Hand Hygiene Practices Among Nurses, Nursing Education, Simulation Training, Virtual Reality
Conditions
Keywords
hand hygiene, virtual reality, nursing education, simulation, Healthcare-associated infections
Brief summary
Healthcare-associated infections (HAIs) are an important patient safety concern, and hand hygiene is one of the most effective measures for preventing their transmission. However, hand hygiene compliance among healthcare professionals, including nurses, remains suboptimal. Innovative educational approaches may support the development of hand hygiene knowledge, behaviour, and compliance. Virtual reality (VR) simulation provides an immersive and interactive learning environment that allows learners to practice clinical situations and reinforce knowledge and skills. In nursing education, VR simulation may facilitate the transfer of theoretical knowledge into practice and provide opportunities for repeated learning experiences. This randomized controlled study evaluated the effectiveness of a VR-based hand hygiene simulation for nurses. Participants in both the experimental and control groups received standard hand hygiene training, while participants in the experimental group additionally received VR-based hand hygiene simulation. The study evaluated the effects of the intervention on nurses' hand hygiene knowledge, handwashing behaviour, and hand hygiene compliance.
Interventions
BEHAVIORALVirtual Reality Hand Hygiene Simulation
Participants in the experimental group received standard hand hygiene training followed by a virtual reality (VR) hand hygiene simulation. The VR simulation provided an immersive and interactive learning environment in which nurses practiced hand hygiene in simulated clinical scenarios. The simulation was designed to reinforce hand hygiene knowledge and appropriate hand hygiene practices through an interactive learning experience.
OTHERStandard Hand Hygiene Training
Participants received standard hand hygiene training covering the principles and recommended practices of hand hygiene. This training represented the standard educational intervention and did not include the virtual reality (VR) hand hygiene simulation.
Sponsors
Askin Selvi
The Scientific and Technological Research Council of Turkey
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
Nurses who volunteered to participate in the study. Nurses who were actively working in the specified patient care units.
Exclusion criteria
Nurses who had received any hand hygiene training other than general orientation within the previous year. Nurses with a history of epilepsy or seizures. Nurses with neurological or vision-related disorders that could interfere with the use of a VR headset. Nurses with motion sickness that could interfere with the use of a VR headset.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary Outcome Measure - Title: Hand Hygiene Knowledge | Baseline, immediately after the intervention, and at 2-month follow-up | Hand hygiene knowledge was assessed using a 20-item Knowledge Test developed by the researchers based on the content of the hand hygiene training programme. The test was designed to assess nurses' level of knowledge regarding hand hygiene. Content validity was evaluated using the Lawshe technique based on the opinions of eight experts, and the content validity index was 0.99. Cronbach's alpha coefficient was 0.739 in the present study. Higher scores indicate a higher level of hand hygiene knowledge. |
| Handwashing Behaviour | Baseline (pre-training), immediately after the intervention (post-training), and at 2-month follow-up | Handwashing behaviour was assessed using the Scale for Assessment of Hand Washing Behaviour in the Frame of Theory of Planned Behaviour. The scale consists of 46 items across eight subscales and assesses healthcare professionals' knowledge, beliefs, and attitudes regarding handwashing. Higher scores indicate stronger and more positive motivation toward handwashing. Cronbach's alpha coefficient was 0.943 in this study. |
| Hand Hygiene Compliance | Baseline (pre-training), within approximately 3 days after the intervention, and at 2-month follow-up | Hand hygiene compliance was assessed by direct observation using the Hand Hygiene Observation Form based on the WHO Five Moments for Hand Hygiene: before touching a patient, after touching a patient, after body fluid exposure risk, before clean/aseptic procedures, and after touching patient surroundings. Trained independent observers conducted the assessments, and each nurse was observed for 25 hand hygiene indications. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORAŞKIN SELVİ, Assistant Professor
İstanbul University-Cerrahpasa, Turkey
Outcome results
None listed