Hand hygiene compliance among paediatric nurses in Ebonyi, Nigeria: a mixed methods study

Paediatric patients are more vulnerable to Hospital-Acquired Infections (HAIs). Hand Hygiene Compliance (HHC) is considered a cost-effective way of preventing HAIs. Compliance with this practice is not often assessed in Nigeria and thus poses a significance risk to the quality of care and patient...

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Main Author:	Chioma, Oko Constance
Format:	Thesis
Language:	English
Published:	2022
Subjects:	RA Public aspects of medicine
Online Access:	http://eprints.usm.my/57705/1/OKO%20CONSTANCE%20CHIOMA-FINAL%20THESIS%20P-SKD001219-CR-24%20pages.pdf
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id	my-usm-ep.57705
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spelling	my-usm-ep.577052023-08-14T07:52:25Z Hand hygiene compliance among paediatric nurses in Ebonyi, Nigeria: a mixed methods study 2022-11 Chioma, Oko Constance RA Public aspects of medicine Paediatric patients are more vulnerable to Hospital-Acquired Infections (HAIs). Hand Hygiene Compliance (HHC) is considered a cost-effective way of preventing HAIs. Compliance with this practice is not often assessed in Nigeria and thus poses a significance risk to the quality of care and patient safety, especially during COVID-19. The purpose of this study was to determine the level of HHC and explore factors that influence compliance among paediatric in paediatric care setting in Ebonyi State, Nigeria. A mixed-method research design was conducted in two phases: phase 1a and 1b comprises data collection using the WHO hand hygiene (HH) observational tool on the nurse’s perceived HHC and direct observation of their HHC practice. Phase 2 involved an in-depth interview exploring factors influencing compliance using a semistructured interview guide. The Statistical Package for Social Sciences (v26) was used to analyze the quantitative data while the qualitative data were analyzed thematically. Data collection commenced from the 26th of October 2020 to the 5th of March 2021. In phase 1a, 96 participants were involved in the survey, and all duty nurses on duty on the observation days were observed for HHC giving a total of 1417 HH opportunities in phase 1b. Phase 2 involved 17 staff nurses and five ward managers. Chi-square analysis showed that perceived compliance was significantly associated with HH education and last HH education (p<0.001). Chi-square tests revealed that the observed HH compliance varied significantly with the units, type of shift, and the five moments of HH (FMHH) (p<0.005). The perceived HHC rate was high compared to the observed compliance rate. The analysis of qualitative data was to identify organizational and contextual barriers and facilitators to HHC. Four key themes emerged from organizational factors: leadership, administrative responsibility, prompt, and HH monitoring. Three themes emerged from the contextual factor: experience, workload, and perception. This study showed that observed HHC among nurses in paediatric settings was poor. These challenges in this setup contributed to the poor compliance seen in this study. In designing HH intervention programs, a moment-by-moment approach should be employed to increase recall across all the moments. The findings of this study revealed the need for specific strategies such as training and retraining of nurses, improvement in HH facilities, and continuous HH monitoring with feedback on performance, especially during the COVID-19 pandemic. These measures will prevent HAIs among this vulnerable population as well as improve patient safety and quality of care. 2022-11 Thesis http://eprints.usm.my/57705/ http://eprints.usm.my/57705/1/OKO%20CONSTANCE%20CHIOMA-FINAL%20THESIS%20P-SKD001219-CR-24%20pages.pdf application/pdf en public phd doctoral Universiti Sains Malaysia Pusat Pengajian Sains Kesihatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RA Public aspects of medicine
spellingShingle	RA Public aspects of medicine Chioma, Oko Constance Hand hygiene compliance among paediatric nurses in Ebonyi, Nigeria: a mixed methods study
description	Paediatric patients are more vulnerable to Hospital-Acquired Infections (HAIs). Hand Hygiene Compliance (HHC) is considered a cost-effective way of preventing HAIs. Compliance with this practice is not often assessed in Nigeria and thus poses a significance risk to the quality of care and patient safety, especially during COVID-19. The purpose of this study was to determine the level of HHC and explore factors that influence compliance among paediatric in paediatric care setting in Ebonyi State, Nigeria. A mixed-method research design was conducted in two phases: phase 1a and 1b comprises data collection using the WHO hand hygiene (HH) observational tool on the nurse’s perceived HHC and direct observation of their HHC practice. Phase 2 involved an in-depth interview exploring factors influencing compliance using a semistructured interview guide. The Statistical Package for Social Sciences (v26) was used to analyze the quantitative data while the qualitative data were analyzed thematically. Data collection commenced from the 26th of October 2020 to the 5th of March 2021. In phase 1a, 96 participants were involved in the survey, and all duty nurses on duty on the observation days were observed for HHC giving a total of 1417 HH opportunities in phase 1b. Phase 2 involved 17 staff nurses and five ward managers. Chi-square analysis showed that perceived compliance was significantly associated with HH education and last HH education (p<0.001). Chi-square tests revealed that the observed HH compliance varied significantly with the units, type of shift, and the five moments of HH (FMHH) (p<0.005). The perceived HHC rate was high compared to the observed compliance rate. The analysis of qualitative data was to identify organizational and contextual barriers and facilitators to HHC. Four key themes emerged from organizational factors: leadership, administrative responsibility, prompt, and HH monitoring. Three themes emerged from the contextual factor: experience, workload, and perception. This study showed that observed HHC among nurses in paediatric settings was poor. These challenges in this setup contributed to the poor compliance seen in this study. In designing HH intervention programs, a moment-by-moment approach should be employed to increase recall across all the moments. The findings of this study revealed the need for specific strategies such as training and retraining of nurses, improvement in HH facilities, and continuous HH monitoring with feedback on performance, especially during the COVID-19 pandemic. These measures will prevent HAIs among this vulnerable population as well as improve patient safety and quality of care.
format	Thesis
qualification_name	Doctor of Philosophy (PhD.)
qualification_level	Doctorate
author	Chioma, Oko Constance
author_facet	Chioma, Oko Constance
author_sort	Chioma, Oko Constance
title	Hand hygiene compliance among paediatric nurses in Ebonyi, Nigeria: a mixed methods study
title_short	Hand hygiene compliance among paediatric nurses in Ebonyi, Nigeria: a mixed methods study
title_full	Hand hygiene compliance among paediatric nurses in Ebonyi, Nigeria: a mixed methods study
title_fullStr	Hand hygiene compliance among paediatric nurses in Ebonyi, Nigeria: a mixed methods study
title_full_unstemmed	Hand hygiene compliance among paediatric nurses in Ebonyi, Nigeria: a mixed methods study
title_sort	hand hygiene compliance among paediatric nurses in ebonyi, nigeria: a mixed methods study
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Kesihatan
publishDate	2022
url	http://eprints.usm.my/57705/1/OKO%20CONSTANCE%20CHIOMA-FINAL%20THESIS%20P-SKD001219-CR-24%20pages.pdf
_version_	1776101207675240448

Hand hygiene compliance among paediatric nurses in Ebonyi, Nigeria: a mixed methods study

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