Effectiveness of hand hygiene education in a basic nursing school curricula.

OBJECTIVES: Although hand hygiene (HH) is the cheapest and simplest tool for the prevention of hospital-acquired infections, poor HH compliance has been reported among health care professionals. A variety of factors influence the compliance with HH guidelines, the most important being the quality of the basic nursing education. The aims of this study were to analyze the effectiveness of the basic nursing education in relation to HH, and to explore the skills and attitudes toward HH among nursing students in praxis. DESIGN AND SAMPLE: A mixed-method approach using a cross-sectional survey combined with observation and curricular analysis was used. A total of 188 nursing students participated in the study. RESULTS: Content analysis revealed significant deficits in the quality of HH-related information in basic nursing educational programs. Our results correlate directly with the reported insufficient levels of HH knowledge and the associated poor HH compliance by students during their training in clinical settings; as shown in observation and questionnaire-based surveys. CONCLUSIONS: The lack of compliance with HH standards among students lead to poor compliance among health care professionals in praxis. Consequently, the role of educational institutions in the prevention of hospital-acquired infections is significant, if the effectiveness of HH education is to be improved.

Increasing trends of tobacco use in medical students in Slovakia--a reason for concern?

OBJECTIVE: The article analyses changes in tobacco use in medical students in Slovakia in 1995, 1999 and 2004. METHODS: Questionnaire survey in 448 students of the Jessenius Faculty of Medicine, Comenius University in Martin, Slovakia, was carried out in October and November 2004. Data were compared with similar surveys carried out in 1995 and 1999. RESULTS: Prevalence of daily smoking in men increased from 11.1 in 1995 to 21.8% in 2004. In women, within 1995-2004, daily smoking increased from 5.2% to 12.3%, occasional smoking from 11.6% to 19.8%. Also proportion of women initiating smoking during their university study increased. In both genders the proportion of never smokers dramatically dropped between 1995 and 1999 (in men from 43.2% to 23.2%; in women from 61.9 to 18.2). CONCLUSION: Upward trend in tobacco use, particularly in women, is a reason for concern. In medical faculties, principles of prevention should be more emphasized and the students motivated for healthy life-style and to fulfill their future role in public health. The situation noted among medical students indicates that a community in Slovakia is still not satisfactory inclined towards non-smoking and a dramatic decrease of tobacco use can hardly be expected either in the near future.

Economic rewarding of smoking cessation-facilitating drugs--a comparison of over-the-counter and prescribed nicotine replacement therapy.

Smoking cessation represents a very difficult task for the smoker, often requiring medical assistance. The introduction of smoking cessation drugs has been crucial to this process. Currently, there are two standardly used treatments: nicotine replacement therapy (NRT) and the antidepressant bupropion. Soon after their introduction, NRTs were sold over-the-counter (OTC), as oppose to on prescription, although in most countries, bupropion remains available only on prescription. Both prescribed and OTC NRTs have similar efficacy (i.e., their use approximately doubles the cessation rate among users and their use has shown a high level of economic rewarding). The most important advantage of OTC NRT is availability, as some patients may not be comfortable with the use of prescribed drugs. The introduction of OTC NRT has led to a substantial rise in their use, increasing the proportion of ex-smokers in the population. However, there are a lack of published, cost-benefit analysis data comparing prescription with OTC NRT. Considering the different economic, social and cultural conditions within particular countries, it is difficult to formulate a common optimal economic model for the distribution of NRT. Authentic studies and trials in this field in order to develop the appropriate policies in each particular country, are clearly required.