title: A novel approach to improve hand hygiene compliance of student nurses.
abstract: BACKGROUND
  The National University Hospital, Singapore routinely undertakes standardized Hand Hygiene auditing with results produced by ward and by staff type. In 2010 concern was raised over consistently low compliance by nursing students averaging 45% (95% CI 42%-48%) prompting us to explore novel approaches to educating our next generation of nurses to improve their hand hygiene practice.We introduced an experiential learning assignment to final year student nurses on attachment to NUH inclusive of hand hygiene auditor training followed by a period of hand hygiene observation. The training was based on the World Health Organisation (WHO) "My 5 moments for hand hygiene" approach. Upon completion students completed an anonymous questionnaire to evaluate their learning experience.
  
  
  RESULTS
  By 2012, nursing students were 40% (RR: 1.4, 95% CI 1.3-1.5, p<0.001) more likely to comply with hand hygiene practices. 97.5% (359/368) of nursing students felt that the experience would enhance their own hand hygiene practice and would recommend participating in audits as a learning instrument.
  
  
  CONCLUSIONS
  With consideration of all stakeholders a sustainable, flexible, programme was implemented. Experiential learning of hand hygiene was a highly valued educational tool and in our project was directly associated with improved hand hygiene compliance. Feedback demonstrated popularity amongst participants and success in achieving its program objectives. While this does not guarantee long term behavioural change it is intuitive that instilling good habits and messages at the early stages of a career will potentially have significant long-term impact.
authors.affiliation: Infection Control Team, National University Health System, 1E Kent Ridge Rd, Singapore 119228, Singapore. dale_andrew_fisher@nuhs.edu.sg.
authors.forename: Sharon
authors.initials: S
authors.lastname: Salmon
authors.forename: Xiao Bei
authors.initials: XB
authors.lastname: Wang
authors.forename: Theresa
authors.initials: T
authors.lastname: Seetoh
authors.forename: Siu Yin
authors.initials: SY
authors.lastname: Lee
authors.forename: Dale A
authors.initials: DA
authors.lastname: Fisher