Objective: The research was carried out to determine the beliefs and practices of nurses working in the intensive care unit (ICU) about hand hygiene. Material and Methods: The research is crosssectional and descriptive and was conducted between October 2019 and January 2020, with nurses working in the mixed ICU of a state hospital, the pediatric and neonatal care units of a city hospital and a university hospital. One hundred thirty-nine nurses working in the ICU and willing to participate in the study were included in the study. Personal Information Form, Hand Hygiene Belief Scale and Practice Inventory were used in the research. In the evaluation of the data, number, percentage, mean, t-test and one-way ANOVA, Mann-Whitney U and Kruskall-Wallis tests were used. Results: Nurses' hand hygiene belief score was 87.34±9.73, and practice score was 67.42±4.98. It has been determined that female nurses and nurses between the ages of 31-40 have high hand hygiene belief and practice scores. A significant difference was found between gender, age and hand hygiene belief score. It was found that the hand hygiene belief and practice score of the nurses who graduated from undergraduate and higher education were higher. It was determined that those who received hand hygiene training had higher positive attitudes (p=0.016). The lowest practice score was formed after the invasive procedure (4.64±0.69), after entering the isolation room (4.64±0.75) and after contact with the patient's secretions (4.64±0.74). Conclusion: It has been determined that nurses generally have a positive attitude and practice hand hygiene. Even if it is stated that hand hygiene is done, it is important to transform it into behavior. Hand hygiene observations and training should be done continuously, compliance should be further increased, especially after contact with the patient and patient's secretions. Institutions should develop and maintain multifaceted strategies to increase hand hygiene compliance.
Keywords: Beliefs; hand hygiene; intensive care unit; nurse; practices
Amaç: Bu çalışma, yoğun bakım ünitesinde (YBÜ) çalışan hemşirelerin, el hijyenine olan inançlarını ve uygulama durumlarını belirlemek amacıyla gerçekleştirilmiştir. Gereç ve Yöntemler: Araştırma kesitsel ve tanımlayıcı tipte olup, Ekim 2019 ve Ocak 2020 tarihleri arasında, bir devlet hastanesinin karma yoğun bakım, bir şehir hastanesi ve bir üniversite hastanesinin çocuk ve yenidoğan bakım ünitelerinde çalışan hemşireler ile gerçekleştirilmiştir. Yoğun bakımda çalışan ve araştırmaya katılmak isteyen 139 hemşire, araştırmaya dâhil edilmiştir. Araştırmada; Kişisel Bilgi Formu, El Hijyeni İnanç Ölçeği ve Uygulama Envanteri kullanılmıştır. Verilerin değerlendirilmesinde; sayı, yüzde, ortalama, t-test ve one-way ANOVA, Mann-Whitney U ve Kruskall-Wallis testleri kullanılmıştır. Bulgular: Hemşirelerin el hijyeni inanç puanı 87,34±9,73, uygulama puanı ise 67,42±4,98 olarak bulunmuştur. Kadın hemşirelerin ve 31-40 yaş arasındaki hemşirelerin; el hijyeni, inanç ve uygulama puanlarının yüksek olduğu belirlenmiştir. Cinsiyet, yaş ile el hijyeni inanç puanı arasında anlamlı farklılık bulunmuştur. Lisans ve üzeri mezun hemşirelerin, el hijyeni inancı ve uygulama puanı daha yüksek bulunmuştur. El hijyeni eğitimi alanların daha yüksek pozitif tutuma sahip oldukları belirlenmiştir (p=0,016). En düşük uygulama puanını invaziv işlem sonrası (4,64±0,69), izolasyon odasına girdikten sonra (4,64±0,75) ve hastanın vücut sıvıları ile temastan sonra (4,64±0,74) yapılan işlemler oluşturmuştur. Sonuç: Hemşirelerin genel olarak pozitif tutuma sahip oldukları, el hijyeni uygulamalarını yaptıkları belirlenmiştir. El hijyeni yapıldığı ifade edilse de bunun davranışa dönüştürülmesi önemlidir. El hijyeni gözlemleri ve eğitimleri sürekli yapılmalı, özellikle hastayla ve vücut sıvıları ile temas sonrası uyum daha da yükseltilmelidir. Kurumlar, el hijyeni uyumunu yükseltecek çok yönlü stratejiler geliştirmeli ve sürdürmelidir.
Anahtar Kelimeler: İnançlar; el hijyeni; yoğun bakım ünitesi; hemşire; uygulama
- She J, Jiang J, Ye L, Hu L, Bai C, Song Y. 2019 novel coronavirus of pneumonia in Wuhan, China: emerging attack and management strategies. Clin Transl Med. 2020;9(1):19. [Crossref] [PubMed] [PMC]
- World Health Organization [Internet]. Good hand hygiene by health workers protects patients from drug resistant infections. 2014. Available from: [Link]
- Tartari E, Fankhauser C, Masson-Roy S, Márquez-Villarreal H, Fernández Moreno I, Rodriguez Navas ML, et al. Train-the-Trainers in hand hygiene: a standardized approach to guide education in infection prevention and control. Antimicrob Resist Infect Control. 2019;8(1):206. [Crossref] [PubMed] [PMC]
- van Dijk MD, Mulder SA, Erasmus V, van Beeck AHE, Vermeeren JMJJ, Liu X, et al. A multimodal regional intervention strategy framed as friendly competition to improve hand hygiene compliance. Infect Control Hosp Epidemiol. 2019;40(2):187-93. [Crossref] [PubMed] [PMC]
- Macías AE, Ponce-de-León S. Infection control: Old problems and new challenges. Arch Med Res. 2005;36(6):637-45. [Crossref] [PubMed]
- Meng M, Sorber M, Herzog A, Igel C, Kugler C. Technological innovations in infection control: A rapid review of the acceptance of behavior monitoring systems and their contribution to the improvement of hand hygiene. Am J Infect Control. 2019;47(4):439-47. [Crossref] [PubMed]
- Hoffmann M, Sendlhofer G, Gombotz V, Pregartner G, Zierler R, Schwarz C, et al. Hand hygiene compliance in intensive care units: An observational study. Int J Nurs Pract. 2020;26(2):e12789. [Crossref] [PubMed]
- Cohen B, Saiman L, Cimiotti J, Larson E. Factors associated with hand hygiene practices in two neonatal intensive care units. Pediatr Infect Dis J. 2003;22(6):494-9. [Crossref] [PubMed] [PMC]
- Alsubaie S, Maither AB, Alalmaei W, Al-Shammari AD, Tashkandi M, Somily AM, et al. Determinants of hand hygiene noncompliance in intensive care units. Am J Infect Control. 2013;41(2):131-5. [Crossref] [PubMed]
- Karasu D, Yılmaz C, Durmuş G, Özer D, Çağlayan Ü, Karaduman İ, et al. Evaluation of healthcare-related infections in critically ill patients treated for a long time in the care unit. Klimik Journal. 2016;29(2):71-6. [Crossref]
- Artuvan Z, Çetin H. Yoğun bakımda, kliniklerde hastane enfeksiyonlarının önlenmesi ve el hijyeni [Prevention of hospital infections and hand hygiene in intensive care, clinics]. Journal of Intensive Care Nursing. 2019;23(3):180-4. [Link]
- Chakravarthy M, Myatra SN, Rosenthal VD, Udwadia FE, Gokul BN, Divatia JV, et al. The impact of the International Nosocomial Infection Control Consortium (INICC) multicenter, multidimensional hand hygiene approach in two cities of India. J Infect Public Health. 2015;8(2):177-86. [Crossref] [PubMed]
- Saharman YR, Aoulad Fares D, El-Atmani S, Sedono R, Aditianingsih D, Karuniawati A, et al. A multifaceted hand hygiene improvement program on the intensive care units of the National Referral Hospital of Indonesia in Jakarta. Antimicrob Resist Infect Control. 2019;8:93. [Crossref] [PubMed] [PMC]
- Sakihama T, Kayauchi N, Kamiya T, Saint S, Fowler KE, Ratz D, et al. Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals. Am J Infect Control. 2020;48(1):77-81. [Crossref] [PubMed]
- Watson JA. Role of a multimodal educational strategy on health care workers' handwashing. Am J Infect Control. 2016;44(4):400-4. [Crossref] [PubMed]
- Lim K, Kilpatrick C, Storr J, Seale H. Exploring the use of entertainment-education YouTube videos focused on infection prevention and control. Am J Infect Control. 2018;46(11):1218-23. [Crossref] [PubMed]
- Kaya Ş, Kaçmaz Z, Çetinkaya N, Kaya Ş, Temiz H, İnalcan M. Assesment of knowledge and behavior on hand hygıene in health care workers. Erciyes Med J. 2015;37(1):26-30. [Crossref]
- Paul ET, Kuszajewski M, Davenport A, Thompson JA, Morgan B. Sleep safe in clean hands: Improving hand hygiene compliance in the operating room through education and increased access to hand hygiene products. Am J Infect Control. 2019;47(5):504-8. [Crossref] [PubMed]
- Thi Anh Thu L, Thi Hong Thoa V, Thi Van Trang D, Phuc Tien N, Thuy Van D, Thi Kim Anh L, et al. Cost-effectiveness of a hand hygiene program on health care-associated infections in intensive care patients at a tertiary care hospital in Vietnam. Am J Infect Control. 2015;43(12):e93-9. [Crossref] [PubMed]
- Karadağ M, Yıldırım N, İşeri Ö. El Hijyeni İnanç Ölçeği ve El Hijyeni Uygulamaları Envanterinin geçerlilik ve güvenirliliğ [Validity and reliability of hand hygiene belief scale and hand hygiene practices inventory]. Cukurova Medical Journal. 2016;41(2):271-84. [Link]
- Hoffmann M, Sendlhofer G, Pregartner G, Gombotz V, Tax C, Zierler R, et al. Interventions to increase hand hygiene compliance in a tertiary university hospital over a period of 5 years: An iterative process of information, training and feedback. J Clin Nurs. 2019;28(5-6):912-9. [Crossref] [PubMed]
- Sadule-Rios N, Aguilera G. Nurses' perceptions of reasons for persistent low rates in hand hygiene compliance. Intensive Crit Care Nurs. 2017;42:17-21. [Crossref] [PubMed]
- Mahfouz AA, Al-Zaydani IA, Abdelaziz AO, El-Gamal MN, Assiri AM. Changes in hand hygiene compliance after a multimodal intervention among health-care workers from intensive care units in Southwestern Saudi Arabia. J Epidemiol Glob Health. 2014;4(4):315-21. [Crossref] [PubMed] [PMC]
- Belela-Anacleto ASC, Kusahara DM, Peterlini MAS, Pedreira MLG. Hand hygiene compliance and behavioural determinants in a paediatric intensive care unit: An observational study. Aust Crit Care. 2019;32(1):21-7. [Crossref] [PubMed]
- Karaoğlu M, Akın S. Hemşirelerin el yıkama alışkanlıklarına ilişkin görüşleri ve el hijyeni uyum oranlarının değerlendirilmesi [Evaluation of nurses' views about hand washing habits and hand hygiene compliance rates]. Journal of Education and Research in Nursing. 2019;16(1):33-40. [Link]
- Hillier MD. Using effective hand hygiene practice to prevent and control infection. Nurs Stand. 2020;35(5):45-50. [Crossref] [PubMed]
- Wetzker W, Bunte-Schönberger K, Walter J, Pilarski G, Gastmeier P, Reichardt CH. Compliance with hand hygiene: reference data from the national hand hygiene campaign in Germany. J Hosp Infect. 2016;92(4):328-31. [Crossref] [PubMed]
- Scheithauer S, Oude-Aost J, Heimann K, Haefner H, Schwanz T, Waitschies B, et al. Hand hygiene in pediatric and neonatal intensive care unit patients: daily opportunities and indication- and profession-specific analyses of compliance. Am J Infect Control. 2011;39(9):732-7. [Crossref] [PubMed]
- Sönmezer M, Gülhan B, Otuzoğlu M, Yakut H, Tezer H. Pediatri yoğun bakım ünitesindeki sağlık personelininin el hijyenine uyumunun değerlendirilmesi [Evaluation of hand hygiene compliance of health personnel in the pediatric intensive care unit]. Journal of Pediatrics Turkey. 2014;2:75-8. [Crossref]
- Artan Y, Sözeri İ, Akyol A. Yoğun bakımda çalışan yardımcı hizmet personelinin el hijyeni uyumunun değerlendirilmesi [Assessment of hand hygiene compliance of auxiliary service personnel working in intensive care unit]. Journal of Intensive Care Nursing. 2018;22(1):10-8. [Link]
- Geilleit R, Hen ZQ, Chong CY, Loh AP, Pang NL, Peterson GM, et al. Feasibility of a real-time hand hygiene notification machine learning system in outpatient clinics. J Hosp Infect. 2018;100(2):183-9. [Crossref] [PubMed]
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