title: Survey of attitudes and practices of Irish nursing students towards hand hygiene, including handrubbing with alcohol-based hand rub.
abstract: BACKGROUND
  Hand hygiene is widely recognised as the most important measure a healthcare worker can take in preventing the spread of healthcare associated infections. As a member of the healthcare team, nursing students have direct patient contact during clinical practice; hence, good hand hygiene practice among nursing students is essential. Low to moderate levels of hand hygiene knowledge and poor attitudes and practices are reported among nursing students. However, less is known about their attitudes and practices of handrubbing with ABHR, even though handrubbing is the recommended optimum practice in most situations.
  
  
  OBJECTIVE
  The aim of this study was to explore attitudes and practices of hand hygiene, in particular handrubbing with alcohol-based hand rub, among nursing students in Ireland.
  
  
  METHODS
  This survey employed a descriptive, self-report design using a questionnaire to gather data. It was administered electronically to all undergraduate nursing students (n=342) in the Department of Nursing and Midwifery at the University of Limerick, Ireland in March and April 2015.
  
  
  RESULTS
  Response rate was 66%. Attitudes towards hand hygiene were generally positive. Compliance with hand hygiene after contact with body fluid was high (99.5%) and before a clean or aseptic procedure (98.5%). However, suboptimal practices emerged, before touching a patient (85%), after touching a patient (87%) and after touching patients' surroundings (61%), with first year students more compliant than fourth year students. 16% of students were not aware of the clinical contraindications for using alcohol-based hand rub and 9% did not know when to use soap and water and when to use alcohol-based hand rub.
  
  
  CONCLUSIONS
  Educators and practitioners play an important role in ensuring that nursing students develop appropriate attitudes towards hand hygiene and engage in optimal handrubbing practices. Raising awareness among nursing students of their responsibility in preventing the occurrence and reducing the transmission of HCAI as an on-going endeavour is required, with the laudable aim of preventing complacency and ultimately improving patient outcomes.
authors.affiliation: Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland. Electronic address: liz.kingston@ul.ie.
authors.forename: Liz M
authors.initials: LM
authors.lastname: Kingston
authors.affiliation: Department of Clinical Microbiology, University Hospital Limerick, Limerick, Ireland; Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland.
authors.forename: Nuala H
authors.initials: NH
authors.lastname: O'Connell
authors.affiliation: Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland.
authors.forename: Colum P
authors.initials: CP
authors.lastname: Dunne
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000592:standards; D003428:Cross Infection / Q000517:prevention & control; D019983:Guideline Adherence / Q000592:standards; D063373:Hand Hygiene / Q000379:methods* / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007494:Ireland; D057566:Self Report; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D000891:Anti-Infective Agents, Local
keywords: Alcohol-based hand rub; Attitudes; Hand hygiene; Infection prevention and control; Ireland; Nursing students; Practice; Self-report