Major ArticleGuiding hand hygiene interventions among future healthcare workers: implications of knowledge, attitudes, and social influences
Section snippets
Methods
This cross-sectional study spanning 6 months was conducted among medical students enrolled in 3 different medical universities in Karachi, Pakistan, with each university corresponding to a different sector: public, private, or semi-private. A sample size of 384 respondents was calculated under a 95% confidence interval using Open Epi, however, we opted for a total sample of 450 medical students. The study received approval from the Ethical Review Committee of Baqai Medical University.
The
Results
Our response rate was 96%, as 15 of 450 questionnaires were left unfilled. Three-quarters of the participants (74.8%) were women. Participants were from the third year (n = 139), fourth year (n = 150), and fifth year (n = 145) of medical training. They were from public (n = 133), semi-private (n = 150), and private (n = 151) medical colleges, respectively (Table 1). The mean age of study participants was 22.0 ± 1.22 years. The mean age for men and women was 22.5 ± 1.32 years and 21.9 ± 1.14
Discussion
The results of this multicenter study conducted among medical students in their clinical years show that self-reported HH compliance is uniformly low irrespective of sex, year of study, and institute of study. Women comprised approximately three-quarters of our sample, which reflects the prevalence of female medical students in Pakistani medical colleges. Only 56.8% of students in our sample reported a “high” likelihood of performing HH when indicated, whereas the same was reported for only
Limitations
Despite our best efforts, this study is subject to limitations arising from its methodological design. The first of these is the use of a nonprobability sampling technique, which is predisposed to selection bias. However, the inclusion criteria applied during judgmental sampling were relatively broad (all medical students in their clinical years who were enrolled in the selected colleges were given equal consideration for inclusion). In addition, to ensure a representative and valid sample, a
Strengths
To our knowledge, this is the first large-scale study to investigate HH trends across multiple centers in Pakistan corresponding to 1 of 3 medical university types (public, private, and semi-private). It therefore provides an unmatched, holistic view of the situation in Pakistan. In contrast to previous studies, we did not include students from disciplines outside of medicine, such as nursing or dentistry, thus providing a uniform representation of HH trends in our chosen population.
Conclusion and recommendations
This study showed that HH awareness and compliance are uniformly low among medical students in public, private, and semi-private universities in Pakistan. Public university students demonstrated greater HH knowledge compared to their counterparts in other institution types. This may be attributed to the higher level of “achievement orientation” among public university students and indicates that incorporation of HH training in assessment situations (such as SBLs and OSCEs) may improve HH
References (25)
- et al.
Beliefs about hand hygiene: a survey in medical students in their first clinical year
Am J Infect Control
(2011) - et al.
Setting the right foundations: improving the approach used to teach concepts of hand hygiene to medical students
J Hosp Infect
(2017) - et al.
Association between students' personality traits and hand hygiene compliance during objective standardized clinical examinations
J Hosp Infect
(2015) - et al.
Medical students' perceptions of their role as covert observers of hand hygiene
Am J Infect Control
(2014) - et al.
Improved hand hygiene technique and compliance in healthcare workers using gaming technology
J Hosp Infect
(2013) Improving adherence to hand hygiene practice: a multidisciplinary approach
Emerg Infect Dis
(2001)Healthcare workers' hand decontamination practices: compliance with recommended guidelines
J Adv Nurs
(2005)- et al.
Self-reported practices of hand hygiene among the trainees of a teaching hospital in a resource limited country
J Pak Med Assoc
(2009) - et al.
Introducing alcohol-based hand rub for hand hygiene the critical need for training
Infect Control Hosp Epidemiol
(2007) Hand hygiene in healthcare settings | Hand hygiene
Hand hygiene: knowledge and attitudes of fourth-year clerkship medical students at Alfaisal University, College of Medicine, Riyadh, Saudi Arabia
Cureus
Hand hygiene practices among medical students
Interdiscip Perspect Infect Dis
Cited by (19)
A survey of hand hygiene practices among Indian medical undergraduates
2022, Medical Journal Armed Forces IndiaCitation Excerpt :HCW include a diverse mix of doctors, residents, nurses, and paramedical staff, with gaps in knowledge and many behavioral issues impacting their compliance with hand hygiene.8 Hand hygiene knowledge and practices among medical undergraduate students, who are the future HCWs, have not been studied comprehensively.9 However, there have been many studies on hand hygiene compliance among student nurses.10
Interprofessional perceptions and emotional impact of multidrug-resistant organisms: A qualitative study
2019, American Journal of Infection ControlBeyond entry and exit: Hand hygiene at the bedside
2019, American Journal of Infection ControlCitation Excerpt :Few studies examine HH compliance with the WHO 5 moments. The compliance measured in this study is consistent with data from similar studies in which a wide range of compliance is found.3,6-12 We previously reported a compliance of only 7% among 1,034 WHO-defined opportunities in a busy trauma resuscitation unit,10 with compliance the lowest (0 of 178 moments) before a clean procedure.
Impact of an automated hand hygiene monitoring system combined with a performance improvement intervention on hospital-acquired infections
2020, Infection Control and Hospital EpidemiologyCognitive bias in professional hand hygiene and feedback: A national online-survey on overconfidence in Germany
2019, Infection Control and Hospital EpidemiologyAn Agreement Among Nurse Educators on Infection Prevention and Control Practices to Ensure Safe Clinical Training Post-COVID-19
2024, Iranian Journal of Nursing and Midwifery Research
Conflicts of interest: Authors declare no conflicts of interest.
Financial disclosure: None to declare.
Name(s) of institutions where research was conducted: Dow University of Health Sciences (DUHS), Karachi, Pakistan, Baqai Medical University, Karachi, Pakistan, and Karachi Medical and Dental College, Karachi, Pakistan.