Investigation of fluorescent concretisation intervention on intensive care nurses' hand hygiene training according to the kirkpatrick model: A cluster randomised controlled study

Abstract

Background The predominant fomite responsible for the transmission of healthcare-associated infections via the hands of healthcare professionals is ineffective handwashing within critical care. Aim The fundamental aim was to evaluate the impact of fluorescent concretisation intervention on handwashing efficiency, skill performance, duration scores and educational programmes on hand hygiene (HH). A secondary aim was to determine the level of HH knowledge in intensive care nurses. Study Design A cluster-randomised controlled pre-test-post-test and follow-up research design. This study was conducted with 76 nurses in Turkey. The participants in the intervention group (n = 39) had their hand washing efficiency evaluated using ultraviolet A light. The dirty spots were shown to the participants, and the reasons were discussed. The participants in the control group (n = 37) received handwashing training without fluorescent concretisation and ultraviolet light intervention. The evaluation followed Kirkpatrick's four levels: reaction, learning, behaviour and results. Results From the first follow-up to the last follow-up, the highest increase in handwashing coverage was observed between the fingers, as determined by fluorescent assessment: from 15.4% to 82.1% for the right hand and from 20.5% to 76.9% for the left hand. When compared with the second and third follow-ups, the handwashing skill checklist total score percentage changes in the intervention group increased from 11 to 17, while the increase was from 5 to 9 in the control group. Conclusions A training programme can be effective in improving HH compliance among ICU nurses, although further studies are needed to determine the added value of specific reinforcement strategies. Relevance to Clinical Practice Findings from this study provide evidence that a structured training programme based on Kirkpatrick's learning model can significantly improve hand hygiene compliance among ICU nurses. Utilising technology tools that offer visual feedback in the structured hand hygiene training programmes may reduce healthcare-acquired/associated infections.Trial Registration Trial methods were retrospectively registered on the ClinicalTrials.gov Protocol Registration and Results System (PRS) (ClinicalTrials.gov ID: NCT06572176). https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000EUO9&selectaction=Edit&uid=U0006UI0&ts=2&cx=3ldzyg