Effectiveness of hand-washing teaching programs for families of children in paediatric intensive care units

Abstract

Aims: The authors developed a video-centred teaching program based on social learning principles to demonstrate hand-washing technique. A comparison was made between families who viewed the video and families who were taught the same techniques with the aid of an illustrated poster in terms of compliance and improvement in hand-washing skills.

Background: Nosocomial infections are a significant cause of morbidity and mortality in paediatric intensive care unit patients. Hand hygiene is considered the most important preventive action against hospital-acquired infections. A number of studies have shown that increased compliance with hand-washing guidelines for health-care workers leads to decreases in nosocomial infection rates. Furthermore, recommendations have been made to ensure that parents who visit their children in intensive care units wash their hands first.

Study design: Quasi-experimental time series. Compliance and accuracy measurements were collected during one to five visits following the initial teaching intervention.

Methods: A total of 123 families, who visited paediatric intensive care units, were recruited and assigned to two groups - one experimental (61 families) and the other a comparison group (62). Participants in the comparison group were taught hand-washing skills using simple illustrations. A 20-item hand-washing checklist was used to examine hand-washing compliance and accuracy.

Results: No significant differences were noted in terms of demographics between the two groups. Results from a general estimated equation analysis showed that families in the experimental group had higher compliance and accuracy scores at statistically significant levels.

Conclusion: The video-based teaching program was effective in increasing compliance and accuracy with a hand-washing policy among families with children in intensive care units.

Relevance to clinical practice: The education program is a simple, low-cost, low technology intervention for substantially reducing the incidence of nosocomial infection.