Promoting Preventive Behaviors of Nosocomial Infections in Nurses: The Effect of an Educational program based on Health Belief Model

Ali Khani Jeihooni, Seyyed Hannan Kashfi, Mina Bahmandost, Pooyan Afzali Harsini


Objective. To determine the effect of educational program based on Health Belief Model (HBM) on promoting preventive behaviors of nosocomial infections in nurses.

Methods. In this randomized controlled trial study, 120 nurses working in a hospital in Fasa City, Fars (Iran). Intervention group (n=60) received an educational program based on HBM while control group (n=60) did not received it. A questionnaire consisting of demographic information, HBM constructs (knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, performance and cues to action) was used to measure changes toward the prevention of nosocomial infections before, immediately after intervention and four months later (of the end of the intervention).

Results. Immediately and four months after the intervention, the intervention group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, Self-efficacy, cues to action and performance compared to the control group.

Conclusion. This study in nurses showed that the effectiveness of the Educational program based on HBM on promoting preventive behaviors of nosocomial infections. Hence, this model can act as a framework for designing and implementing educational interventions for the prevention of nosocomial infections.

Descriptors: cross infection; control groups; perception; surveys and questionnaires; nurses.


How to cite this article: Jeihooni AK, Kashfi SH, Bahmandost M, Harsini PA. Promoting Preventive Behaviors of Nosocomial Infections in Nurses: The Effect of an Educational program based on Health Belief Model. Invest. Educ. Enferm. 2018; 36(2):e09.

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(1) Kostakoğlu U, Saylan S, Karataş M, İskender S, Aksoy F, Yılmaz G.Cost Analysis And Evaluation Of Nosocomial Infections In Intensive Care Units. Turk. J. Med. Sci. 2016; 46(5):1385-92.

(2) Dawczynski K, Schleußner E, Dobermann H, Proquitté H. Infection Prevention in Premature Infants and Newborns in Thuringia: Implementation of Recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO). Z Geburtshilfe Neonatol. 2017; 221(1):30-8. [German]

(3) Ghadamgahi F, Zighaimat F, Ebadi A, Houshmand A. Knowledge, attitude and self-efficacy of nursing staffs in hospital infections control. Iran. J. Mil. Med. 2011; 13(3):162-72. [Persian]

(4) Petty WC. PACU-why hand washing is vital!. J. Perianesth. Nurs. 2009; 24(4):250-3.

(5) Cardo D, Dennehy PH, Halverson P, Fishman N, Kohn M, Murphy CL, et al. Moving toward elimination of healthcare- associated infections: a call to action. Infect. Control Hosp. Epidemiol. 2010; 31(11):1101-5.

(6) Lee MK, Chiu CS, Chow VC, Lam RK, Lai RW. Prevalence of hospital infection and antibiotic use at a university medical center in Hong Kong. J. Hosp. Infect. 2007; 65(4):341-7.

(7) Luo Y, He GP, Zhou JW, Luo Y. Factors impacting compliance with standard precautions in nursing, China. Int. J. Infect. Dis. 2010; 14(12):e1106-14.

(8) Stone PW, Hasan S, Quiros D, Larson EL. Effect of guideline implementation on costs of hand hygiene. Nurs. Econ. 2007; 25(5):279-84.

(9) White A. Clinical decision making among fourth year nursing students: An interpretive study. J. Nurs. Educ. 2003; 42(3):113-20.

(10) Bird A, Wallis M. Nursing knowledge and assessment skills in the management of patient receiving analgesia via epidural infusion. J. Adv. Nurs. 2002; 40(5):522-31.

(11) Erasmus V, Brouwer W, van Beeck EF, Oenema A, Daha TJ, Richardus JH, et al. A qualitative exploration of reasons for poor hand hygiene among hospital workers: lack of positive role models and of convincing evidence that hand hygiene prevents cross-infection. Infect. Control Hosp. Epidemiol. 2009; 30(5):415-9.

(12) Van Rensburg GH, Botma Y. Bridging the gap between self-directed learning of nurse educators and effective student support. Curationis. 2015; 38(2):1503.

(13) Glanz K, Rimer B, Viswanath K. Health Behavior and Health Education: Theory, Research and Practice. 4th ed. San Francisco: Jossey-Bass; 2008.

(14) Jeihooni AK, Hidarnia A, Kaveh MH, Hajizadeh E, Askari A. Effects of an Osteoporosis Prevention Program Based on Health Belief Model Among Females. Nurs. Midwifery Stud. 2015; 4(3):e26731.

(15) Zeigheimat F, Ebadi A, Rahmati-Najarkolaei F, Ghadamgahi F. An investigation into the effect of health belief model-based education on healthcare behaviors of nursing staff in controlling nosocomial infections. J. Educ. Health Promot. 2016; 5:23.

(16) Hazavehei SM, Khani Jeihooni A, Hasanzadeh A, Amini S. The effect of educational program based on BASNEF model for eye care in non-insulin dependent diabetic patients. J. Res. Health Sci. 2010; 10(2):81-90.

(17) Suchitra JB, Lakshmi Devi N. Impact of education on knowledge, attitudes and practices among various categories of health care workers on nosocomial infections. Indian J. Med. Microbiol. 2007; 25:181–7.

(18) Ghaffari M, Tavassoli E, Esmaillzadeh A, Hassanzadeh A. Effect of Health Belief Model based intervention on promoting nutritional behaviors about osteoporosis prevention among students of female middle schools in Isfahan, Iran. J. Educ. Health Promot. 2012; 1:14.

(19) Sabane HH, Dixit RR, Durge P. Impact of knowledge about Post exposure prophylaxis among nursing students-A cross sectional study. Healthline. 2011; 2(1):27-30.

(20) Gorman JR, Brewer NT, Wang JB, Chambers CD. Theory-based predictors of influenza vaccination among pregnant women. Vaccine. 2012; 31:213–8.

(21) Javaheri Tehrani F, Nikpour S, Haji Kazemi EA, Sanaie N, Shariat Panahi SA. The effect of education based on health belief model on health beliefs of women with urinary tract infection. Int. J. Community Based Nurs. Midwifery. 2014; 2(1):2-11.

(22) Jeong HS, Lee DW, Youn CH, Lee MK, Lee SJ, Suh YS, et al. Perception and Performance of Preventive Behaviors for the Pandemic Influenza in Hospital Employees and Outpatients. Yonsei Med. J. 2011;52:181–7.

(23) Noruzi T, Rassouli M, Khanali Mojen L, Khodakarim S, Torabi F. Factors associated with nosocomial infection control behavior of nurses working in nursery & NICU based on Health Belief Model. J. Health Promot. Manag. 2015; 4(3):1-11.

(24) George J, Shalansky SJ. Predictors of refill non-adherence in patients with heart failure. Br. J. Clin. Pharmacol. 2007; 63(4):488-93.

(25) Ghanbari M K, Farazi AA, Shamsi M, Khorsandi M, Esharti B. Measurement of the Health Belief Model (HBM) in Nurses Hand Hygiene among the Hospitals. World Appl. Sci. J. 2014; 31(5):811-8.

(26) Pike T, O'Donnell V. The impact of clinical simulation on learner self-efficacy in pre-registration nursing education. Nurse Educ. Today 2010; 30(5):405-10.

(27) Kowitlawakul Y, Brenkus R, Dugan N.Predictors for success for first semester, second-degree Bachelor of Science in Nursing students. Int. J. Nurs. Pract. 2013;19(Suppl 1):38-43.

(28) Khani Jeihooni A, Hidarnia A, Kaveh MH, Hajizadeh E. The Effect of a Prevention Program Based On Health Belief Model on Osteoporosis. J. Res. Health Sci. 2015; 15(1):47-53.

(29) Chariyeva Z, Golin CE, Earp JA, Suchindran C. Does motivational interviewing counseling time influence HIV-positive persons' self-efficacy to practice safer sex?. Patient Educ. Couns. 2012; 87(1):101-7.

(30) Masood Hussain Rao. Assessment of Knowledge, Attitude and Practices Pattern of Hand Washing in Some Major Public Sector Hospitals of Pakistan (A Multi-Center Study). Pak. J. Med. Res. 2012; 51(3):76-82.

(31) Boyce JM, Pittet D; Healthcare Infection Control Practices Advisory Committee. Society for Healthcare Epidemiology of America. Association for Professionals in Infection Control. Infectious Diseases Society of America. Hand Hygiene Task Force. Infect. Control Hosp. Epidemiol. 2002; 23(12 Suppl):S3-40.

(32) Jeihooni AK, Hidarnia A, Kaveh MH, Hajizadeh E, Askari A. The Effect of an Educational Program Based on Health Belief Model on Preventing Osteoporosis in Women. Int. J. Prev. Med. 2015; 6:115.

(33) Kaewchana S, Simmerman M, Somrongthong R, Suntarattiwong P, Lertmaharit S, Chotipitayasunondh T. Effect of intensive hand washing education on hand washing behaviors in thai households with an influenza-positive child in urban Thailand. Asia Pac. J. Public Health. 2012; 24(4):577-85.

(34) Farzan M, Zerin I, Kabir M, Pavel M, Hossain M. Health Education Intervention on Hand Washing in a selected Primary School Children. Bangladesh J. Dental Res. Educ. 2012; 2:7–11.

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