The hand hygiene compliance of student nurses during clinical placements

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Abstract
Aims and objectives: To observe student nurses’ overall and moment‐specific hand hygiene compliance during clinical placement.Background: Hand hygiene is the single most important measure to prevent healthcare‐associated infections. However, research has shown low compliance among healthcare workers. During clinical placements, student nurses perform various nursing tasks and procedures to a large number of patients, requiring extensive patient contact. It is crucial that they practice correct hand hygiene to prevent healthcare‐associated infections.Design: Open, standardised and nonparticipating observations.Methods: Twenty‐nine student nurses were observed three times for 20 ± 10 min during clinical placement in a Norwegian university hospital. To measure compliance, we used WHO's Hand Hygiene Observation tool, based on the model “My five moments for hand hygiene”.Results: Overall hand hygiene compliance in the student group was 83.5%. Highest moment‐specific compliance was after touching patient surroundings, after touching patients and after body fluid exposure risk. Lowest moment‐specific compliance was recorded before touching patients or patient surroundings, and before clean/aseptic procedures.Conclusions: Nurse education needs to be improved both theoretically and during clinical placements in order to advance and sustain compliance among student nurses.Relevance to clinical practice: Increasing healthcare workers’ compliance with hand hygiene guidelines remains a challenge to the clinical community. In order to reduce healthcare‐associated infections, it is important to educate student nurses to comply with the guidelines during clinical placements. Identifying student nurses’ hand hygiene performance is the first step towards developing teaching methods to improve and sustain their overall and moment‐specific compliance. As a measure to ensure student compliance during clinical placements, mentors should be aware of their influence on students’ performance, act as hand hygiene ambassadors, encourage students to comply with established guidelines and provide regular feedback.

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