Background: Healthcare-associated infections (HAIs) contribute to patient morbidity and mortality. Hand hygiene is essential for preventing HAIs, but training can fail to transfer to clinical practice. Experiential learning through virtual reality (VR) may improve adherence by offering realistic practice opportunities and feedback.
Methods: We developed and evaluated a VR-based training program that uses the World Health Organization's (WHO) "My Five Moments for Hand Hygiene" framework to provide feedback about pathogen transmission and hand hygiene adherence in four clinical scenarios. Sixty-eight registered nurses from four hospitals in the United States completed the VR training program. Using the Theory of Planned Behavior, we assessed behavioral determinants (intention, attitudes, subjective norms, and perceived behavioral control [self-efficacy]) of hand hygiene adherence pre-, midway, and post-training. We also measured overall adherence to the Five Moments in each scenario.
Results: From the beginning to the end of the training program, self-efficacy scores and overall hand hygiene adherence in VR increased linearly by 11% (p = 0.02) and 68% (p <.001), respectively.
Conclusions: Our findings support VR as an educational tool for enhancing hand hygiene practices of HCWs. Future research should assess the transfer of training to clinical settings and its impact on real-world adherence and HAIs.
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