Knowledge, Attitude, and Practice Toward Infection Prevention Strategies Pre- and Post-COVID-19 Among Nursing Students: A Systematic Review
DOI:
https://doi.org/10.33755/jkk.v11i1.790Keywords:
Attitudes, COVID-19, Health Knowledge, Infection Control, Nursing student, PracticeAbstract
Aims: COVID-19 (Coronavirus Disease 2019) has significantly impacted infection control, highlighting the vulnerabilities of the global healthcare system. This study evaluates measurable outcomes and barriers in nursing students' knowledge, attitudes, and practices, and barriers to infection prevention before and after COVID-19.
Method: systematic review, with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) registered on PROSPERO: CRD42022322706. Using the PICO framework for article selection: Population (involving nursing students), Intervention/exposure (infection control or prevention), Compare and Outcome (knowledge, attitudes, and practice). We searched nine databases from March to June 2022, with inclusion criteria for full-text articles published in English from 2012 to 2022. The study quality used The Joanna Briggs Institute (JBI) Critical Appraisal tool and the National Institutes of Health (NIH). PICO synthesis for analysis.
Results: Of 3,030 articles, only 15 met the criteria for inclusion: Cross-sectional (12/15, 80%), Descriptive study (2/12, 13%), and pre-post study (1/15, 6.67%). Infectious disease (4/15, 26.6%) and All disaster events (4/15, 26.6%), with the condition: pre-COVID-19 (11/15,73.3%), and during COVID-19 (4/15, 26.6%). The five themes were: (1) nursing students' knowledge level regarding infection control standards, (2) nursing students' attitudes towards infection control standards, (3) nursing students' practice on infection control standards, (4) factors affecting infection control in nursing students, (5) roles of nursing schools and hospitals in infection control.
Conclusion: Nursing students showed increased knowledge, but gaps in attitudes and practice remain. Future efforts should develop standardized infection prevention curricula, integrate social media training, and strengthen academic-healthcare partnerships.
References
Rodríguez Plasencia A, Donoso Noroña RF, Gómez Martínez N, Vilema Vizuete EG. Identification of the impact of healthcare-associated infections in intensive care units[Identificación del impacto de infecciones asociadas a atención de salud en unidades de cuidados intensivos]. Revista Cubana de Investigaciones Biomedicas. 2024 Jan 1;43:e3642.
Iliyasu G, Dayyab FM, Habib ZG, Tiamiyu AB, Abubakar S, Mijinyawa MS, et al. Knowledge and practices of infection control among healthcare workers in a Tertiary Referral Center in North-Western Nigeria. Ann Afr Med [Internet]. 2016 Mar 1 [cited 2023 Dec 8];15(1):34. Available from: /pmc/articles/PMC5452692/
Livshiz-Riven I, Hurvitz N, Ziv-Baran T. Standard Precaution Knowledge and Behavioral Intentions Among Students in the Healthcare Field: A Cross-Sectional Study. Journal of Nursing Research [Internet]. 2022 Oct 23 [cited 2023 Dec 8];30(5):E229. Available from: https://journals.lww.com/jnr-twna/fulltext/2022/10000/standard_precaution_knowledge_and_behavioral.3.aspx
Fithriyyah YN, Aulawi K. Using mobile phone applications in engaging nurses for preventing healthcare-associated infections: A systematic review. Nursing Practice Today [Internet]. 2022 Mar 13 [cited 2023 Dec 8];9(2):84–101. Available from: https://publish.kne-publishing.com/ index.php/NPT/article/view/8892
Hill B, Lamichhane G, Wamburu A. Infection prevention and control: Critical strategies for nursing practice. British Journal of Nursing. 2024 Sep 19;33(17):804–11.
Park E, Park HR, Lee JH. Barriers to Learning Healthcare-Associated Infections Prevention and Control during Clinical Practicum among Nursing Students in Korea: A Focus Group Study. Int J Environ Res Public Health. 2023 Jul 1;20(14):6430.
Lee SH, Yang IS. Enhancing competency in infection prevention and control: Identifying priorities for clinical nurse educational needs. Nurse Educ Today. 2024 Mar 1;134:106085.
Hawker C, Courtenay M, Gould D. How aseptic technique is taught to undergraduate student nurses: A qualitative study. Nurse Educ Today. 2023 Mar 1;122:105717.
NJ Health Department. Department of Health | Communicable Disease Service | Healthcare Associated Infections (HAIs) [Internet]. 2021 [cited 2023 Dec 8]. Available from: https://www.nj.gov/health/cd/topics/hai.shtml
Filip R, Gheorghita Puscaselu R, Anchidin-Norocel L, Dimian M, Savage WK. Global Challenges to Public Health Care Systems during the COVID-19 Pandemic: A Review of Pandemic Measures and Problems. J Pers Med [Internet]. 2022 Aug 1 [cited 2023 Dec 8];12(8). Available from: /pmc/articles/PMC9409667/
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. The BMJ. 2021 Mar 29;372.
Brennan SE, Cumpston MS, McKenzie JE, Thomas J. The use of ‘PICO for synthesis’ and methods for synthesis without meta-analysis: protocol for a survey of current practice in systematic reviews of health interventions. F1000Res. 2020 Nov 1;9.
Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetc R, et al. Chapter 7: Systematic Reviews of Etiology and Risk. JBI Manual for Evidence Synthesis. 2020;
Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: Methodological guidance for systematic reviewers utilizing meta-aggregation. Int J Evid Based Healthc. 2015 Sep 1;13(3):179–87.
National Institutes of Health. Study Quality Assessment Tools | NHLBI, NIH [Internet]. 2021 [cited 2023 Dec 8]. Available from: https://www. nhlbi.nih.gov/health-topics/study-quality-assessment-tools
Albaqawi HM, Alquwez N, Balay-odao E, Bajet JB, Alabdulaziz H, Alsolami F, et al. Nursing Students’ Perceptions, Knowledge, and Preventive Behaviors Toward COVID-19: A Multi-University Study. Front Public Health. 2020 Dec 23;8.
Fakhri N, Jallal M, Belabbes S, Khudur K, Kaddar R, Oubaasri A, et al. COVID-19 and Moroccan nursing students: A multicentre cross-sectional survey on their related knowledge, attitudes and practices. Nurs Open. 2021 Jul 1;8(4):1634–41.
Stefanowicz-Bielska A, Słomion M, Stefanowicz J. COVID-19 pandemic—Knowledge, attitudes, behaviours, and actions among faculty of health sciences students. Int J Environ Res Public Health. 2021 Nov 1;18(22).
Davran E. Knowledge Level of Nursing Students on Nosocomial Infection. Erciyes Medical Journal. 2020;
Etafa W, Wakuma B, Tsegaye R, Takele T. Nursing students’ knowledge on the management of peripheral venous catheters at Wollega University. PLoS One. 2020 Sep 1;15(9 September).
Olorunfemi O, Oyewole OM, Oduyemi RO. Nursing students’ knowledge and practice of infection control in Burns and Medical-Surgical Units at the University of Benin Teaching Hospital, Nigeria, 2019. Journal of Nursing and Midwifery Sciences. 2020 Jan 1;7(1):42–6.
Alriyami M, Al Omari O, Al-Daken L, Alriyami T, Al Rashdi R, Al Shukaili S, et al. Assessing knowledge of nosocomial infection among Omani student nurses: a cross-sectional study. https://doi.org/1012968/bjon202231266 [Internet]. 2022 Jan 29 [cited 2023 Dec 8];31(2):66–70. Available from: https://www.magonlinelibrary.com/doi/10.12968/bjon.2022.31.2.66
Khubrani A, Albesher M, Alkahtani A, Alamri F, Alshamrani M, Masuadi E. Knowledge and information sources on standard precautions and infection control of health sciences students at King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia, Riyadh. J Infect Public Health. 2018 Jul 1;11(4):546–9.
Majidipour P, Aryan A, Janatolmakan M, Khatony A. Knowledge and performance of nursing students of Kermanshah-Iran regarding the standards of nosocomial infections control: A cross-sectional study. BMC Res Notes. 2019 Aug 6;12(1).
Hassan ZM. Improving knowledge and compliance with infection control Standard Precautions among undergraduate nursing students in Jordan. Am J Infect Control. 2018 Mar 1;46(3):297–302.
Melo G de SM, Tibúrcio MP, Freitas CCS de, Vasconcelos QLD de AQ de, Costa IKF, Torres G de V. Semiotics and semiology of Nursing: evaluation of undergraduate students’ knowledge on procedures. Rev Bras Enferm. 2017 Apr 1;70(2):249–56.
Turan GB, Mankan T, Asst R. Nursing Students’ Levels of Knowledge on the Prevention of Intravascular Catheter Infections [Internet]. Vol. 11, International Journal of Caring Sciences. 2018. Available from: www.internationaljournalofcaringsciences.org
Brosio F, Kuhdari P, Stefanati A, Sulcaj N, Lupi S, Guidi E, et al. Knowledge and behaviour of nursing students on the prevention of healthcare associated infections. Vol. 58, J PREV MED HYG. 2017.
Mitchell BG, Say R, Wells A, Wilson F, Cloete L, Matheson L. Australian graduating nurses’ knowledge, intentions and beliefs on infection prevention and control: A cross-sectional study. BMC Nurs. 2014 Dec 12;13(1):1–7.
Ojulong J, Mitonga KH, Iipinge SN. Knowledge and attitudes of infection prevention and control among health sciences students at University of Namibia. Afr Health Sci. 2013;13(4):1071–8.
Botha BS, Hugo-van Dyk L, Nyoni CN. Simulating infection prevention and control through virtual reality: a vehicle for equity, diversity, and inclusivity in Africa. Front Educ (Lausanne). 2023 Jan 1;8:1214321.
Ayele DG, BayeTezera Z, Demssie NG, Woretaw AW. Compliance with standard precautions and associated factors among undergraduate nursing students at governmental universities of Amhara region, Northwest Ethiopia. BMC Nurs. 2022 Dec 1;21(1):375.
Nakagawa H, Sasai H. Nursing students’ practicums during the covid-19 crisis and the effect on infection-prevention behavior in students: A mixed-method approach. Medicina (Lithuania). 2021 Dec 1;57(12):1354.
Sultan Hamood Al Rawahi M, Muthukrishnan A, Tayyib NA, Lathamangeswari C, Pandurangan H, Nomani I, et al. Infection Control Behavior Factors to Prevent COVID-19 among Nursing Students: Cross-Sectional Online Survey. ASEAN Journal of Psychiatry [Internet]. 2022 May 30 [cited 2023 Dec 8];23(5):1–18. Available from: https://www. aseanjournalofpsychiatry.org/articles/infection-control-behavior-factors-to-prevent-covid19-among-nursing--students-crosssectional-online-survey-89525.html
Amalia RN, Emaliyawati E, Mediawati AS. Description Of Perceptions Of The Donning And Doffing Of Personal Protective Equipment In Unpad Nursing Students Class Of 2017. Padjadjaran Acute Care Nursing Journal [Internet]. 2021 [cited 2023 Dec 8];3(1). Available from: https://jurnal.unpad.ac.id/pacnj/article/view/38346
Banstola B, Shakya N, Sharma P. Anxiety among nursing students towards clinical placement during covid-19 in a tertiary hospital of nepal: A descriptive cross-sectional study. Journal of the Nepal Medical Association. 2021 Jun 1;59(238):542–6.
Kim K, Jeong H, Lee J. COVID-19 Related Fear, Risk Perceptions, and Behavioral Changes According to Level of Depression among Nursing Students. Int J Environ Res Public Health. 2022 Apr 2;19(8):4814.
Bouchoucha SL, Philips NM, Lucas J, Kilpatrick M, Hutchinson A. An investigation into nursing students’ application of infection prevention and control precautions. Nurse Educ Today. 2021 Sep 1;104:104987.
Jamiran NS, Ludin SM. Knowledge, Attitude and Practice on Infection - Control Among IIUM Kuantan Nursing Students During Coronavirus 2019 Disease (COVID-19) Outbreak. INTERNATIONAL JOURNAL OF CARE SCHOLARS [Internet]. 2021 Dec 9 [cited 2023 Dec 8];4(Supp1):58–65. Available from: https://journals.iium.edu.my/ijcs/index.php/ijcs/article/view/219
Savitsky B, Findling Y, Ereli A, Hendel T. Anxiety and coping strategies among nursing students during the covid-19 pandemic. Nurse Educ Pract [Internet]. 2020 Jul 1 [cited 2023 Dec 8];46:102809. Available from: /pmc/articles/PMC7264940/
Haque M, McKimm J, Sartelli M, Dhingra S, Labricciosa FM, Islam S, et al. Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview. Risk Manag Healthc Policy [Internet]. 2020 [cited 2023 Dec 8];13:1765. Available from: /pmc/articles/PMC7532064/
Leaver CA, Stanley JM, Goodwin Veenema T. Impact of the COVID-19 Pandemic on the Future of Nursing Education. Academic Medicine [Internet]. 2022 Mar 1 [cited 2023 Dec 8];97(3):S82. Available from: /pmc/articles/PMC8855777/
Chang SO, Sohng KY, Kim K, Won J, Chaung SK, Choi MJ. How nursing students learn infection control education through undergraduate nursing programs: a phenomenographic research study. BMC Nurs [Internet]. 2023 Dec 1 [cited 2023 Dec 8];22(1):1–11. Available from: https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-023-01465-9
Boeira ER, Silva e Souza AC, Pereira MS, Vila V da SC, Tipple AFV. Infection control and patient safety measures addressed in nursing pedagogical projects. Rev Esc Enferm USP [Internet]. 2019 [cited 2023 Dec 8];53. Available from: https://pubmed.ncbi.nlm.nih.gov/30726337/
Cieślak I, Łuszczki JJ, Panczyk M, Nowak-Starz G, Wawrzuta D, Jaworski M, et al. Social media literacy among nursing students during the COVID-19 pandemic – does year of study matter? A nationwide cross-sectional study. Annals of Agricultural and Environmental Medicine [Internet]. 2023 Mar 31 [cited 2023 Dec 8];30(1):171–6. Available from: https://www.aaem.pl/Social-media-literacy-among-nursing-students-during-the-COVID-19-pandemic-does-year,162219,0,2.html
