ABSTRACT

The purpose of the thesis was to study the knowledge and practice of hand washing as a measure of disease control among students in Afe Babalola University. The goal was to know how well the knowledge of hand hygiene is known to the students and their attitudes towards maintaining good hand hygiene and to find possible ways for better adherence. The quantitative research method was used. Questionnaire was divided in 4 sections and distributed to students who were used for the study as respondents. Results from the findings indicated that majority of the students maintained good hygiene prior and after eating. The students also maintain good hand hygiene after using the restroom.

The results revealed that although majority of the students wash hands during these cases most of them do not fully know or understand the right procedures and techniques of proper and effective hand hygiene and the right use of alcohol hand rub in the prevention of illness. In the conclusion it came to attention that there is the need for further education for the students on the various procedures of proper hand and personal hygiene to effectively prevent the spread of infection and diseases. It was recommended to hold hand hygiene educational events interesting enough to attract students from all the various fields of study to participate.

 

 

 

CHAPTER ONE

INTRODUCTION

1.1       BACKGROUND OF STUDY

Health associated infections are the most common adverse event in health care resulting in a significant burden on patients, their families, and health care systems (WHO, 2012). In addition, every time a patient is treated for a health care-associated infection, the opportunity for microorganisms to develop resistance to antimicrobial drugs increases. The increasing incidence of multi-drug resistant organisms and emerging infections such as Ebola virus disease continue to heighten the need for taking every possible measure to control the spread of infectious diseases. Hand hygiene is the leading measure for preventing the spread of pathogens and reducing health care-associated infections, but health care providers’ adherence to recommended practices remains suboptimal in most settings, and improvement is difficult to sustain (WHO, 2012). The hand hygiene practices of health care providers, the reasons for suboptimal practice, and the intractable nature of changing practice have been extensively researched; based on this research, an increasing number of health care agencies are implementing programs aimed at addressing the barriers to hand hygiene. Barriers to hand hygiene are highly complex and multifactorial, influenced by elements at both the organizational and individual levels (WHO, 2012). Common barriers at the organizational level include inadequate hand hygiene facilities and workplace climates that do not value or emphasize the importance of hand hygiene. At the individual level, habits developed early in life and a lack of knowledge combined with misconceptions about hand hygiene during the delivery of care produce barriers to appropriate practice. While single one-time interventions that do not address the multiple barriers have been unsuccessful in sustained improvements in hand hygiene practices, on-going multimodal programs have been more effective (WHO, 2013). Key elements of successful programs include system change within the organization, combined with on-going education, and assessment and performance feedback to health care providers. University students represent the future workforce and must be prepared to demonstrate professional accountability and safe practice (Alberta, 2013). Hand hygiene is a basic skill and key component of safety, and affects the morbidity and mortality of students in all health care settings (PHAC, 2012). The hand hygiene habits students develop in the course of their daily activities will affect their future health stability (Kelcíkova, Skodova, & Straka, 2012; Nicol, Watkins, Donovan, Wynaden, & Cadwallader, 2015). In addition, students are actively engaged in direct communication with one another while in their daily rotations and, consequently, have an important role in infection control during their education. Ensuring that students recognize the importance of hand hygiene in the prevention of health associated infections, know when and how hand washing and hygiene should be performed, and follow recommended practice is of utmost importance.

 

1.2       STATEMENT OF THE PROBLEM

Hand Washing is a milestone of infectious disease control, and promotion of improved hand hygiene has been recognized as an important public health measure. It has long been recognized to be a convenient, effective, and also cost-effective means of preventing communicable diseases. According to the definition of World Health Organization, hand hygiene is a general term referring to any action of hand cleansing, i.e., it is the act of cleaning one’s hands with or without the use of water or another liquid, or with the use of soap, for the purpose of removing soil, dirt, and/or microorganisms. A causal link between hand hygiene and rates of infectious disease illness has also been established earlier. Globally, .3.5 million children younger than 5 years, mainly concentrated in developing countries including Nigeria, die from diarrhoea and acute lower respiratory tract infections. The transmission of communicable diseases is responsible for .164 million lost school days per school year among students up to twelfth grade worldwide. Approximately 2.4 million deaths can be prevented annually by good hygiene practice, reliable sanitation, and drinking water. A meta-analysis on 30 hand hygiene studies found that improvements in hand washing reduced the incidence of upper respiratory tract infections by 21% and gastrointestinal illnesses by 31%. Evidence showed that hand washing with soap could reduce the risk of diarrheal diseases by 42%–47%, and hand washing promotion could save millions of lives. Despite the proven importance and benefits of washing hand, proper hand washing is not as pervasive as desired to prevent infections until now, especially in the developing countries that bear the greatest burden of infectious diseases. A survey undertaken in Ghana indicated that hand washing practice with soap before eating was much lower than after defecation, and a gap persists between perception and practice of proper hand washing practices with soap. Another observational study in rural Ghana showed that 14% of all persons washed both hands with soap after defecation, while, 1% used soap and water for washing hand before eating. Several studies addressed hand hygiene among different population in Nigeria; however, hand hygiene studies among college or university students are very limited. Although the morbidity and mortality associated with respiratory and gastrointestinal illnesses among university students are relatively low, these infections may contribute to absenteeism along with sickness “presenteeism”, which can ultimately affect academic performance and efficiency and can also be associated with outbreaks of viral gastroenteritis, upper respiratory tract infections, and group B streptococcal colonization in this setting, which ultimately affect potential human resource development. With the limited research about hand washing knowledge and practice among university students, this study seeks to evaluate hand washing knowledge, attitude and practice as a measure of disease control among students of Afe Babalola University, Ekiti State.

 

1.3       RESEARCH OBJECTIVES

The purpose of this research was to investigate hand washing knowledge, attitude and practice as a measure of disease control among students of Afe Babalola University. The following specific research objectives were formulated for this research work:

1. To determine the level of knowledge about hand washing and hygiene that students have
2. To determine the extent to which students have positive beliefs about hand washing as a means of infection and disease prevention
3. To investigate the self-reported hand washing and hygiene practices of students

 

1.4       RESEARCH QUESTIONS

The following research questions guided the study based on the research objectives;

1. What level of knowledge about hand washing and hygiene do students have?
2. Under what circumstances students in Afe Babalola University maintain their hand hygiene?
3. What are the self-reported hand washing and hygiene practices of students?
4. Under what circumstances do the students need to maintain their hand hygiene?

 

 

1.5       SIGNIFICANCE OF STUDY

The overall aim of the research is to collect and interpret data on the knowledge and practice of hand washing as a measure of disease control among students in Afe Babalola University, the frequency that hand washing and safe health practice awareness is taught and assessed during undergraduate education, with the goal of providing information useful for undergraduate students curriculum development in the area of hand hygiene and safe health practices. Results of the study will be provided to the programs involved in the study and to participants upon request. The results will also be submitted for presentation at conferences and publication in peer reviewed journals on university education and infection control.

Also, this work would add to the existing body of literature on hand washing and safe health practices among university students, and serve as a reference point to other researchers who would consider this subject matter in future.

 

1.6       SCOPE OF STUDY

This study focuses on the knowledge and practice of hand washing as a measure of disease control among students in Afe Babalola University, Ekiti State. It covers areas such as theoretical framework on hand hygiene and washing practices, knowledge and practice evaluation of the hand washing as means of preventing and controlling disease spread, challenges to safe health practices among undergraduate students, etc. The study is limited to Afe Babalola University, Ekiti State.

 

 

1.7       LIMITATIONS TO STUDY

The study faced some challenges, however, the major constraints of the study include:

• Time: The researcher did not have enough time to carry out this study coupled with other academic activities. There was constraint of time in going to places where data and information relevant to the study could be obtained.
• Finance: A lot of money is required in data collection, analysis and interpretation. The researcher is constrained financially. Owing to this constraint, the researcher had to select Afe Babalola University, Ekiti State.
• Attitude of Respondents: Some of the respondents showed lukewarm attitude towards the study. This is because there was no financial benefit attached to it. A few others withheld certain information due to confidentiality.

 

1.8       OPERATIONAL DEFINITION OF TERMS

• Beliefs: Belief has been defined as; Mental reliance on or acceptance of a particular concept, arrived at by weighing external evidence, facts, and personal observation and experience. Belief is essentially a subjective feeling about the validity of an idea or set of facts. It is more than a mere suspicion and less than concrete knowledge. Unlike suspicion, which is based primarily on inner personal conviction, belief is founded upon assurance gained by empirical evidence and from other people. (“Belief,” 2008, para. 1)

 

• Hand Hygiene: PHAC (2012, p. 5) has defined HH as: Encompasses hand washing, hand antisepsis and actions taken to maintain healthy hands and fingernails. Hand washing is the process of using soap and water to remove soil and transient microorganisms from the hands. Hand antisepsis includes either rubbing the hands with alcohol-based hand rub or hand washing with antiseptic soap, to destroy resident and transient microorganisms on the hands.

 

• Health Infections: The can be defined as; an infection occurring in anyone during the process of exposure to germs, virus or other communicable diseases carriers, which affects the wellbeing of a person as well as hinder participation in productive activities.