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CAREERS STUDENT LIFE
Nailing hand hygiene Nursing students frequently witness poor clinical hygiene, but are reluctant to report it. Dinah Gould examines why A recent study indicates that qualified nurses and doctors often set a poor example for nursing students in terms of infection prevention and control. All 488 nursing students who completed an anonymous online survey (see resources) reported witnessing lapses in infection control practice at some time during their clinical placements. Most were related to hand hygiene. More than 75 per cent of the respondents witnessed qualified staff failing to wash hands between patients, and 60 per cent had noticed nurses wearing nail polish or nail extensions. Other departures from good practice included failure to comply with isolation precautions, inadequate cleaning of the patient environment, not changing personal protective clothing between patients and unsafe handling of sharps. Incidents were reported from all clinical areas, but most often from community settings and long-stay facilities for older people.
The impetus for the study came from the researcher teaching experience, where concerns about hygiene standards are frequently expressed in the classroom. Student understanding of infection prevention is good and they are keenly aware that their observations on placement did not reflect what they had been taught.
Exposure
Deciding what to do about poor standards of infection control is much more difficult. Students face being perceived as unpopular and risk an unfavourable placement report if they expose poor care standards. A few who had gone down this route felt they had been punished and ostracised for the rest of the placement, and given an inferior final testimonial. Then there is the question of who the whistleblower should tell. Few students feel confident enough to approach senior nurse managers and they
66 january 29 :: vol 28 no 22 :: 2014
quickly discover the pressures of modern health care: when staff shortages prevail, any clean hands, even poorly washed ones, are better than none. All placement areas are subject to periodic audit to ensure their suitability as a learning environment. But this research suggests poor infection control practice is endemic. If lapses occur everywhere, then where can students learn to provide the correct standards of care? Are the audits conducted by university staff insufficiently rigorous, or do teaching staff know that if the auditing process is too zealous, there will be a shortfall in clinical placements? It is certainly a challenge to ensure 100 per cent adherence to infection control precautions. Much has been done to correct these situations by providing healthcare staff with resources such as alcohol cleaners, which are less damaging to the skin than soap. Major campaigns have increased awareness of hand hygiene and many barriers to compliance have been removed. But perhaps the most worrying finding from this research is the premeditated poor compliance indicated by wearing nail enhancements and jewellery during patient care, despite their effect on the wearer’s ability to wash their hands effectively NS Dinah Gould is professor of nursing, School of Health Care Sciences, Cardiff University
RESOURCES Student nurses’ experiences of infection prevention and control during clinical placements tinyurl.com/GouldDreyAJIC Infection Prevention Society www.ips.uk.net Student Life on the internet www.nursing-standard.co.uk/students
NURSING STANDARD
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CAREERS STUDENT LIFE
Nailing hand hygiene Nursing students frequently witness poor clinical hygiene, but are reluctant to report it. Dinah Gould examines why A recent study indicates that qualified nurses and doctors often set a poor example for nursing students in terms of infection prevention and control. All 488 nursing students who completed an anonymous online survey (see resources) reported witnessing lapses in infection control practice at some time during their clinical placements. Most were related to hand hygiene. More than 75 per cent of the respondents witnessed qualified staff failing to wash hands between patients, and 60 per cent had noticed nurses wearing nail polish or nail extensions. Other departures from good practice included failure to comply with isolation precautions, inadequate cleaning of the patient environment, not changing personal protective clothing between patients and unsafe handling of sharps. Incidents were reported from all clinical areas, but most often from community settings and long-stay facilities for older people.
The impetus for the study came from the researcher teaching experience, where concerns about hygiene standards are frequently expressed in the classroom. Student understanding of infection prevention is good and they are keenly aware that their observations on placement did not reflect what they had been taught.
Exposure
Deciding what to do about poor standards of infection control is much more difficult. Students face being perceived as unpopular and risk an unfavourable placement report if they expose poor care standards. A few who had gone down this route felt they had been punished and ostracised for the rest of the placement, and given an inferior final testimonial. Then there is the question of who the whistleblower should tell. Few students feel confident enough to approach senior nurse managers and they
66 january 29 :: vol 28 no 22 :: 2014
quickly discover the pressures of modern health care: when staff shortages prevail, any clean hands, even poorly washed ones, are better than none. All placement areas are subject to periodic audit to ensure their suitability as a learning environment. But this research suggests poor infection control practice is endemic. If lapses occur everywhere, then where can students learn to provide the correct standards of care? Are the audits conducted by university staff insufficiently rigorous, or do teaching staff know that if the auditing process is too zealous, there will be a shortfall in clinical placements? It is certainly a challenge to ensure 100 per cent adherence to infection control precautions. Much has been done to correct these situations by providing healthcare staff with resources such as alcohol cleaners, which are less damaging to the skin than soap. Major campaigns have increased awareness of hand hygiene and many barriers to compliance have been removed. But perhaps the most worrying finding from this research is the premeditated poor compliance indicated by wearing nail enhancements and jewellery during patient care, despite their effect on the wearer’s ability to wash their hands effectively NS Dinah Gould is professor of nursing, School of Health Care Sciences, Cardiff University
RESOURCES Student nurses’ experiences of infection prevention and control during clinical placements tinyurl.com/GouldDreyAJIC Infection Prevention Society www.ips.uk.net Student Life on the internet www.nursing-standard.co.uk/students
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 18, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
