This approach is endorsed by the Centers for Disease Control and prevention (CDC) as a best-practice training for hand hygiene that results in immediate improvements in compliance ( Moghnieh et al., 2017). This was accomplished by using the World Health Organization (WHO) “My Five Moments for Hand Hygiene” approach as an intervention. This research project was an attempt to improve hand hygiene practice and compliance among Certified Nursing Assistants (CNA) in a health care facility to introduce a hand hygiene intervention and expand on previous studies, as a way to reduce infection rate. According to NHHV (2018), the Department of Community Health, in the South Atlantic United States, that oversees nursing homes in the state reported that federal inspection records showed that over 40% of its nursing homes had been cited for infection-related issues. However, after the use of photocatalytic coating intervention, the infection rate decreased by 30% (55.5, p = 0.02). A study by Pulliam (2015) revealed that a facility in the South Atlantic United States reported 185 cases of HAIs over a 12-month period. These infections are a major cause of hospitalizations and death about 380,000 health care facilities residents die from infections each year. The CDC’s data are limited but estimates in the medical literature indicate that one to three million life-threatening infections occur in health care facilities every year. The CDCP (2016) estimated that four million Americans reside in health care facilities. After the intervention training, the intervention floors had significantly more hand sanitizer use than the control floors ( p = 0.033). For the hand sanitizer measurement, there was no significant difference in hand sanitizer use between control and intervention floors at baseline ( p = 0.175). The analysis for Attitude indicated a significant main effect ( F 1, 43) = 29.37, p<0.001, pη 2 = 0.42). The results of the 2 by 2 factorial ANOVA conducted to determine Belief and Attitude indicated a significant main effect ( F 1, 43) = 30.55, p<0.001, pη 2 = 0.42). The results indicated that the mean difference 0.14, 95% CI [0.05-0.23) in Knowledge between the treatment and control groups was significant ( p = 0.004). The participants included 30 CNAs selected as the intervention group and 15 CNAs as the control group. The intervention administered was the WHO's "My Five Moments for Hand Hygiene" approach to improve hand hygiene practice and compliance. The World Health Organization Hand Hygiene Knowledge Questionnaire for Health Care Workers, the Hand Washing Self-Assessment Inventory Scale Questionnaire for belief and attitude and a wall hand sanitizer as a proxy to measure hand compliance were the instruments. Pre-test and posttest assessments were in addition to an intervention approach administered after the pretest and before the posttest. The purpose of this research project was to provide a nonrandomized pretest/posttest on knowledge, belief, attitudes and compliance to all 45 CNAs selected for this study to improve current hand hygiene practices of certified nursing assistants employed by a health care facility. These infections at long-term care facilities are a major cause of hospitalizations and death. According to the CDC, an estimated four million Americans reside in long-term care facilities in the United States, among which one to three million life-threatening infections occur every year.
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