person-to-person' dimension while second-year students reported higher compliance on the 'disposal of sharps' (M=2.67, SD=0.57) dimension. 'Contextual Cues' was identified as the factor (M=3.41, SD=0.40) that had the greatest influence on adherence and 'Practice Culture' (M=1.84, SD=0.66) and 'Justification' (M = 1.35, SD.68 had the lowest influence. Fourth year students identified 'Leadership' (M=2.90, SD=0.49) as an important influence on adherence to SPs.
To increase nursing students' adherence there needs to be greater emphasis on the importance of SPs in theoretical sessions and regular monitoring and feedback on hand hygiene performance and personal protective equipment use while students are on placements. More visible organizational leadership and promotion of high levels of adherence to SPs may assist students to translate their theoretical knowledge into practice.
本研究旨在探讨泰国护理学生对标准预防措施（SPs）的遵守情况和对 SPs 的态度，以确定可能增加对 SPs 以及感染预防和控制最佳实践的依从性的因素。
在泰国等医疗保健相关感染率较高的情况下，采取有效策略促进临床医生高度遵守 SPs 是当务之急。护理学生是在照顾患者中发挥重要作用的医护人员群体之一，是未来护理人员队伍的重要组成部分。
采用横断面调查设计。
将包括《标准预防措施依从性量表》和《影响标准预防措施依从性因素量表》的自我报告式调查问卷作为泰国纸质调查问卷分发给护理学生。
曼谷一所护理学院的 533 名二至四年级护理学生完成了调查。护理学生对 SPs 的平均依从率为 68.5%。大多数（91.2%）学生仅使用水进行手卫生，57.2%学生报告重复使用手术口罩。四年级学生在“预防人与人之间的交叉感染”维度上的依从性更高（M=3.90，SD=1.12），而二年级学生在“处理锐器”（M=2.67，SD=0.57）维度上的依从性更高。“情境线索”被确定为对依从性影响最大的因素（M=3.41，SD=0.40），而“实践文化”（M=1.84，SD=0.66）和“正当性”（M=1.35，SD=0.68）的影响最小。四年级学生认为“领导力”（M=2.90，SD=0.49）对他们对 SPs 的依从性有重要影响。
为了提高护理学生的依从性，需要在理论课程中更加重视 SPs 的重要性，并在学生实习期间定期监测和反馈手卫生执行情况和个人防护设备使用情况。更明显的组织领导力和对 SPs 高度依从性的推广可能有助于学生将理论知识转化为实践。
