Hand Hygiene Awareness in Saudi Nursing Students

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Abstract

This document will describe the level of hand hygiene awareness depicted by nursing students from Saudi Arabia. The sample for the study will be from the five educational hospitals situated in different provinces of Saudi Arabia. The sample size utilized will be 500, and will be from each of the educational centers. A simple random sampling is the most appropriate method to apply. The study utilizes a quantitative research design for its data collection. The participants of the study will have to answer the structured questions in the questionnaire. The findings of this study will be useful in making decisions that will help enhance hand hygiene among nursing students around the world thus the reduced disease transmission.

Background

Studies conducted by scientists from diverse locations around have shown hand hygiene to be significant in and endeavor to control the transmission of the disease-causing pathogens among patients. It is apparent that some health care professionals have failed to maintain hand hygiene thus the spread of diseases. Reports have depicted direct contact to be amongst the basic causes of transmission of the disease-causing pathogens in a health care setting (Alston & Bowles, 2003). Researchers have indicated handwashing to be a principal intervention that would help curb the rising disease transmission cases in the hospital units. However, the noncompliance depicted by some health care professionals has acted as an obstacle towards formulating strategies for controlling infections. Although sources have depicted the availability of other approaches to monitoring a nurse’s hand hygiene, there exists no appropriate measure of conducting such an activity effectively. Therefore, this study aims to describe the hand hygiene awareness among nurses’ students of Saudi Arabia from five dissimilar hospitals located in assorted regions. The main reason for conducting this research is to help identify the main reasons behind the rising rate of transmission reported at dissimilar health care settings.

The literature review

This document reviews its literature from numerous currently published articles, discussing the issue of hand hygiene awareness by nurse students from different hospitals situated in diverse regions. In accessing these articles, the study has utilized two databases, which are CINAHL Plus and Ovid MEDLINE. In many countries around the globe, researchers have devoted their efforts towards understanding how poor hand hygiene has significantly contributed to the escalating transmission of diseases amongst patients. The central reason for the transmission is the negligence depicted by many healthcare professionals, who work with patients on a daily basis. Numerous articles have explained some studies undertaken by researchers possessing an enormous desire to understand how serious the health care professionals have perceived this issue.

The knowledge depicted by different nursing students on hand hygiene

A survey conducted by Gail (2007) aimed to understand the hand hygiene practices of nursing students from dissimilar groups. The survey was qualitative in nature and it utilized numerous data collection procedures. Amongst the procedures used was the interview method, which could help to examine an individual’s knowledge on the issue. In addition to the interview method, the survey utilized the grounded theory in the data collection phase. The open-ended type of questions provided room for the participants to contribute fully to the topic. After a careful examination of the answers provided by the participating nursing students, the researcher could alter the question thus providing room for detailed feedback (Gail, 2007). The results of the research depicted a low proportion of nurses who complied with the handwashing guidelines. Amongst the participants, the study indicated a 55% compliance rate, which is not the expected percentage.

Hand washing practices by different nursing students in Saudi Arabia

Amin & Wehedy (2009) participated in a quantitative study on handwashing at diverse surgical wards in numerous health care facilities in, Saudi Arabia. To understand whether health care professionals adhere to the handwashing rules, numerous researchers conducted an observational study on one of the health care facilities that on average could hospitalize 17,350 patients annually. Therefore, it is evident that 50% of health care workers did not stick to the handwashing rules (Amin & Wehedy, 2009).

Perceptions on hand hygiene

Barrett & Randle (2008) conducted a qualitative study that aimed to establish the perceptions portrayed by different nursing students on the issue of hand hygiene. The study indicated that decontamination of an individual’s hands could curb the rate of disease transmission. In an endeavour to identify some of the methods to use for controlling infections, the researchers utilized some structured interviews for data collection procedure (Barrett & Randle, 2008). The result of the study indicated that time, business, as well as the clinical procedure acted as barriers towards complying to hand hygiene guidelines.

Hand hygiene practices among nursing students in care hospitals in Kuwait

Al-Wazzan et al. (2011) conducted a research at Kuwait university faculty of medicine. The main objective was to examine the nurses’ hand hygiene compliance. The research was extensive since it involved six hospitals, all situated in Kuwait. The qualitative study utilized the questionnaire, as well the observation tools for data collection. First, the researchers made an observation on the different practices portrayed by such nurses. The results depicted a 33.4% level of hand washing compliance (Al-Wazzan et al., 2011). The results of the study depicted poor hand hygiene compliance.

Hand washing in-Shams University in Cairo

Khaled, Abd & Bakr, (2008), performed a qualitative survey at Ain-Shams University in Cairo that aimed to establish the knowledge, perception, as well as the hand washing practice amid health care professionals. In its data collection, the study utilized both observational, and the questionnaire methods. They focused on the 10 different departments of the hospital before providing their results. The compliance was high amongst doctors, rated at 37.5% (Khaled, Abd & Bakr, 2008). In addition, nurses portrayed more knowledge on hand washing as compared to doctors. However, the general compliance rate was low among the studied groups.

Beliefs and perceptions depicted by nurses at Sarawak General hospital

The above study conducted by Bakar (2009), was due to the researcher’s belief that preventing a disease occurrence is of substantial use as compared to curing a disease. The reason behind this study was due to an epidemic that occurred at Sarawak General Hospital in 1997. Therefore, the main aim for the study was to establish nurses’ beliefs and perceptions of hand washing on the disease transmission. The qualitative study utilized both interview and observation method for analyzing their beliefs, as well as perceptions. More than 70% of the nurses perceived hand washing as pivotal in disease prevention.

Hand washing practices at Hera General Hospital

Bukhari, et al. (2010) conducted a quantitative survey at Hera General Hospital, which is located at Makah in Saudi Arabia. The intention of the survey was to determine the compliance rate depicted by the nursing students in the hospital (Bukhari et al., 2011). It was a quantitative study as it utilized both the observational data collection methods, as well as the prospective method. In addition to nurses, doctors and clinical technicians also participated in the study. Prior to the observations, Bhukari, et al. (2010), provided education on hand hygiene to the three categories of participants. The study indicated that the compliance rate for the total population of professionals only reached 50% after a continued education.

Hand hygiene compliance at University of Geneva Hospitals

Pittet (2001) conducted a survey in the University of Geneva hospitals with the sole aim of establishing the rate of compliance depicted by the nursing students together with other health care professionals in different departments. The study conducted was quantitative in nature since it involved the usage of observation method in its data collection (Pittet, 2001). The researcher has to educate participants on the most appropriate methods for hand washing. They learned that the use of alcohol-based hand rubs to be effective in fighting the disease-causing microorganisms (Pittet, 2001). The overall compliance rate depicted by the health workers was less than 50%. This is indicative of a low compliance rate, hence the necessity of conducting a study aimed to establish the underlying cause for the noncompliance.

Hand hygiene practices in Greece

According to Mortel, T. (2010), the percentage of students having adequate knowledge on hand washing is low. A qualitative survey conducted by SangKard on students from a number of health care facilities from Greece depicted an insufficient knowledge on the essence of hand washing. The researchers came to this conclusion after submitting questionnaires to numerous students in the field of nursing and medical health. For instance, it tried to establish the rate of compliance to the hand hygiene guidelines provided. In addition to the compliance rate, it also tried to measure the nurse student’s beliefs on hand hygiene. The total compliance rate depicted by the nursing students was 52.3% (Mortel, 2010).

Hand washing adherence at Turkey

According to Celik and Kocasli (2008), the proportion of nursing students who apply the information about hand washing is minimal. This study, conducted performed at different educational health facilities located at diverse locations in Turkey involved 430 students. The two researchers performed a quantitative-descriptive survey and utilized a questionnaire method for the data collection procedure. The results of the analysis indicated that 71.9% of all the students applied the knowledge acquired from programs enlightening such students on the significance of hand washing for infections control (Akyol, 2005). Despite the appropriateness of teaching methods utilized, only a limited proportion adheres to such teachings.

Hand washing, as well as gloving at Riyadh medical facility

Basurrah & Madani (2006) participated in a survey that was at Riyadh medical facility in Saudi Arabia. The study focussed on the hand washing in both the nursing, as well as the surgical department (Basurrah & Madani, 2006). In addition, the study utilized the observational method for its data collection. The qualitative study indicated that diverse groups of professionals working in different departments depicted disparities in their hand washing, as well as gloving. Consequently, nursing students together with the health care professionals largely complied to hand washing and gloving practices at an average of 75.5% (Basurrah & Madani, 2006).

Theodor Bilharz hospital study on staff and nursing students’ disease infection

A qualitative survey performed by Sayed & Abou (2000) at Theodore Bilharz hospital aimed to identify the hand hygiene practice portrayed by the staff and nursing students. It was necessary to gather such information as it would help in devising ways of controlling the spread of infection. Such researchers administered questions to both the staff and nursing students by using questionnaires. It is evident from the results that the two groups did not possess adequate information on infection since their score was below 80% thus the need for educational programs (Sayed & Abou, 2000).

Hand hygiene compliance among health care professionals in Ireland

Creedon et al. (2008) conducted a qualitative survey aimed at understanding the hand compliance level among health care professionals at different acute hospitals located at Ireland. The quantitative study utilized the observation method for the data collection. The researchers observed the professionals’ compliance to the stated guidelines, after which they did an analysis (Creedon et al., 2008). The results depicted a low compliance, which might have risen from the hospitals’ cultures.

A study of hand hygiene practices in US

A recent study conducted by Bergman (2008) stationed in US aimed to establish the hand hygiene practices depicted by nursing students. He dedicated his efforts for a period of 12 months. The qualitative research utilized the observation technique method in data collection. Although US nursing students depicted knowledge on hand hygiene practice, they have not fully understood all practices since they only depicted a 70% compliance rate.

Hand washing compliance

A qualitative observational study conducted by Bischoff, et al. (2000), aimed to establish the awareness compliance shown by health workers from medical schools in Germany. The study was in different departments of the main medical hospital. After Implementing a working education program, they examined the level of compliance shown by participants and noted that it was low. On average, the total compliance level was less than 50%, and this indicated an ineffectiveness of the hand hygiene education offered.

In an endeavour to access these articles from the database, I used the terms hand hygiene, nursing students, and the diseases transmission. This is because the literature of interest ought to discuss how non-compliance to hand hygiene by nursing students has contributed to diseases transmission in the health care facilities (Tarling & Crofts, 2002). It was necessary to choose the above studies, since they properly described what some researchers have done in understanding how hands hygiene to help to curb new infections. Such studies are all current thus depicting the exact picture of what is happening now in health care facilities. However, it was unnecessary to utilize the studies from articles that utilized a small sample in their study thus not representative of the entire population. It is clear that a majority of studies on hand hygiene compliance were high in the western countries.

Therefore, it is clear that the majority of studies, which try to understand the hand hygiene compliance among nursing students, are not effective. This is because these studies only concentrate on a certain category of individuals. It is perceptible that the sample used to make such conclusion is not representative of the whole population. This calls for the need to conduct a study, which utilizes a well-selected sample involving nursing students from varied health facilities around the globe (Tarling & Crofts, 2002).

The research aims and objectives

This research aims at identifying the hand hygiene awareness among the students of nursing in Saudi Arabia. Although some research has been done on the same area, it has been hard to measure the degree to which such students depict such awareness, due to the size of the sample used, as well as the methodology. Therefore, this research will utilize a sample that is representative, and thus the accuracy of its results will help to determine the most appropriate thing to do in enhancing the hand hygiene among them.

The research question

The research question: what is the level of hand hygiene awareness among nursing students in Saudi Arabia?

The research design and methodology

For a successful accomplishment of goals and objectives of a research, it is necessary to formulate a research design that explains the method, as well as the procedure to follow in the entire process. The literature has indicated that in scenarios where by researchers adopted in appropriate research designs and methodologies, the results were questionable (Bergman, 2008). In addition to providing inappropriate results, sources have indicated that a research design not chosen properly can result to discarding of the study results (Burns & Grove, 2007).

Therefore, this research utilizes a quantitative-descriptive design in the collection of data that would help identify the hand hygiene awareness for Saudi Arabia nursing students. This research design entails the researcher making informed observations, as well as providing a description of an entity’s behavior without changing its original setting. In a descriptive quantitative design, researchers usually obtain a sample from a population of interest in making an inference about it. Such a sample can be a proportion of a population from a small region, or it can be from a large population thus a difference in its size. This is the most appropriate research design for the study, since it aims to aims to establish the level of hand hygiene an aspect that is quantifiable. The research will try to establish the awareness depicted by these students depending on their knowledge in this subject. The research utilizes a sample of size 500 obtained from five educational hospitals, whereby each educational hospital provides 100 students to form the overall sample.

Setting of the research

Participants of this study will be nursing students from different educational hospitals located at the five provinces of Saudi Arabia. This study will incorporate a number of students from the different study levels starting from second years to the fifth years. Students in the fifth years are interns as they are almost completing their course. The participants of the study will be chosen randomly. The study will engage students from the five educational hospitals, and each province will provide only one educational center. This will be crucial since it will enhance a clear representation of all the nursing students in Saudi Arabia. The total proportion of participants to take part in the study will be 500. This value is because of obtaining a random sample of 100 students across the five level studies from the five educational hospitals situated at varied locations in the five provinces. The five provinces of Saudi Arabia are the (North, South, East, West, and Central). The study will be conducted in one of the educational hospitals, usually in the one from the Central province. It will be after a well thought-out plan, whereby the students will gather in one of the hospitals. For accurate results, it is be imperative to ensure no disclosure of the purpose of the gathering thus enhancing the originality of the result (Burns & Grove, 2007).

Sample of the research

Studies have designated the process of obtaining a sample to represent the population of interest to be crucial when conducting a research. The process of the sample selection ought to depict a high degree of appropriateness, accuracy, as well as efficacy. This is because; it is from the chosen sample that a researcher obtains all the information needed to answer the study question (Caputi & Balnaves, 2001).

The two mostly used sampling procedures are the probability, as well as the non-probability techniques. The non-probability sampling fails to utilize a random sample as researchers obtain such a sample by using dubious methods such as the word of mouth. Although the technique is not scientific, at times, nursing researchers opt for this procedure. Some of the reasons contributing to using this strategy are feasible. In a number of scenarios, a researcher will opt for it due to limitation of finances, as well as time. This study will utilize the probability sampling technique, whereby the researcher obtains a random sample from the population of interest. A random sample is the most appropriate in a quantitative research because it ensures a representation of all individual components in the population (Polit, Hungler & Beck, 2001). For instance, the sample to use in this study is representative of the entire population, since a random sampling technique has aided the process of choosing the 100 students from each of the educational hospital. After the 500 students making the sample come together, what will result is a sample consisting of individuals having diverse level of awareness about hand hygiene. Therefore, after subjecting these students into an activity such as responding to a questionnaire, it is true that their results would vary. The analysis of the obtained results will enable the researcher to know the rate of awareness depicted by nursing students in Saudi Arabia (Polit, Hungler & Beck, 2006).

Data collection

Data collection involves visiting the population from where the researcher obtains the sample thus conducting any necessary activity, which can assist in the data collection process. In data collection, it is necessary to get approval from the concerned category of individuals thus their permission to conduct the study. In both quantitative and quantitative research designs, three methods of data collection are common. These methods are the interview, questionnaire, as well as observations (Schneider, et al., 2007). It deems necessary to have a glimpse on each of the data collection procedure to understand the most appropriate for this study. When utilizing the interview method, the researcher constructs different questions aimed to address diverse issues. The two interview categories are the structured, which follow well-described questions, and the unstructured without a given format (Johnson & Christensen, 2010). Structured interviews are descriptive since they utilize open-ended questions, which provide room for discussions.

The second most frequently used procedure for data collection is observation, whereby the researcher makes observations based on the subject under the study. In this data collection procedure, the researcher keeps records of what he or she observes and later subjects in to into analysis thus obtaining the study results. The other data collection strategy needing some attention in this study is the usage of questionnaires. In a questionnaire, the researcher formulates questions based on the study hypothesis. There are two categories of questionnaires used in such a case, which are open together with the closed questions (McNabb, 2010). In open-ended questions, the respondent has the permission of explaining or describing their answers while in open-ended there is no such an option. This study will utilize the latter method of data collection, since the intention of the study is to establish the level of hand hygiene awareness for these students. It will be appropriate to design a questionnaire that incorporates both open and closed-ended questions. The questions will majorly be on the main practices contributing to hand hygiene, some of which are the hand washing, wearing of gloves, use of soap and antiseptics (Cormack, 2000).

Data analysis

After data collection, what follows is its analysis, and the appropriateness of the analysis method determines the accuracy of the results obtained. In quantitative-descriptive study, numerous data analysis procedures are common. One of the frequently used analysis package is the “Statistical Package for Social Sciences” (SPSS) (Connolly, 2007). This statistical package allows the analyst to design the template used in feeding data for the different variables. This Package contains both the data, as well as the variable view. The variable view allows one to manipulate the data, and the questions used to collect the data for research will be necessary when designing the templates. The data view, in addition, allows one to view the different options provided in answering the questionnaire questions (Roberts & Taylor, 2002). The study utilizes the chi-square test since the aim of this test is to note any variation between the observed value and the hypothesized value. A conclusion will only be after making the comparison thus noting the level of awareness they depict.

Limitations

In conducting a research, it is impossible to perform everything comfortably without some challenges, which limits the entire procedure. In most studies, limitations may arise due to utilization of poor sampling, and analysis method. All these steps are vital in conducting a research that provides correct results. In this study, the validity of the results might tend to be inadequate due to the analysis method adopted. In addition to the analysis procedure adopted, the sampling procedure though randomly conducted might also be the result of inefficiency of the research. The instrument used for data collection purposes could also have some errors thus the limitation.

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