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The present study aims to investigate the effect of face-to-face and distance educations of hand hygiene on knowledge and attitude of patient care assistants of Namazi hospitals of Shiraz in 2016. This is a cross sectional-interventional study. 68 patient care assistants who are working in Namazi hospital of Shiraz have been studied. Demographic specifications, knowledge and attitude of patient care assistants were collected by WHO questionnaire which validity and reliability were confirmed. SPSS 19, Mann-Whitney, Wilcoxon and Spearman correlation tests have been used for data analysis. Among 68 participants, 39 persons were female (57.3%). Mean age of patient care assistants was 29.7 years old, work experience of participants was 4.4 years and 67.6% of them had diploma. There was a significant relationship between knowledge amount of patient care assistants before and after face-to-face and distance educations but there was no significant relationship between attitudes of patient care assistants before and after face-to-face and distance educations. There was a direct and significant relationship between age and attitude in face-to-face education (r= 0.46, p= 0.009).
Continuous educational program for hand hygiene is necessary for those who are working in healthcare system especially patient care assistants. The knowledge of patient care assistants is not enough for good performance rather their attitudes have to be changed and their beliefs should be planned deeply and scientifically. One of the main measures is to create a sense of vulnerability to infections for all treatment team especially patient care assistants and nurses.
hand hygiene, knowledge, patient care assistant, attitude
According to definitions of WHO in 2006, hand hygiene is referred to hand cleaning, washing and rubbing (Maher, Eslami, & Ali-Mohammadzadeh, 2016). Nowadays, hand hygiene has been recognized as one of the most effective interventions for reduction of infection transmission in hospitals (Kapil, Bhavsar, & Madan, 2015). Hand hygiene is one of the most cost effective methods in reduction of microbial transfer and it has been introduced as one of the most important ways for prevention from hospital infections (Rodriguez et al., 2015). Among different preventive ways from hospital infections, correct hand hygiene is considered as a key approach (Sakihama et al., 2016).
Based on WHO facts, 80% of hospital infections are transmitted by infectious hands (Mosadegh M, 2013). In Europe, 4544100 infectious cases have been estimated per year and 37000 people will die directly (Kingston, O’Connell, & Dunne, 2016) and such infections will cause 16 million days of extra hospitalization in hospital (Zingg et al., 2015). In the USA, annual cost of hospital infection treatments has been estimated between 28.4 and 33.8 billion dollars (Sakihama et al., 2016). Hospital infections in Iran have been reported between 1.9 and 25%(Abdollahi AA, 2003).
Results from patient care aides in Namazi Hospital of Shiraz indicated that the correlation between age and knowledge and also between knowledge and attitude is not significant in face-to-face education but there is a direct and significant relationship between age and attitude (r= 0.46, p= 0.009). The study conducted by (Abdollahi AA, 2003) showed that there was no significant relationship between knowledge and attitude and between knowledge and performance. This result is consistent with current results. The knowledge cannot lead merely to increasing attitude and performance because facilities and environmental condition are effective on performance. Results of the research conducted by (Linden, 1990) showed that nurses had good knowledge on infection control but there was no significant relationship between their knowledge and performance. (GH., 2000) wrote: knowledge merely cannot lead to good performance rather attitudes should be changed and the structure of beliefs should be planned deeply and scientifically in order that proper performance is created. To create a positive attitude and to reinforce healthy beliefs, one of the main measures is to create a sense of vulnerability to such infections in all treatment personnel especially patient care assistants and nurses in nursing team because they do not believe in risk of infections due to their job, dealing with affected patients and risky behaviors (Dubik-Unruh, 1999).
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