Assessing The Effectiveness of Aversive Stimuli on Hand Hygiene.Compliance among Nursing Students during Clinical Postings: A Problem-Solving Approach inA Selected Nursing College of New Delhi

Abstract

Background: Hand hygiene plays a key role in breaking the chain of infection thereby reduces the incidence of cross-infection and healthcare-associated infections (HAIs). Improving hand hygiene compliance requires changing human behavior. By mentally associating unwashed hands with the feelings of disgust or discomfort, this conditioning promotes lasting improvements in compliance. Aversive stimuli are the unpleasant experiences that individuals naturally try to avoid and are often used to shape behavior. This can be an effective tool in promoting desirable behaviors. This study aims to assess the effectiveness of aversive stimuli on hand hygiene compliance during clinical posting among nursing students of select Nursing College of New Delhi.

Methods: A quantitative, pre‑experimental one‑group pretest–post-test design was employed. Data were collected from 37 GNM students between May and June 2024 using a modified WHO hand hygiene observation checklist. Both descriptive and inferential statistical methods were applied to analyze the results. The finding shows that, before the intervention, majority—22 students (59.46%)—demonstrated very poor compliance, followed by 12 students (32.43%) with poor compliance and 3 students (8.11%) showing moderate compliance. Notably, none of the students exhibited excellent hand hygiene compliance. After intervention, significant improvement was observed. The number of students with very poor compliance decreased to 9 (24.32%), and those with poor compliance dropped to 8 (21.62%). Meanwhile, moderate compliance increased to 14 students (37.84%), and 6 students (16.22%) achieved excellent compliance. There was a significant mean difference t-value of 8.606 (p ≤0.001). This indicates that aversive stimuli has effectively enhanced hand hygiene compliance.

Conclusion: Participants developed stronger internal motivations to wash their hands, as mental pairing of poor compliance with unpleasant experience reduced the occurrence of undesired behavior. Ultimately, this approach offers a promising, durable approach for improving hygiene behaviors in healthcare settings.