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Member Research & Reports

Member Research & Reports

Columbia: More Infection Prevention Education Wanted by Student Nurses

A national survey led by professor of epidemiology Dr. Elaine Larson, at Columbia University Mailman School of Public Health and the School of Nursing found that almost 40 percent of nursing students say they feel they need more instruction on preventing and controlling infection, especially in busy healthcare environments. More than half of respondents also reported observing breaches in prevention practices during clinical placements, yet have trouble addressing them because they feel unqualified or fear retaliation from others. The findings are published in Nurse Education Today. 

[Photo: Dr. Elaine Larson]

The survey results are particularly important, given the critical role that nurses play in preventing nosocomial infections, which contribute substantially to patient morbidity and mortality, as well as healthcare costs.

Student nurses overwhelmingly reported that they knew when and how to use various infection prevention precautions, but acknowledged that it was often difficult to perform these practices when busy, which speaks to the complexity of the healthcare environment, according to Dr. Larson, senior author, who is also associate dean of research at the Nursing School. “Education is important but education alone is not sufficient.”

The research team interviewed student nurses about their programs’ overall approach to infection prevention and control. Students assessed the amount of time devoted to infection prevention, the quality of instruction, and the settings (lecture, simulation lab, clinical rotations) where they received instruction. They rated the difficulty of adhering to infection-prevention practices when they were busy. They also described the difficulty they often felt addressing breaches in prevention protocol that they observed during clinical rotations.

Despite students’ believing that their program emphasizes infection prevention, nearly 40 percent said additional education was needed. The survey found a significant association between the self-reported amount of instruction students received in handwashing, wearing personal protective equipment such as gowns and gloves, following isolation precautions, and hygienically inserting and maintaining catheters and other invasive devices, and their ability to follow these procedures when they were busy. Those who received less than an hour of instruction––compared with those who received more––were significantly more likely to have trouble following prevention protocol when they were pressed for time.

The survey also found that 51 percent of respondents witnessed poor infection prevention and control practices during clinical rotations but often had difficulty addressing them. There is a need to empower nurses to speak up in order to improve patient care, and that empowerment should start early in training, before nurses get their RN degree, noted the authors.