Development of virtual reality simulation for hand hygiene education and evaluation of its effectiveness: An example of in-service training in nursing

Introduction: Hand hygiene is considered an important measure in preventing healthcare-associated infections that pose problems in terms of the quality of healthcare services and patient safety. Well-structured training programs are needed to maintain and increase nurses' hand hygiene compliance rates. Purpose: The research was conducted to develop and implement hand hygiene virtual reality simulation training for nurses to acquire hand hygiene behaviors and to evaluate its effect on hand hygiene compliance. Method: The research is a randomized controlled experimental study. The research was conducted with nurses from an university hospital. The sample of the study was determined as a total of 66 people with the power to represent the universe within a 95% confidence interval determined by taking the effect size as 0.05 and the error level as 5% through the sample calculation with the known universe size. Considering the possibility of data loss, planning was made with 76 nurses, and the study was carried out with 67 nurses, including those who dropped out. The training program titled "Hand Hygiene in the Prevention of Healthcare-Associated Infections" was applied to the nurses in the experimental and control groups. The nurses in the experimental group were also given hand hygiene VR simulation training. Data were collected with the Introductory Form, Knowledge Test, Hand Washing Behavior Assessment Scale in Terms of Planned Behavior Model, Hand Hygiene Observation Form before, after and 2 months after the training. In order to evaluate the training program, the Training Evaluation Form was used for all nurses, and the Simulation Design Scale, Student Satisfaction in Learning and Self-Confidence Scale was used for nurses who only received virtual reality simulation training. The obtained data were evaluated using percentage, mean, standard deviation, minimum and maximum, Chi-Square analysis for categorical variables, t-test for dependent and independent groups, and Mixed Design Anova. The significance level of the study was taken as p<0.05. Results: It was found that the hand hygiene knowledge level score, hand washing behavior score and hand hygiene compliance rate of the nurses who received hand hygiene VR simulation training were significantly higher than the nurses in the control group. Conclusion: It was determined that the developed hand hygiene VR simulation training was effective in increasing nurses' knowledge level regarding hand hygiene, hand washing behavior and hand hygiene compliance rates Keywords: Hand hygiene training, Virtual reality, Simulation, Nurse