Hand hygiene practices in the operating theatre : nurses' knowledge, attitudes and reported behaviours

Abstract

This study explored the knowledge, attitudes and reported practices of operating theatre nurses in relation to hand hygiene. The study aimed to identify whether these nurses' hand hygiene behaviours are based on recommended policies and practices and to identify the factors which act as barriers to compliance with the recommended hand hygiene practices. Quantitative data were collected using the survey approach from a random sample of 25 scrub and 25 anaesthetic nurses working in the operating theatre of the local general state hospital. The data collection instrument consisted of a self-administered questionnaire assessing knowledge, attitudes and self-reported behaviours. The questionnaire was constructed by the researcher on the basis of evidence based literature. A 90% response rate (n = 45) was obtained. Data were analysed quantitatively by means of frequencies, cross-tabulation and descriptive statistics. Tables and figures were then used to illustrate these findings. Participation was on a voluntary basis and any participant was free to withdraw from the study at any time. Confidentiality and anonymity was adhered to at all times. Results showed a fairly good knowledge of basic hand hygiene, although this wasn't consistently reflected in the healthcare workers' reported practices. This was mainly due to hand hygiene barriers, including understaffing, irritation and dryness caused by hand washing agents, excess workload, inappropriate use of gloves and forgetfulness. Furthermore, results showed poor knowledge regarding the effectiveness of alcohol-based hand rubs. The results had several implications and a number of recommendations for research, practice and education were identified. It was concluded that a theory-practice gap exists in operating theatre nurses. This shows the need for further educational programmes to educate and promote hand hygiene among healthcare workers. Recurring educational campaigns would be expected to improve hand hygiene behaviours. Furthermore, continuous monitoring and observation is needed to promote behavioural change which will lead to increased hand hygiene compliance. Further research on larger samples of nurses working in different sectors would ensure a better statistical power and representativeness. Moreover, the use of unstructured interviews would allow a deeper exploration of issues which emerged from this study.