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Background:Healthcare-associated infections (HCAIs) have a large negative impact onmorbidity, mortality, and quality of life. Approximately 9% of all patients hospitalized inSweden suffer from HCAI. Hand hygiene plays a key role and is considered the single mostimportant measure to reduce HCAI. The hospital organization works actively to reduceHCAI. Implementing electronic systems to remind and/or notify healthcare workers raisesawareness of and adherence to hand hygiene. However, there is a paucity of studiesaddressing individuals’ perceptions of having such a system and how the organizationworks.

Aim:To investigate healthcare workers’ perceptions of infection prevention in thehealthcare organization and perceptions and acceptance of an electronic reminder systemthat encourages good hand hygiene.

Methods:Qualitative descriptive design with data collected in eight focus group inter-views including assistant nurses, nurses, and physicians (N¼38). Content analysis wasapplied and data were related to the Theory of Planned Behaviour.

Findings:Healthcare workers perceive lack of feedback from the hospital organizationand are positive towards an electronic reminder system to increase adherence to handhygiene. The electronic reminder system should not register data at an individual levelsince it could be used as an instrument for control by the management that could bestressful for staff.

Conclusion:In general, there is positive acceptance of the electronic reminder system,and the respondents perceived it as having the ability to change behaviour. However, theconcept has to be further developed to protect the individual’s integrity and needs to beused with feedback on a group level

Aim

To determine the level of knowledge and explore the difference of hand hygiene between nursing students and nurses.

Background

Annually, 3.8 million people in Europe acquire healthcare-associated infections, highlighting the importance of hand hygiene. Despite WHO's emphasis on the fact that greater hand hygiene knowledge correlates with improved hand hygiene compliance, several studies have shown knowledge gaps among nurses and nursing students regarding hand hygiene.

Design

Descriptive cross-sectional comparative survey.

Methods

A version of the WHO “Hand Hygiene Knowledge Questionnaire”, translated into Swedish, was used for data collection among nursing students in the first and last semester, and registered nurses from a university and associated hospital. Data were analyzed by descriptive statistics, and comparison between groups with Fisher's exact test, one-way ANOVA, and post-hoc tests (Pairwise Z-Tests, Tukey HSD).

Results

The survey, conducted between December 2020 and January 2021, received responses from 201 participants, including 71 first semester students, 46 last semester students and 84 registered nurses, showing moderate (55.7% [50–74% correct answers]) to good (43.8% [75–100% correct answers]) knowledge levels. First-semester students scored lower (17.0 ± 2.1) than last-semester students (18.8 ± 1.8) and registered nurses (18.3 ± 2.1) out of 25 questions.

Discussion

It is necessary for all groups to receive proper education on hand hygiene knowledge and to have an educational program that does not separate the groups but combines them with continuing education, since the students will someday be influencing future hand hygiene knowledge as a peer, together with the nurse.

AimTo describe and compare attitudes toward hand hygiene and the perceived effectiveness of prevention methods among nursing students and registered nurses at a university and its affiliated university hospital.DesignA descriptive cross-sectional comparative survey.MethodsA total of 201 first- and final-semester nursing students and registered nurses completed the World Health Organisation's 'Perceptions Survey for Health-Care Workers'. The survey examined perceptions on hand hygiene, patient safety and the usefulness of improvement measures. Responses were analysed using descriptive statistics.ResultsNursing students consistently rated the importance of hand hygiene and related interventions higher than registered nurses. Students particularly emphasised the availability of hand disinfectants, ongoing education and supportive leadership. Both groups acknowledged the role of management support, regular feedback and organisational policies in reinforcing optimal hand hygiene.ConclusionDifferences in attitudes between nursing students and registered nurses underscore the need for ongoing education, strong managerial involvement and supportive policies to sustain adherence. Strengthening these factors can help maintain positive perceptions formed during training and enhance patient safety in clinical practice.Implications for the Profession and/or Patient CareEducational curricula and workplace strategies that prioritise hand hygiene may help lower healthcare-associated infections. Management-led feedback, continuous training and accessible hand hygiene resources offer additional support for safe patient care.ImpactWhat problem did the study address? Low adherence to hand hygiene is a key driver of preventable infections. What were the main findings? Nursing students rated hand hygiene and improvement measures more highly than registered nurses, highlighting a need for strategies that sustain positive attitudes during the transition from education to clinical practice. Who will benefit? Nurse educators, clinical leaders and healthcare workers can use these findings to improve infection prevention across educational and practice settings.Reporting MethodWe adhered to STROBE guidelines for cross-sectional research.Patient or Public ContributionNo patients or members of the public were involved in designing or conducting this study, which focused on perceptions of nursing students and registered nurses.

Background: Hand hygiene is a cornerstone of infection prevention and control and plays a critical role in preventing healthcare-associated infections. During the COVID-19 pandemic, hand hygiene awareness and adherence increased across healthcare systems, but evidence on whether these improvements were sustained as pandemic pressures subsided remains limited. Nursing students and registered nurses are key groups for understanding long-term behavioural changes, as their knowledge, perceptions, and workplace experiences influence patient safety practices.

Objective: To compare nursing students' and registered nurses' knowledge and perceptions of hand hygiene at two time points: during the peak of the COVID-19 pandemic in 2020 and in the post-pandemic period in 2023.

Design: Comparative cross-sectional survey study conducted at two time points (2020 and 2023).

Setting: A Swedish university and its affiliated university hospital. Participants: A total of 376 individuals: first-semester nursing students, final-semester nursing students, and registered nurses surveyed in 2020 (n = 201) and 2023 (n = 175).

Methods: This study employed a two-time point, independent-sample design. Data were collected online using two validated World Health Organization instruments: the Hand Hygiene Knowledge Questionnaire for Health Care Workers and the Perception Survey for Health Care Workers. Descriptive statistics were computed for all variables. Comparisons between 2020 and 2023 were performed using the Mann-Whitney U test for ordinal variables and Fisher's exact test for categorical variables.

Results: Total knowledge scores did not differ significantly between time points. However, first-semester students had lower knowledge of transmission routes and preventive actions in 2023. Perceptions of hand hygiene differed between time points. The mean score for perceived importance of hand hygiene as a patient safety measure was significantly lower in 2023 than in 2020 for first-semester students (3.77 vs 3.30, p < 0.001), final-semester students (3.61 vs 2.89, p < 0.001), and registered nurses (3.39 vs 3.19, p = 0.041). Perceived patient expectations about hand hygiene were also lower among nursing students, and registered nurses rated perceived hand hygiene adherence among healthcare workers lower in 2023. By contrast, first-semester students reported higher ratings of educational support and tolerance of alcohol-based hand rubs in 2023.

Conclusions: The findings indicate group-level differences in hand hygiene perceptions between the pandemic-period and post-pandemic samples, while total knowledge scores did not differ significantly within any participant group. Given the independent-sample design, these findings should not be interpreted as individual-level changes over time. Lower perceived importance of hand hygiene suggests a need for continued educational reinforcement and organisational support to maintain hand hygiene practices.