| Summary: | 碩士 === 國立臺北護理健康大學 === 長期照護研究所 === 104 === Hand hygiene is the most effective measure for preventing health care-associated infection in long-term care facilities. In long-term care facilities, nurses frequently provide nursing services to residents so their hands become a medium for transmission of microbes easily. Thus, recognizing the importance of hand hygiene and ensuring effectiveness of hand hygiene behavior are basic tasks and responsibilities of every nursing staff in long-term care facilities.
The purpose of this study was to investigate hand hygiene knowledge, attitude, and behavior of nursing staff in nursing homes. A cross-section research design was adopted. Data were collected face-to-face from 99 nurses in 22 nursing homes in Tainan City. The research instruments included a questionnaire on demography of nurses and environmental characteristics of their workplace, hand hygiene knowledge scale, hand hygiene attitude scale, and hand hygiene behavior scale.
The results were as follows: (1) The nursing staff in nursing homes scored above the intermediate level on hand hygiene knowledge, hand hygiene attitude, and hand hygiene behavior (Mean=15.88, SD=1.39; Mean=42.45; SD=4.59; Mean=
129.48,SD=16.53), and among the five moments for hand hygiene, their hand hygiene behavior was lowest in the third moment “After body fluid exposure risk” (Mean=23.07, SD=3.89); (2) Hand hygiene behavior was positively related to hand hygiene attitude (r=0.33, p<0.05); (3) In the hand hygiene behavior prediction model, “availability of sanitary paper in the facility” and “hand hygiene knowledge (moments)” and “hand hygiene attitude” were important predictors, explaining a total of 17.4% variances, with “hand hygiene attitude” having the highest prediction power. Further analysis of the prediction model in the five moments for hand hygiene showed that the model had the highest explanatory power in the third moment “After body fluid exposure risk”, reaching 25%. “Hand hygiene attitude” was a significant predictor in the model of hand hygiene behavior and across the five moments for hand hygiene, suggesting that the hand hygiene attitude of nursing staff is a key to control of hand hygiene in long-term care facilities.
Based on the results, this study suggested that hand hygiene concepts and attitudes be more heavily stressed in future long-term care education. In addition to cultivating a better hand hygiene attitude through fundamental education, it is necessary to constantly remind nurses of the correct concepts and methods of hand hygiene through on-job training. Regular evaluation of hand hygiene behavior and proper rewards for compliance are also helpful for hand hygiene attitude. On the other hand, long-term care facilities should provide handwash materials and facilities, such handrubs containing glycerol or protective agents, to minimize barriers to nursing staff’s hand hygiene behavior. Future researchers can probe into use of different handwash agents among nursing staff in long-term care facilities to gain an insight into their hand hygiene behavior and improve the service quality of long-term care facilities.
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