Assessing the current hand hygiene knowledge and attitudes in Buffalo Public School teachers and the hand hygiene practices of teachers and students to guide future hand hygiene promotion programs
Bolas, Stefanie M.
MetadataShow full item record
Problem under investigation . Following the detection of methicillin-resistant Staphylococcus aureus infections among Buffalo school children, an elevated concern for infectious disease transmission in the schools led to the installation of 7,000 hand sanitizer dispensers in classrooms and common areas. The Buffalo Public Schools health services staff need help generating a hand hygiene program that will improve overall hand hygiene with specific emphasis on increasing the use of the hand sanitizers. Objectives . (1) To assess the association between teacher knowledge and attitudes, and observed student and teacher hand cleansing at critical times; (2) (a) To assess whether there is a correlation between teacher-reported hand sanitizer use and observed hand sanitizer use by teachers; (b) To assess whether there is a correlation between teacher-reported hand sanitizer use by students and observed hand sanitizer use by students; (3) To assess the correlation between observed teacher hand cleansing and observed student hand cleansing at critical times. Research Design/Material Methods . We performed a cross-sectional study of 10 Buffalo Public Schools including teachers and students in the grades kindergarten, third, and seventh. Structured observations were performed in order to collect information regarding hand hygiene behavior opportunities and practices in the classroom. The questionnaire assessed knowledge, attitudes, and practices of teachers regarding hand hygiene. Statistical Analysis . Descriptive statistics (frequencies and measures of central tendency) were examined for each variable. In order to assess the proportions of hand sanitizer use observed among classrooms following an exposure warranting use between different categories of each questionnaire variable, the Wilcoxon rank sums test was used. The Spearman's rank order correlation coefficient was used to assess the correlation between teacher-reported hand cleansing and observed hand cleansing (both for the teachers and the students) and to assess the correlation between observed teacher hand cleansing and observed student hand cleansing at critical times. Results . In total, 58 teachers completed the hand hygiene questionnaire and we conducted observations in 55 classrooms. There were significant differences in the mean appropriate sanitizer use in classrooms of teachers who reported reminding their students to cleanse hands most or all of the time before and after critical exposures compared to classrooms of teachers who sometimes or never reminded students to cleanse hands before or after critical exposures. There was no significant correlation between teacher-reported hand cleansing and observed hand sanitizer use by teachers, between teacher-reported student hand sanitizer use and observed classroom hand sanitizer use by students, or between appropriate hand cleansing by teachers and appropriate hand cleansing by students. Discussion . This study has shown that, as leaders of the classroom, teachers play an important role in influencing their student's knowledge and behavior. There were important differences between grade levels and by gender with respect to appropriate sanitizer use. The study findings will guide future development of a hand hygiene educational program in the Buffalo Public Schools.