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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 2  |  Page : 131-135

Impact of video-assisted teaching programs regarding hand hygiene among oncology nurses


1 Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India
2 Department of Nursing, Indian Railway Health Services, Bikaner, Rajasthan, India

Date of Submission07-Apr-2021
Date of Acceptance24-Apr-2021
Date of Web Publication02-Jun-2021

Correspondence Address:
Dr. Shatrughan Pareek
Department of Nursing, Indian Railway Health Services, Bikaner, Rajasthan.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mgmj.mgmj_20_21

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  Abstract 

Background and Objectives: Hand hygiene is one of the most important measures in reducing the transmission of infectious agents in health-care settings, and it assists in the prevention of infection in patients with surgical intervention. The aims of the present study were to assess the knowledge of nursing professionals regarding hand hygiene and to evaluate the effectiveness of video-assisted teaching programs on knowledge regarding hand hygiene. Materials and Methods: A quantitative approach and pre-experimental research design were found suitable for the study. The investigator assessed the existing knowledge among staff nurses regarding hand hygiene for the prevention of infection in patients with cancer undergoing surgery by using a structured knowledge questionnaire; they found an association between knowledge and selected demographic variables. Results: The majority (63.30%) of the sample were female. Nearly half of the participants belonged to the age group 21–30 years. In professional education, most (55.00%) of the samples had a diploma in nursing. Further, the mean pretest knowledge score was 15.5 ± 3.735 whereas the posttest knowledge score was 24.38 ± 4.446. Therefore, the t-test was statistically significant (P = 0.0001) and it revealed that the video-assisted teaching program was effective in enhancing the knowledge of the nurses about hand hygiene. In addition, there was a significant association between age, source of information, working experience, and area of working but no significant association was reported between gender and professional qualification. Conclusion: The intervention was significantly effective in enhancing the knowledge of nursing professionals regarding hand hygiene. Therefore, administrators have to implement such educational programs to increase the knowledge of nurses.

Keywords: Hand hygiene, infection, nursing professionals, oncology, prevention


How to cite this article:
Kumar S, Pareek S. Impact of video-assisted teaching programs regarding hand hygiene among oncology nurses. MGM J Med Sci 2021;8:131-5

How to cite this URL:
Kumar S, Pareek S. Impact of video-assisted teaching programs regarding hand hygiene among oncology nurses. MGM J Med Sci [serial online] 2021 [cited 2021 Oct 21];8:131-5. Available from: http://www.mgmjms.com/text.asp?2021/8/2/131/317445




  Introduction Top


Patient safety is a primary concern for any health-care systems, and hand hygiene is one of the main effective factors.[1] Hospital-acquired infection is one of the leading causes of preventable deaths in our health-care system. The US Center for Disease Control and Prevention identifies that nearly 1.7 million hospitalized patients annually acquire health care-associated infections (HCAIs) while being treated for other health issues and that more than 98,000 of these patients (1 in 17) die due to HCAIs.[2] These infections not only cause a significant amount of morbidity and mortality, but they also greatly increase health-care costs. Hand hygiene compliance is one of the most effective ways to combat the spread of infection within a hospital.[3] Hand drying is equally important to prevent cross infection, because microorganisms thrive in a damp environment.[4] Health care-related infections are a main factor to achieving quality health care. In Europe, around 37,000 patients lost their lives, whereas about 2 million infections and 100,000 deaths every year were reported in the United States.[5] Various research studies have reported that hand hygiene compliance in nursing homes estimate of 6% to 27%.[6],[7],[8] Hand hygiene is a crucial method of prevention of infections in hospitals.[5] Only 62.73% of subjects were familiar with the World Health Organization (WHO) guidelines about hand hygiene. The WHO estimates that 10–30% of all hospital admissions result in health care-acquired infections. An estimated 1.4 million people suffer from health care-acquired infections at any given time. The average rate of prevalence of health care-acquired infection in Europe is 7.1%, resulting in 16 million extra days of hospital stay and this accounts for a loss of approximately 7 billion a year (excluding indirect costs), as per a state’s annual report on communicable diseases.[3],[4],[5],[6],[7],[8],[9] A few studies highlighted that morbidity and mortality rates decline in nursing homes when hand hygiene compliance is enhanced by hand hygiene interventions.[6] The effectiveness of hand hygiene knowledge and practice depends on both the implementation of hygiene prevention and the symptoms of the infectious diseases. The continuous practice of hand hygiene during the risk transmission of infections played a significant role in the prevention of infections.[10] Ahmed et al. reported that the adherence to hand disinfectant application before and after each patient contact was found to be only 12.3%.[5] HCAIs are an important cause of morbidity and mortality among hospitalized patients worldwide. Compliance by health-care workers with recommended hand hygiene procedures has remained unacceptable, with compliance rates being generally below 50% of hand hygiene opportunities.[11] Surgical site infections are the most common and serious complications among surgically treated patients. They comprise approximately 25% of all nosocomial infections.[12] Postoperative cancer surgical site infections are the most life-threatening infections.[13] Handwashing should become an educational priority. Hand hygiene is the practice of evidence-based medicine. Hospital curricula should now treat it thus and should study the efficacy of educational programmers to improve hand hygiene.[14] The investigator felt that effective hand hygiene practices in hospitals play a key role in improving patient and staff safety, and in preventing the spread of HCAIs. Hence, the investigator undertook this study to create awareness about the importance of hand hygiene practices and its impact on surgical site infections among nurses.


  Materials and methods Top


In the present study, a quantitative research approach was applied with a one-group pretest–posttest design to evaluate the effectiveness of a video-assisted teaching program among nurses regarding hand hygiene for the prevention of infection in patients with cancer undergoing surgery. The sample comprised 60 nurses, selected by the nonprobability purposive sampling technique. In this study, the independent variable was the video-assisted teaching program on hand hygiene and the dependent variable was the knowledge regarding hand hygiene. Data collection was done with the help of a demographic tool and a structured knowledge questionnaire. The maximum knowledge score was 30. The obtained knowledge scores were categorized as poor (0–35%), average (36–70%), and good knowledge (Above 71%). Ethical permission was taken from the ethical committee, and well-informed written consent was taken from the subjects. Anonymity and confidentiality of the subjects was maintained while carrying out the study. The data analysis was done with help of SPSS 20.0 version.


  Results Top


The major findings of the study revealed that the majority (63.30%) of the sample were female. Age-wise distribution highlighted that most of the sample (48.30%) belonged to the age group 21–30 years. In professional education, the majority (55.00%) of the samples had a diploma in nursing whereas nearly half of the subjects had 0–4 years of working experience [Table 1]. Most of the participants (43.3%) worked in medical units, and 36.70% acquired knowledge through journals/magazines/newspapers. The pretest knowledge toward hand hygiene revealed that the majority of nurses (78.3%) had poor to average knowledge followed by good knowledge among 21.7% of nurses [Table 2]. Further, posttest knowledge revealed that the majority of nurses (45%) had good knowledge followed by 30% who had average knowledge regarding hand hygiene. The mean pretest knowledge score was 15.5±3.735, whereas the posttest knowledge score was 24.38±4.446. According to [Table 3], the t-test was statistically significant as the obtained value (11.742) was higher than the tabulated value (1.97) and it was found to be statistically significant (P = 0.0001); hence, the intervention was significantly effective in enhancing the knowledge of nurses. As per [Table 4], there was a significant association between age, source of information acquired, working experience, and area of working; however, there was no significant association between gender, professional qualification, and frequency of patients with postmastectomy in the ward.
Table 1: Frequency and percentage distribution of demographic variables. n = 60

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Table 2: Knowledge scores and responses of participants regarding hand hygiene during pretest and posttest. n = 60

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Table 3: Comparisons of pretest and posttest mean and standard deviation on improving knowledge regarding hand hygiene. n = 60

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Table 4: Association between demographic variables and knowledge scores regarding hand hygiene. n = 60

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  Discussion Top


Hand hygiene is not only the responsibility of the Infection Control Department, but it is also related to a multidisciplinary approach: Hospital administration, other key leaders, and nursing leaders are the key to success for hand hygiene compliance within a hospital.[15] The present study highlighted that during pretest, the majority of subjects (78.3%) have poor to average levels of knowledge toward hand hygiene [Figure 1]. In this context, an observational study was carried out on hand hygiene practices in the surgical ward; it was concluded that the adherence to hand hygiene guidelines by the health-care professionals was extremely low.[16] Moreover, a quantitative study was conducted to assess the knowledge, attitudes, and practices of the five moments of hand hygiene among nursing staff. Only 14% of participants had good knowledge regarding hand hygiene.[17] The present study also communicated that only 21.7% subjects had good knowledge toward hand hygiene during the pretest. A cross-sectional study involving 130 nursing professionals reported that most of the participants exhibited moderate levels of knowledge toward hand hygiene.[18] The present study’s findings were consistent with those of the study referred to earlier. Further, regarding the effectiveness of video-assisted teaching programs, Jeffin Thomas Jacob et al. reported that a significant difference in the pretest and posttest knowledge scores was noted after the administration of video-assisted teaching (P < 0.05).[19] The present study also communicated that video-assisted teaching programs regarding hand hygiene for the prevention of infection in oncology units among nursing professionals was significantly effective in enhancing the nurses’ knowledge. Martos-Cabrera MB et al. conducted a systematic review regarding hand hygiene teaching strategies among nurses and nursing students. The study revealed that teaching techniques such as lectures were more effective at increasing hand hygiene compliance.[1] In addition, a descriptive study by Farotimi AA and Ajao EO revealed that 62.90% participants in the post-intervention group had a high knowledge level compared with the pre-intervention group where no one had a high knowledge level.[20] The present study also reported that nearly half of the subjects had good knowledge after the intervention. Further, the present study also elucidated a significant association between age (P = 0.03), source of information (P = 0.04), professional qualification (P = 0.04), and area of working (P = 0.03); however, no significant association was reported between gender (P = 0.53) and experience (P = 0.68). In this context, Zakeri H et al. also highlighted that the mean knowledge score was not associated with gender (P = 0.84).[21] The researchers highlighted that the intervention was effective in increasing the knowledge of nurses regarding hand hygiene in oncology units.
Figure 1: Bar diagram showing percentage distribution of the levels of knowledge scores.

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  Conclusion Top


Hand hygiene is vital need for every health-care professional in a hospital setting. The drastic impact of surgical infections in oncology units was responsible for the emphasis laid on hand hygiene. The present study highlighted that nurses have limited knowledge toward hand hygiene. The video-assisted teaching program was significantly effective in enhancing the knowledge regarding hand hygiene. Our findings suggested that hand hygiene practices can be improved through the multimedia intervention. The increasing incidence of hospital-acquired infections and their complications can be minimized by developing and implementing knowledge and awareness programs about hand hygiene practices.

Limitation

The present study was conducted at a single center with a limited sample size. The study was focused on the knowledge aspect regarding hand hygiene.

Financial support and sponsorship

Self-funded.

Conflicts of interest

None.



 
  References Top

1.
Martos-Cabrera MB, Mota-Romero E, Martos-García R, Gomez-Urquiza JL, Suleiman-Martos N, Albendin-Garcia L, et al. Hand hygiene teaching strategies among nursing staff: A systematic review. Int J Environ Res Public Health2019;16:3039.  Back to cited text no. 1
    
2.
Klevens RM, Edwards JR, Richards CL. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep2007;122:160-6.  Back to cited text no. 2
    
3.
Haque M, Sartelli M, McKimm J, Abu Bakar M Health care-associated infections - An overview. Infect Drug Resist 2018;11:2321-33.  Back to cited text no. 3
    
4.
Huang C, Ma W, Stack S The hygienic efficacy of different hand-drying methods: A review of the evidence. Mayo Clin Proc 2012;87:791-8.  Back to cited text no. 4
    
5.
Ahmed J, Malik F, Memon ZA, Arif TB, Ali A, Nasim S, et al. Compliance and knowledge of healthcare workers regarding hand hygiene and use of disinfectants: A study based in Karachi. Cureus2020;12:e7036.  Back to cited text no. 5
    
6.
Teesing GR, Erasmus V, Petrignani M, Koopmans MPG, de Graaf M, Vos MC, et al. Improving hand hygiene compliance in nursing homes: Protocol for a cluster randomized controlled trial (HANDSOME study). JMIR Res Protoc 2020;9:e17419.  Back to cited text no. 6
    
7.
Temime L, Cohen N, Ait-Bouziad K, Denormandie P, Dab W, Hocine MN Impact of a multicomponent hand hygiene-related intervention on the infectious risk in nursing homes: A cluster randomized trial. Am J Infect Control 2018;46:173-9.  Back to cited text no. 7
    
8.
Hocine MN, Temime L Impact of hand hygiene on the infectious risk in nursing home residents: A systematic review. Am J Infect Control 2015;43:e47-52.  Back to cited text no. 8
    
9.
World Health Organization. Health care-associated infections: Fact sheet. Geneva: WHO; 2020. Available at: https://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf. Accessed on 10 December 2020.  Back to cited text no. 9
    
10.
Aiello AE, Coulborn RM, Perez V, Larson EL Effect of hand hygiene on infectious disease risk in the community setting: A meta-analysis. Am J Public Health 2008;98:1372-81.  Back to cited text no. 10
    
11.
Mani A, Shubangi AM, Saini R Hand hygiene among health care workers. Indian J Dent Res 2010;21:115-8.  Back to cited text no. 11
    
12.
Reichman DE, Greenberg JA Reducing surgical site infections: A review. Rev Obstet Gynecol 2009;2:212-21.  Back to cited text no. 12
    
13.
Korol E, Johnston K, Waser N, Sifakis F, Jafri HS, Lo M, et al. A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One 2013;8:e83743.  Back to cited text no. 13
    
14.
Mathur P Hand hygiene: Back to the basics of infection control. Indian J Med Res 2011;134:611-20.  Back to cited text no. 14
    
15.
Maxfield D, Dull D Influencing hand hygiene at spectrum health. Physician Exec 2011;37:30-2, 34.  Back to cited text no. 15
    
16.
Shobowale EO, Adegunle B, Onyedibe K An assessment of hand hygiene practices of healthcare workers of a semi-urban teaching hospital using the five moments of hand hygiene. Niger Med J 2016;57:150-4.  Back to cited text no. 16
    
17.
Dreidi M, Alrimawi I, Saifan A, Batiha A Hand hygiene knowledge, practices and attitudes among nurses and physicians. Health 2016;8:456-62. doi: 10.4236/health.2016.85048  Back to cited text no. 17
    
18.
Mehta A, Tripathi K Knowledge, attitude and practices of hand hygiene among nurses and nursing students in a tertiary health care center of Central India: A questionnaire based study. Int J Comm Medi Public Health 2019;6:5154-60. doi:10.18203/2394–6040.ijcmph20195462  Back to cited text no. 18
    
19.
Jeffin TJ, Elsa SD, Janet PD, Vandana KE, Mukhopadhyay C Video assisted teaching program on knowledge and preventive practices of catheter related blood stream infections among health care professionals: A hospital-based prospective study. Medico-Legal Update 2019;19:78-83. https://ijop.net/index.php/mlu/article/view/747  Back to cited text no. 19
    
20.
Farotimi AA, Ajao EO, Nwozichi CU, Ademuyiwa IY Effect of training on knowledge, perception and risk reduction regarding infection control among nurses in selected teaching hospitals in Nigeria. Iran J Nurs Midwifery Res 2018;23:471-7.  Back to cited text no. 20
    
21.
Zakeri H, Ahmadi F, Rafeemanesh E, Saleh LA The knowledge of hand hygiene among the healthcare workers of two teaching hospitals in Mashhad. Electron Physician 2017;9:5159-65.  Back to cited text no. 21
    


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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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