Improving hand hygiene compliance amongst second-year nursing students and staff by implementing a standardised aseptic hand wash protocol in hospitals in the Northern Cape Province, South Africa

Keywords: hand washing, aseptic hand washing, nurse education, infection prevention, infection control, wound infection


Background: Infection prevention and control is essential within the scope and practice of every nurse or health care practitioner. It is also mandatory for wound care practitioners to ensure safe practices to avoid infection and decrease the associated risks, which would impact wound healing. At Henrietta Stockdale Nursing College (HSNC) in Kimberley, Northern Cape Province (NCP), students for the diploma in nursing are trained on social hand washing, alcohol hand rubbing and aseptic hand washing during their first year; and surgical hand scrubbing during the second year. Throughout the years, it was found that students copied different hand washing practices from different hospitals where they were placed for clinical training, despite the specified aseptic hand washing skill/procedure that was taught at HSNC. This has led to poor compliance with the prescribed aseptic hand washing skill/procedure, which could lead to the introduction of infection in those hospitals. Clinical preceptors also realised that students were failing their second-year practical examination due to failure of aseptic hand washing skills.

Methods: This study was a clinical, observational, qualitative, action research performed from May to December 2021. After a preliminary meeting to identify barriers to the study, assessment of needs, training material was made available for preceptors and students were placed in three hospitals within the NCP for clinical assessment. A questionnaire and evaluation tool were used to assess students’ and staff’s knowledge on aseptic hand washing technique. Descriptive statistic was used to compile results.

Results: A total of 25 students and 17 hospital staff members participated in the aseptic hand hygiene study. The pre-test percentage score for the evaluation tool for the students was 52%, and the objective structured clinical assessment (OSCA) score was 96%. The pre-test percentage score for the evaluation tool for the staff was 24%, and the OSCA score was 100%.

Conclusion: Continued training and support should be offered to all clinical facilities to minimise the gap between knowledge and attitude related to hand hygiene practices. Infection control units need to be resuscitated to adhere to audit programmes in the clinical facilities and to provide ongoing support and education on hand hygiene practices to the clinical facilities.

Author Biography

L E Katz-Hulana, Henrietta Stockdale Nursing College

Clinical Department, Henrietta Stockdale Nursing College, South Africa

Original Research