C(H)ATS: Creating Hand Hygiene Awareness Through Simulation

Introduction:

Hand hygiene is a cornerstone in preventing healthcare-associated infections (HAIs). Compliance amongst nurses remain inconsistent due to workload, awareness and limited reinforcement. Traditional teaching methods may not capture the understanding of complexities in actual clinical environment, hence result in challenges to instil behavioural change among nurses. Simulation-based education aims to integrate and standardize hand hygiene practices. This initiative targets to enhance hand hygiene adherence in a realistic, risk-free clinical environment. Through immersing realistic clinical scenarios, nurses are able to identify lapses, receive immediate feedback, evoke critical thinking and engage in discussions which deepen their understanding on importance of hand hygiene. 

Description:

Simulation set-up comprises of a hospital ward mock-up which establish an environment conducive and safe for learners. A pre-simulation survey was conducted with focus on professional attitudes, healthcare beliefs, knowledge and awareness, hand hygiene compliance, self-evaluation and challenges. Roles within the simulation are: 2 patients, 2 nurses, 1 distractor and observers. Case scenarios were curated to reflect real-life encounters in clinical areas, ensuring relevance in the learning experience. The presence of distractor adds a subtle disruption in the role play, adding elements of realism, thus creating an immersive depth of simulated experience. Instructions were given to participants before commencement of the role-play. This includes an emphasis towards ensuring safety within the role play. Verbal consent was obtained from participants for video recording, which is used for debrief and educational purposes. Observers documented their observations on a structured activity sheet, which is utilized to guide the debrief sessions along with video recording. Nurses were given an opportunity to visualise the application of glow-gel, as an educational tool to emphasize on effective hand hygiene practices. 

Discussion:

136 nurses responded to the post simulation survey with results depicting a positive experience. 92.65% of nurses reported that hand hygiene is an important part of patient safety. 94.86% reported that they are confident in performing proper hand hygiene in patient care. 96.32% feels that workplace culture strongly influence adherence to hand hygiene practices. 97.8% believes that simulation-based role play should be continued for future staff. Simulation-based education has emerged as an innovative educational tool and approach to strengthen infection prevention measures. It also underscores the value of simulation in promoting culture of patient safety. Preliminary outcome of the above initiative shows that simulation not only reinforces theoretical knowledge but also improves confidence level and adherence to hand hygiene protocol amongst nurses.

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