Evaluate the Knowledge and Practice of class four workers regarding Hand washing in selected Hospitals

 

Shivateerthayya Hiremath

Department of Medical-Surgical Nursing, Vijaysinh Mohite Patil College of Nursing and Medical Research Institute, Akluj, Aurangabad, Maharashtra - 413118, India.

*Corresponding Author E-mail: Shivateerth@gmail.com

 

ABSTRACT:

Background: A study to evaluate the knowledge and practice of class four workers regarding hand washing in selected hospital was conducted. Objectives: The objective of the study to identify level of the knowledge of class four workers regarding hand washing and to find the association of knowledge and practice of hand washes with selected demographic variables. Method: Research method adapted for the study was quantitative approach. The research design used was non experimental survey research design. The sample size of study was 100 class four workers in selected hospitals. The purposive sampling technique is used to select the sample. Questionnaire was used to find out the knowledge of class four workers. Results: In the present study 72% of the class four workers had good knowledge (score 14-20) and 28% of them had average knowledge (score 7-13) regarding hand washing. All of class four workers had good hand washing practices. In this study the 21% of highly satisfied class four workers with hand washing materials had average knowledge and 27% of them had good knowledge, and the satisfied class four workers had 21% had average knowledge and 45% of them had good knowledge regarding hand washing. Conclusion: Association of knowledge and practice of class four workers shows that all the p-values are large (greater than 0.05), none of the demographic variable was found 0 have significant association with the knowledge of the class four workers regarding hand washing. All of the class four workers were found to have good practices irrespective of their demography.

 

KEYWORDS: Knowledge, Practice, Hand washing, class four workers.

 

 


INTRODUCTION:

Nosocomial infections can be caused by bacteria, viruses, fungi, or parasites. These microorganisms may already be present in the patient's body or may come from the environment, contaminated hospital equipment, health care workers, or other patients. Depending on the causal agents involved, an infection may start in any part of the body. A localized infection is limited to a specific part of the body and has local symptoms. For example, if a surgical wound in the abdomen becomes infected, the area of the wound becomes red, hot, and painful. A generalized infection is one that enters the bloodstream

and causes general systemic symptoms such as fever, chills, low blood pressure, or mental confusion.1

 

Hand washing is a core element of patient safety for the prevention of health care associated infection and spread of anti microbial resistance. Its promotion represents a challenge that requires a multi model strategy. Hand washing prevents cross infection in hospitals, but class four worker’s adherence to hand washing guidelines is poor.2

 

Hand washing is the most simple, most effective measure for preventing hospital acquired infections. Despite advances in infection control and hospital epidemiological.2

 

Washing practice is unacceptably low. Average compliance with hand hygiene recommendation varies between hospital wards, according to working conditions. Compliance with hand washing recommendation is most important measure in preventing health care associated infections. Transmission of microorganisms from the hands of health care workers is the main source of cross-infection in hospitals and can be prevented by the hand washing.3

 

The hand washing practices of health care workers have long been the main vector for nosocomial infection in hospitals. So the study to examine influences on risk judgment from the individual differences in knowledge levels and health beliefs among class four workers is important.3

 

BACKGROUND OF THE STUDY:

Hand washing significance was first discovered by Holmes in 1843. Hand washing is the practice, which keeps the hands free from pathogens or decrease the amount prior to touching the patient. Hand washing prevents cross-infection in hospitals, but class four workers adherence to hand washing is poor.4

 

Infection due to hospital-acquired microbes is an evolving problem worldwide, and horizontal transmission of bacterial organism continues to cause a high nosocomial infection rate in health setting. Most Nasocomial infections are thought to be transmitted by the hands of class four workers.  The application of hand washing is effective in reducing infection rate.4

 

Hospital acquired infection posses a very real and serious threat to all who are admitted in hospitals. Pathogens are readily transmitted through the hands of class four workers, and hand washing substantially reduces the chance this transmission.5

 

Transmission of microorganisms from the hands of class four workers is the main source of cross infection in hospital and can be prevented by hand washing. Compliance with hand washing is moderate. Variation across hospital wards and types of class four workers suggests that targeted educational programme may be useful. The association between non –compliance and intensity of care suggest that under staffing may decrease the quality of patient care. Nosocomial infections are a leading complication in intensive care units. Although hand washing is the single most efficient preventive measure, compliance with action remains low. nosocomial infection can be transmitted from micro-organisms on the hands of class four workers to patients.5

 

Washing hand is has proven benefit in preventing transmission of infection, yet compliance with hand washing, especially in intensive care units is very important.

 

NEED OF THE STUDY:

Hospital acquired infections affects 1.4 million patients at any time worldwide, as estimated by the world health organization (who).in intensive care units, the burden of hospital acquired infections is greatly increased, causing additional morbidity and mortality. Multidrug-resistant pathogens are commonly involved in such infection and render effective treatment challenge. Proper hand washing is the single most important, simplest and least expensive means of preventing hospital acquired infections.6

 

Most of nosocomial infections are thought to be transmitted by the hands of class four workers. So evaluate the knowledge and practice of hand washing among class four workers (khaled etal 2011) hospital acquired infections poses a very real and serious threat to all who are admitted to hospital. Transmission of microorganism from the hands of class four workers is the main source of cross –infection in the hospitals and can be prevented by hand washing. So identifying predictors of non-compliance with hand washing during routine patient care is important.7

 

Health care associated infections persist as major problem in most intensive care units. Hand washing is the most simple and effective method for the prevention of these. so evaluate the reported hand washing practices and observing is very much important to find out gaps, plan remedial measure to reduce hospital acquired infections. From this point of view the researcher decide to evaluate the hand washing practices among class four workers.8

 

Hand hygiene is now regarded as one of the most important elements of infection control activities. In the wake of the growing burden of health care associated infections(HCAIs), the increasing severity of illness and complexity of treatment, superposed by multi-drug resistant(MDR) pathogenic infection health care practitioners (HCPs) are reserving back to basic of infection preventions by simple measures like hand hygiene. This is because enough scientific evidence supports the observation that if properly implemented, hand hygiene alone can significantly reduce the risk of cross-transmission of infection in healthcare facility (HCFs).9

 

A WHO patient safety 2009 initiative has been established to catalyse this progress. This is next phase of the First Challenge’s work on CCiSC. This initiative has, as of April 2009, seen a total of 3,863 health care facilities registering their commitment, effectively equating to a staff of over 3.6 million people, globally. on May 5, 2009, the WHO highlighted the importance of hand hygiene and launched guidelines and tools on hand hygiene, based on the next phase of patient safety work programme “SAVE LIVES: clean your hands “.(Indian j med res. 2011 Nov)10

 

The WHO has issued guidelines for procedural hand wash in order to reduce the prevalence of hospital associated infections but lack of knowledge amongst health care workers is associated with poor compliance. An alarming revelation was that compliance was found to be worst before high-risk procedures.10

 

Despite evidence and expert opinion that hand hygiene reduces transmission of potential pathogen or antimicrobial resistant organism sustained improvements in adherence to hand hygiene recommendation and proper hand washing technique among health care workers are uncommon, even after educational efforts. At the same time, some hospitals there is not even proper training of hand washing practices. This is shown by the lack of even basic awareness about hand washing guidelines among the hospital personnel. With this background, the present study was undertaken to evaluate the knowledge and practice of class four workers regarding hand washing in selected hospital.

 

PROBLEM STATEMENT:

“A study to evaluate the knowledge and practice of class four workers regarding hand washing in selected hospitals.”

 

OBJECTIVES OF THE STUDY:

1.     To identify level of the knowledge of class four workers regarding hand washing.

2.     To evaluate the practice of class four workers regarding hand washing.

3.     To find an association of knowledge and practice of hand washing with selected demographic variables.

 

OPERATIONAL DEFINATION:

Evaluate:

In this study evaluates means to evaluate hand hygiene knowledge and practice regarding hand hygiene of class four workers.

 

Knowledge:

In this study, knowledge means information and skill Acquired through experience about hand washing.

 

Practice:

In this study practice means it is act of hand washing practice into action.

 

Workers:

In this study, it means a person who does as a class four workers.

 

Hand Washing:

In this study it means it is the practice of keeping the hands free from pathogens by washing with soap and water or alcohol-based hand rubs whenever indicated.

 

Hospital:

In this study, it means same hospital is an institution providing medical and surgical treatment and nursing care for sick or injured people.

 

METHODOLOGY:

RESEARCH APPROACH:

The research method adopted for the study was quantitative approach.

 

RESEARCH DESIGN:

In the present study the investigator selected descriptive non experimental survey research design.

 

SETTING OF THE STUDY:

The study has conducted in MIT Hospital, Aurangabad

 

POPULATION:

The population of the present study was class four workers working in MIT hospital, Aurangabad

 

SAMPLE AND SAMPLING TECHNIQUE:

Non probability purposive sampling technique was uses participant who are easily accessible to the researcher and who meets the criteria of the study.

In the present study selected class four workers of MIT hospital, Aurangabad has been selected by purposive sampling by the investigator.

 

SAMPLE SIZE:

The sample consisted of 100 class four workers working MIT hospital, Aurangabad.

 

CRITERIA FOR SAMPLE COLLECTION:

INCLUSIVE CRITERIA:

·       Class four workers from different area of working in hospital.

·       Class four workers available at the time of data collection.

·       Class four workers willing to participate in practice.

·       Class four workers able read and write Marathi.

 

EXCLUSIVE CRITERIA:

Class four workers not willing to participate.

 

ASSUMPTION:

The study assume that a class four workers may have some knowledge about hand hygiene practices.

 

DATA COLLECTION TECHNIQUE AND INSTRUMENT:

The structured questionnaire on knowledge and practice of hand washing and observational checklist on practice of class four workers was used for data collection.

 

DEVELOPMENT OF TOOL:

The structured questionnaire was prepared for evaluating the knowledge and practice of hand washing and observational check list to evaluate the practice among class four workers.

 

DESCRIPTION OF THE TOOL:

STRUCTURED QUETIONAIRE:

The structured questionnaire include 2 part

Part-1: Items on demographic data.

Part-2: Items on knowledge about hand washing.

 

OBSERVATIONAL CHECKLIST:

The observational checklist includes 3 parts

Part-1: Items on preliminary evaluate

Part-2: Items on article used.

Part-3: items on procedure.

 

DATA COLLECTION OF THE STUDY:

Official permission was taken for data collection from hospital medical superintendent. The list of class four workers from different wards were taken and samples were selected by purposive sampling method. Date for data collection was decided and conveyed to matron and class four workers.

 

Class four workers were busy at the beginning and end of duty timing giving over hence data was collected when class four workers were free. The purpose of the study was explained to the class four workers participating in the study and confidentiality of their response was assured.         

 

ANALYSIS AND INTERPRETATION OF DATA:

The data in the study was arranged and analyzed under the following sections.

1.     The items in the demographic data variables will be computed in terms of frequency and percentages.

2.     Distribution of sample according to received training for hand washing.

3.     Distribution of sample according to use of alcohol based hand rub.

4.     Distribution of sample according to the satisfaction with hand hygiene practice in the unit.

5.     Distribution of sample according to the satisfaction with hand hygiene materials used in           the unit.

6.     Distribution of sample according to knowledge regarding hand washing.

7.     Distribution of samples according to observation of hand hygiene practices.

8.     Distribution of sample according to association between knowledge and practice of hand washing.

 

Section I:

Description of samples (class four workers) based on their personal characteristics:

70% of the class four workers had age 18-25 years and 30% of them had age 26-35 years. 35% of them were males and 65% of them were females. 35% of them were illiterate and 65% of them had primary education. All of them had 1-10 years of experience.

 

65% of them had joint family and 35% of them had nuclear family. 88% of them had income Rs. 5000-10000 and 12% of them had income Rs. 10001-15000. 92% of them received Training for hand washin 92% of them had routinely used alcohol-based hand rub.

 

All of them had hand washing protocol in their hospital.10% of them were working in ICU, 11% of them were working in general ward and 79% of them were working in operation theatre.79% of them were highly satisfied and 21% of them were satisfied with the hand washing practice.34% of them were highly satisfied and 66% of them were satisfied with the hand washing material.

 

Section II:

Analysis of data related to the knowledge of class four workers regarding hand washing:

72% of the class four workers had good knowledge (score 14-20) and 28% of them had average knowledge (score 7-13) regarding hand washing.

 

Section III:

Analysis of data related to the practice of class four workers regarding hand washing.

All of the class four workers had good hand washing practices.

 

Section IV:

Analysis of data related to association of class four workers knowledge and practice of hand washing with selected demographic variables.

Demographic variable

Knowledge

p-value

Average

Good

Age in years

18-25 years

18

52

0.472

26-35 years

10

20

Gender

Male

11

24

0.625

Female

17

48

Education

Illiterate

7

28

0.246

Primary

21

44

Type of family

Joint

17

48

0.643

Nuclear

11

24

Income in rupees

Rs. 5000-10000

22

66

0.090

Rs. 10001-15000

6

6

Received Training for hand washing

Yes

24

68

0.226

No

4

4

Routinely used alcohol-based hand rub

Yes

24

68

0.226

No

4

4

Area of working

Intensive care unit

1

9

0.441

General ward

4

7

Operation theatre

23

56

Rate of satisfaction with hand washing practice

Highly satisfied

23

56

0.787

Satisfied

5

16

Rate of satisfaction with hand washing material

Highly satisfied

7

27

0.347

Satisfied

21

45

 

The above table shows that, since all the p-values are large (greater than 0.05), none of the demographic variable was found zero having significant association with the knowledge of the class four workers regarding hand washing. All of the class four workers were found to have good practices irrespective of their demography.

 

SUMMARY:

This study was under taken to evaluate the knowledge and practice of class four workers regarding hand washing.

The specific objectives of the study were:

1.     To identify level of knowledge of class four workers regarding hand washing.

2.     To evaluate practice of class four workers regarding hand washing.

3.     To find an association of knowledge and practice of hand washing with selected demographic variables.

 

The questionnaire includes 20 questions based on various aspect of hand hygiene and an observation tool is also used to find out the hand hygiene practice. The pilot study was done before main study. The reported sample was 100. Tables and bar diagram are used to illustrate the findings of the study.

 

MAJORE FINDINGS OF THE STUDY:

We found that the bedside class four workers involve inpatient care maximum opportunities for hand hygiene. In the present study 70% of class four workers had age 18-25 years and 30% of them had age 26-35 years. 35% of them were males and 65% of them females. 35% of them were illiterate and 65% of them were had primary education. All of them had 1-10 years of experience. 65% of them had joint family and 35% of them nuclear family. 88% of them have had income Rs. 5000-10000 and 12% of them had income Rs. 10001-15000. 92% of them received training for hand washing. 92% of them had routine used alcohol-based hand rub. 10% of them were working in ICU, 11% of them were working in general ward and 79% of them were working in operation theatre. 79% of them were highly satisfied and 21% of them were satisfied with the hand washing practice. 34% of them were highly satisfied and 66% of them were satisfied with the hand washing materials. 72% of the class four workers had good knowledge (score 14-20) and 28% of them had average knowledge (score 7-13) regarding hand washing. All of class four workers had good hand washing practices.

 

In this study the age group of 18-25 years had 18% of average knowledge and 52% of them had good knowledge, and the age group of 26-35 years had 10% of average knowledge and 20% of them had good knowledge regarding hand washing. Males 11% had average knowledge and 24% of them had good knowledge, and the females 17% had average knowledge and 48% of them had good knowledge regarding hand washing. Illiterate class four workers had 7% average knowledge and 28% of them had good knowledge, and the primary educated class four workers had 21% of average knowledge and 44% of them had good knowledge regarding hand washing. 23% of highly satisfied class four workers with hand washing practices had average knowledge and 56% of them had good knowledge, and the satisfied class four workers had 5% of average knowledge and 16% of them had good knowledge regarding hand washing. 21% of highly satisfied class four workers with hand washing materials had average knowledge and 27% of them had good knowledge, and the satisfied class four workers had 21% had average knowledge and 45% of them had good knowledge regarding hand washing.

 

Analysis of data related to association of class four workers knowledge and practice of hand washing with selected demographic variables:

Since all the p-values are large (greater than 0.05), none of the demographic variable was found o have significant association with the knowledge of the class four workers regarding hand washing.

All of the class four workers were found to have good practices irrespective of their demography.

 

DISCUSSION:

In the present study the investigator evaluates the hand washing practices among class four workers. On analysis it was found that 8% of respondents use soap and water and 92% used alcohol-based hand rub for hand hygiene. Suchitra et al (2011) conducted a study to evaluate the hand hygiene compliance, in the study the researcher given 270 opportunities for hand washing. The categories of staff were doctors, nurses, ward aides. The total compliance was 63.3%. hand washing done by soap and water in 41 situation (71.9%). The remaining 16(28%) opportunities were by use of hand disinfectant agent. They reported the most reported reason for noncompliance was that they were too busy (64%). Patarakul et al (2005) conduced a cross sectional study to evaluate the attitude and hand hygiene compliance of class four workers, the results of the study was that the hand hygiene compliance was less than 50%, the questionnaire- based study, patient need perceived as priority (51.2) was the most common reason for noncompliance, followed by forgetfulness (35.7%), and skin irritation by hand washing agents (15.5%).

 

Though 79% respondents were highly satisfied/ 21% satisfied with the hand hygiene practices presently used in hospital and 66% were satisfied with the hand hygiene materials used in the hospital. 72% respondents have good knowledge of hand washing practices.

 

CONCLUSION:

The researcher concluded that there was good knowledge 72% and practice 102% of hand washing among class four workers.

 

RECOMMENDATION:

The study reveals only the hand washing compliance rate. There is an option for conduct further studies on hand washing to demonstrate reduction in hospital acquired infection, as well as reduction in mortality and morbidity in the hospital.      

 

ACKNOWLEDGMENT:

The authors would like to express their gratitude to the Hospital at Aurangabad  for their help in conducting this study.

 

CONFLICTS OF INTEREST:

None 

 

REFERENCES:

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3.      Potter and perry (2001) Fundamental of Nursing Mosby Publications Missouri 5th pg no 853-856, 1022.

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8.      Probe exploring ancient and modern medical learning January –march 2005 Vol XLIV pg no 1-28, 63-68. http://www.ncbi.nlm.nih.gov/pubmed/19708896

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Received on 02.05.2022         Modified on 17.05.2022

Accepted on 27.05.2022       ©A&V Publications All right reserved

Int.  J. of Advances in Nur. Management. 2022; 10(3):243-248.

DOI: 10.52711/2454-2652.2022.00056