Exploring the hand hygiene competence of student nurses: A case of flawed self assessment
Section snippets
Introduction and background
Hand hygiene remains the single most effective measure to prevent Hospital Acquired Infection (Hass and Larson, 2007, Department of Health, 2003, Pratt et al., 2001). It has spawned a plethora of research (Whitby et al., 2006, Creedon, 2005, McGukin, 2004, Bischoff et al., 2000) and has been referred to as both a simple mechanical task (Paotong et al., 2003, Fell, 2000) and a complex behavioural phenomenon (Pittet, 2004). Its importance does not appear to be sufficiently recognised by health
Design
A methodological triangulation (Shih, 1998, Dootson, 1995) which combined two data collection procedures, a questionnaire and interview was the chosen method for this study. Methodological triangulation is ideally suited when studying complex concepts, like attitude and behaviour that may contain many dimensions (Begley, 1996). Advocates of mixed methods argue that all research approaches are designed to understand and explain behaviour and events, their components, antecedents, corollaries,
Quantitative
All scores with the exception of one were subject to a seven point likert scale, with seven being the highest possible score. The mode was used to highlight the most common answer (Table 1). Although crude, the results appear to confirm the theory that health care workers do not make objective self assessments in relation to their hand hygiene compliance (Jenner et al., 2006). A mode of 7 in relation to personal compliance is discordant with compliance rates reported from observational studies (
Discussion
In the quantitative phase of the study respondents reported a positive attitude and high self evaluation of their hand hygiene behaviour. Although no attempt was made to observe their behaviour this is consistent with the notions of high self assessment and over reporting that are well established in the literature (O’Boyle et al., 2001, Alexander and Sirotnak, 1997, Larson et al., 1997, Tibballs, 1996 Alvaran et al., 1994, Henry et al., 1994). When researchers correlate self assessment of
Conclusion
The word competence is used extensively in nursing education and is gaining international recognition as a means of developing the clinical skills that are a critical component of any undergraduate nursing programme. Hand hygiene is considered a core skill, that can have an enormous impact on the morbidity and mortality associated with hospital acquired infection. Although presented as a simple, mechanical procedure, compliance associated with hand hygiene is in fact complex and incorporates
References (98)
- et al.
Opinions, knowledge, and self-reported practices related to infection control among nursing personnel in long-term care settings
American Journal Infection Control
(1994) - et al.
Implementing objective structured clinical skills evaluation (OSCE) in nurse registration programmes in a centre in Ireland: a utilization focused evaluation
Nurse Education Today
(2006) The use of reflective journals in the promotion of reflection and learning in post-registration nursing students
Nurse Education Today
(2007)Using a motivational paradigm to improve handwashing compliance
Nurse Education in Practice
(2006)- et al.
Competence in nursing practice: a controversial concept – a focused view of the literature
Nurse Education Today
(2005) - et al.
Reflective learning with drama in nursing education – a Swedish attempt to overcome the theory praxis gap
Nurse Education Today
(2004) - et al.
The clean your hands campaign: critiquing policy and evidence base
Journal of Hospital Infection
(2007) So how do you feel about that? Assessing reflective practice
Nurse Education Today
(2004)- et al.
Compliance with universal precautions and needle handling and disposal practices among emergency department staff at two community hospitals
American Journal of Infection Control
(1994) - et al.
Controlling MRSA aka “Superbug”
Lancet
(2005)