| Hospital infection seriously threat to patients and medical staff personnel health and life security. Preventing and controlling hospital infection are the hot spots of public health field research. Standard precautions represents the single most effective way to prevent hospital infection, arouses widespread attention. The Center for Disease Control and Prevention of the United States of America (CDC) integrated many of the characteristics of universal precautions and body substance isolation to standard precautions. Standard precautions are now considered successful, effective and economical main strategy for hospital infection control during the severe acute respiratory syndrome (SARS) outbreak. Because of work environment and serve are specificity.If nurses do not take standard precautions,will seriously affect the safety of patients and themselves health or even seriously harm.Infection occurs or transmitted diseases with a greater danger when nursing students at work. Because nursing students lack of the knowledge and skills. Standard precautions have been given a positive attention at home and abroad.Most studies on knowledge and behavior investigation of standards prevention of medical staff. A small amount of studies on clinical nurse influence factors on compliance with standards prevention. At present, the nursing students as research subjects, the use of the questionnaire a comprehensive and systematic investigation and assessment for standards prevention knowledge, attitude, behavior compliance and its influencing factors system and no large scale research reported. Nursing students is the successor of nursing career. More research in the standards prevention of nursing students should be done, in order to protect the health of students and cause the rapid development of nursing and ensure protect health and safety of nursing students in the course of clinical work.ObjectiveThe objective of this study was to determine the level of knowledge, attitude, and practice and analyze influence factors in regard to standard precautions among nursing students. Reasonable suggestions will be presented and reference for relevant education and training will be provided to improve their level of knowledge and improve their attitude and effectively improve its behavior compliance.MethodsWe have adopted a self-designed questionnaire based on pre-survey and expert consultation and clinical observations and interviews with nursing students.The questionnaire have part 4, that is including the respondents in general, standard precautions knowledge questionnaire, standard precautions attitude questionnaire, compliance with standard precautions questionnaire.(A)General state of nursing students consist of the sociological characteristics of respondents, such as age, gender, education, teaching hospital level,sources of standard precautions knowledge,the degree of standard precautions knowledge required, needle stick-injuries during clinical practice, the situation of hepatitis B antibody and so on. (B)Standard precautions knowledge questionnaire include 42 main questions, that is including standard precautions definition, be suitable for objects, protect objects, hand hygiene, indications for wearing gloves, indications for wearing masks, sharp handling, and standard precautions in line with other isolation measures. Responses to items for knowledge were "yes","no", or "don't know"Choose right answers 1 point, choose wrong answersO point, out of 42 points. The higher the score the better illustrate of their knowledge.(C)Standard precautions attitude questionnaire have 5 latitude,34 items such as risk perception, efficacy of standard precautions, barriers to standard precautions, favorable conditions for action, assessment of self-efficacy. The questions used to assess attitude were in the format of the Likert scale with responses that included positive points from strongly disagree (1 point) to strongly agree (5 points), reverse scored from strongly disagree (5 points) to strongly agree (1 point). The higher the score the better description of their attitude.(D)Compliance with standard precautions questionnaire include 6 dimensions, composed of 48 items.such as hand-washing or hand disinfection, properly use of gloves, masks, sharps protection, medical waste disposal, and other protective measures. Each entry use 1 to 4 score, the total score 48 to 192 points, and never (1 point), sometimes (2 points), often (3 points), always (4 points). The higher the score, the better the compliance behavior.A cross-sectional survey was conducted in four universities and the two secondary institutions in Guangdong province from May to June,2010. We used stratified random sampling method. According to different degree, schools are divided into undergraduate, junior college, secondary.50%members were randomly selected from one school in accordance with the same level of education end of the internship back to school. The answers were recorded and processed using the Statistic Package for SPSS 13.0.Cronbach'sa were employed Content validity statistical analyses of the questionnaire.Descriptive analysis, correlation analysis, ANOVA, Two-sample t test and multiple linear stepwise regressions were performed using SPSS version 13.0.Results1. The reliability and validity tests showed that standard precautions knowledge questionnaire's Cronbach'a coefficient is 0.94, test-retest is 0.94, content validity is 0.92. Standard precautions attitude questionnaire's Cronbach'a coefficient is 0.87, test-retest is 0.88, content validity is0.89. Compliance with standard precautions questionnaire's Cronbach'a coefficient is 0.94, test-retest is 0.92, content validity is 0.91. It suggests the measurements instruments had adequate construct validity and reliability.2. Of the 950 questionnaires distributed,920 (97.0%) were returned completed. Education:undergraduate students 292(31.7%), college students318 (34.6%), secondary students 310 (33.7%). Age include 18-26 (21.36±1.92). Gender:male 33 (3.6%), female 887 (96.4%). Teaching hospital level:level II hospitals,429 (46.6%), level III hospital 491 (53.4%).Accepted standard precautions knowledge:received 67.3%, did not receive 32.7%.Sources of standard precautions knowledge:school education, hospital education, clinical teachers, professional journals, academic seminars and other means. Needle stick injuries:no needle stick injuries48.0%,1 or 2 times 32.4%,3 to 4 timesl2.2% and 5 times 7.4%.NeedIe stick injuries occur while working state:45.2%during very busy work,42.7%during rescue patients, 7.9%during normal working state,4.2%during relatively free of work.Needlestick injury treatment:75.5% extrusion small amount of blood, clean the wound,7.7% do the relevant checks to determine whether infection,41.6% bandaging after disinfection using alcohol or disinfectant,14.2% the wound without making any treatment. Report back to superiors:Only 5.2% reported every time,7.1% reported in most,14.6% reported as the case sometimes and 73% never reported. Not reporting reasons:Do not know need to report, do not know to whom report, there is no need to report,there are other reasons not to report. Most nursing students will view medical records to see whether the patient is suffering from syphilis, hepatitis B, AIDS and other blood-borne diseases, only 1.5% of people never view medical records. Cases of hepatitis B antibody:Positive 417 (45.3%), Negative311 (33.8%), not been detected 192 (20.9%).3. Standard precautions knowledge:The extent of knowledge demand:much needed567 (61.6%), generally require321 (34.9%), not need19 (2.1%), do not care13 (1.4%).The median scores for standard precautions knowledge for all nursing students was 26.05±9.53, score ratio 62%, ranged from 6 to 41. Univariate analysis showed that with the difference among the nursing students of different age, education, teaching hospital level, education means,the extent of knowledge demand, needle stick injuries was significant (P<0.05). Multiple linear regression analysis indicated that the main effects were means of education, educational level, number of needle stick injuries, teaching hospital level.4. Standard precautions attitude:The average score of standard precaution attitude of nursing students was 112.09±19.03, score ratio was 66%, Among them, score of risk perception were the highest(3.52±0.83), secondly,score of efficacy of standard precautions and assessment of self-efficacy (3.34±0.78),(3.32±0.83). And the score of barriers to standard precautions and favorable conditions for action were the lowest (3.19±0.78),(3.20±0.75). Univariate analysis showed that with the difference among the nursing students of different age, education, teaching hospital level, education means,the extent of knowledge demand, needle stick injuries was significant (P<0.05). Multiple linear regression-analysis indicated that the main effects were standard precautions knowledge, means of education, educational level.5. Compliance with standard precautions:the average score of compliance with standard precautions of nursing students was 114.05±21.92, score ratio was59.4%, Among them, score of hand-washing or hand disinfection was(2.38±0.46), score of properly use of gloves was(2.31±0.52), score of properly use of masks was(2.81±0.63),score of sharps protection was(2.64±0.55), score of medical waste disposal was(2.90±0.78), score of other protective measures was(1.10±0.24).Among 6 latitudes two-sample t test showed statistically significant (P<0.001). Disposal of medical waste was significantly higher than scores of other aspects, other protective measures scored significantly lower than other latitudes. Other protective measures include gowns, masks, respirators, and eyewear used to create barriers that prevent blood, body fluids, secretions or excretions splashing operation from infectious agents. Univariate analysis showed that with the difference among the nursing students of different age, education, teaching hospital level, education means,the extent of knowledge demand, needle stick injuries was significant (P<0.05). Multiple linear regression analysis indicated that the main effects were perceived barrier about standard precaution, the way of education, knowledge, needle stick injuries, perceived favorable action, the educational background, the grade of practicing hospital, Self-efficacy assessment.Conclusion1. Lack of knowledge of standard precautions, education and training system should be increased. There are many factors. The main effects were the educational background, teaching hospital level, the way of education.2. The attitudes of standard precautions among practical nurses were poor. Of the five dimensions, the practical nurse, had the highest scores on risk perception, the standard preventive efficacy, self-efficacy assessment, and behavior favorable conditions for the cognitive being the next, and the worst scores on barriers perception. The main effects were standard precautions knowledge, the educational background, the way of education. 3. The compliance with standard precaution among practical nurses was poor. Hand washing or hand disinfection compliance low. Correctly use gloves behavior should be enhanced. Medical waste disposal and mask correctly use more ideal. Sharp operations lack of standardization. The application of other protective measures are concerned.There are many factors. The main positive effects were perceived barrier about standard precaution, the way of education, knowledge, perceived favorable action, the educational background, the grade of practicing hospital, Self-efficacy assessment, as these variables value increased, behavior compliance is better. Needle stick injuries are negative effects, along with the increase of variable values and behavior compliance also is poorer.4.Nursing students are clinical nursing reserves and are the mainstay of the future nursing career.How to increase nursing students' standard prevention knowledge, improve attitude, improve the standard prevention compliance,that should be solved by the school education and hospital infection management.According to the study, we hope to arouse the attention and concern from medical colleges and hospitals. Promoting education of standard precaution, strengthening clinical practice base construction, strengthening pre-job training and specification with education, meanwhile during clinical practice using various forms, multi-channel education from hospital, learning through multi-channel,multi-mode, enhance the awareness of occupational protection and improve compliance behavior. |
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