Healthcare-associated infections (HAIs) are an important patient safety concern, and hand hygiene is one of the most effective measures for preventing their transmission. However, hand hygiene compliance among healthcare professionals, including nurses, remains suboptimal. Innovative educational approaches may support the development of hand hygiene knowledge, behaviour, and compliance. Virtual reality (VR) simulation provides an immersive and interactive learning environment that allows learners to practice clinical situations and reinforce knowledge and skills. In nursing education, VR simulation may facilitate the transfer of theoretical knowledge into practice and provide opportunities for repeated learning experiences. This randomized controlled study evaluated the effectiveness of a VR-based hand hygiene simulation for nurses. Participants in both the experimental and control groups received standard hand hygiene training, while participants in the experimental group additionally received VR-based hand hygiene simulation. The study evaluated the effects of the intervention on nurses' hand hygiene knowledge, handwashing behaviour, and hand hygiene compliance.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
76
Participants in the experimental group received standard hand hygiene training followed by a virtual reality (VR) hand hygiene simulation. The VR simulation provided an immersive and interactive learning environment in which nurses practiced hand hygiene in simulated clinical scenarios. The simulation was designed to reinforce hand hygiene knowledge and appropriate hand hygiene practices through an interactive learning experience.
Participants received standard hand hygiene training covering the principles and recommended practices of hand hygiene. This training represented the standard educational intervention and did not include the virtual reality (VR) hand hygiene simulation.
Aşkin Selvi
Istanbul, Avcılar, Turkey (Türkiye)
Primary Outcome Measure - Title: Hand Hygiene Knowledge
Hand hygiene knowledge was assessed using a 20-item Knowledge Test developed by the researchers based on the content of the hand hygiene training programme. The test was designed to assess nurses' level of knowledge regarding hand hygiene. Content validity was evaluated using the Lawshe technique based on the opinions of eight experts, and the content validity index was 0.99. Cronbach's alpha coefficient was 0.739 in the present study. Higher scores indicate a higher level of hand hygiene knowledge.
Time frame: Baseline, immediately after the intervention, and at 2-month follow-up
Handwashing Behaviour
Handwashing behaviour was assessed using the Scale for Assessment of Hand Washing Behaviour in the Frame of Theory of Planned Behaviour. The scale consists of 46 items across eight subscales and assesses healthcare professionals' knowledge, beliefs, and attitudes regarding handwashing. Higher scores indicate stronger and more positive motivation toward handwashing. Cronbach's alpha coefficient was 0.943 in this study.
Time frame: Baseline (pre-training), immediately after the intervention (post-training), and at 2-month follow-up
Hand Hygiene Compliance
Hand hygiene compliance was assessed by direct observation using the Hand Hygiene Observation Form based on the WHO Five Moments for Hand Hygiene: before touching a patient, after touching a patient, after body fluid exposure risk, before clean/aseptic procedures, and after touching patient surroundings. Trained independent observers conducted the assessments, and each nurse was observed for 25 hand hygiene indications.
Time frame: Baseline (pre-training), within approximately 3 days after the intervention, and at 2-month follow-up
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