Effectiveness of Nurse-Led Education Programmes to Enhance Infection Prevention and Control Among Childcare Workers in Bangkok Daycare Centres, Thailand

Not Applicable

Not yet recruiting

• Conditions: Hand Hygiene Behavior; Infection Control; Infection Prevention

• Registration Number: NCT06736977
• Lead Sponsor: Universiti Putra Malaysia

Brief Summary

The goal of this clinical trial is to evaluate the effects of nurse-led education programmes on childcare workers (CCWs) in improving infection prevention and control (IPC) practices in daycare centres. The main questions it aims to answer are:

1. Is there an increase in IPC knowledge, attitudes, practices, and self-efficacy, as well as hand hygiene intention and compliance of CCWs after receiving the online or onsite IPC nurse-led education programme?

2. Do CCWs who receive the online programme exhibit higher IPC knowledge, attitudes, practices, and self-efficacy, as well as hand hygiene intention and compliance compared to those who do not receive any programme?

3. Do CCWs who receive the onsite programme exhibit higher IPC knowledge, attitudes, practices, and self-efficacy, as well as hand hygiene intention and compliance compared to those who do not receive any programme?

4. Is there a difference in IPC knowledge, attitudes, practices, and self-efficacy, as well as hand hygiene intention and compliance between CCWs who receive the online programme and those who receive the onsite programme?

Detailed Description

Despite the crucial role of infection prevention and control (IPC) in daycare centers (DCCs), research reveals significant gaps. Based on the systematic review of the IPC programmes among childcare workers (CCWs), most studies focus mainly on hand hygiene, neglecting other IPC components like environmental cleaning, waste management, vaccination, and triage of infectious disease patients. Research on the role of nurses in developing and implementing these programmes is also limited. Existing studies often emphasize outcomes related to children and parents rather than assessing the impact on CCWs. Only two studies used a cluster randomized controlled trial (RCT) design, essential for evaluating group interventions.

Additionally, the emergence of online, on-demand, and hybrid learning methods highlights a gap in IPC training, with limited exploration of online learning for IPC education. Comprehensive IPC programmes for CCWs, incorporating various IPC components, clearly defined roles for nurses, and modern educational methods, are urgently needed. These programmes should be rigorously evaluated using cluster RCT designs to provide robust evidence of their effectiveness. Therefore, this clinical trial is aimed to evaluate the effects of nurse-led education programmes on IPC knowledge, attitudes, and practices, as well as hand hygiene intention and compliance among CCWs in daycare centres in Bangkok, Thailand.

Study Timeline

• Status Verified: 2024-12
• Study First Submitted: 2024-12-10
• Study First Submitted QC: 2024-12-13
• Last Update Submitted: 2024-12-13
• Study First Posted: 2024-12-17
• Last Update Posted: 2024-12-17
• Study Start: 2025-02-01
• Primary Completion: 2025-08-31
• Study Completion: 2025-08-31

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 180

Inclusion Criteria

• Registered DCCs in Bangkok, as listed in the Bangkok Metropolis Administrative information.
• At least two or more CCWs work in DCC at the time of recruitment.
• Participants aged 18 years or over.
• Participants had been employed for at least three months at registered DCCs in Bangkok at the time of recruitment.
• Participants provided care for children 0-5 years of age.
• Participants could read and speak Thai language.

Read More

Exclusion Criteria

• Participants are attending any IPC training at the time of recruitment.
• Participants are planning to attend another IPC training within six months after the time of recruitment.
• Participants have completed another IPC training programme within the six months prior to the time of recruitment.

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Infection prevention and control knowledge	From enrollment to the end of the programme at immediatly, 1 month, 3 months, and 6 months	This questionnaire was adapted from an existing validated tool, the knowledge of preventive behaviors for communicable diseases questionnaire. It was developed based on the Disease-Free Child Care Centers Policy from the Department of Disease Control, Thailand Ministry of Public Health, to assess Thai CCWs. The original questionnaire consists of 15 dichotomous questions. The item objective congruence (IOC) was evaluated by five experts, resulting in a score of 0.744, and internal consistency was assessed with a KR-20 of 0.73 (n = 30).; In this study, the researchers added five questions regarding the knowledge of using personal protective equipment, handling food and feeding, and managing waste. Therefore, the final version of this questionnaire consists of 20 dichotomous questions. The total score will be calculated by summing the correct responses, with higher scores indicating greater levels of IPC knowledge.
Infection prevention and control attitudes	From enrollment to the end of the programme at immediatly, 1 month, 3 months, and 6 months	This questionnaire was adapted from an existing validated tool, the attitudes of preventive behaviors for communicable disease questionnaire. It was developed based on the Disease-Free Child Care Centers Policy from the Department of Disease Control, Thailand Ministry of Public Health, to assess Thai CCWs. The original questionnaire consists of 15 items with five-point Likert scales. The IOC was evaluated by five experts, resulting in a score of 0.744, and internal consistency was assessed with a Cronbach's α of 0.71 (n = 30).; In this study, the researchers removed questions that were outside the conceptual definition and added questions regarding beliefs, perceptions, and feelings about the importance and necessity of IPC measures. The final version of this questionnaire still consists of 15 items, including both positive and negative statements, with five-point Likert scales. The total score will be calculated, with higher scores indicating more positive attitudes toward IPC.
Infection prevention and control practices	From enrollment to the end of the programme at immediatly, 1 month, 3 months, and 6 months	This questionnaire was adapted from an existing validated tool, the preventive behaviours for communicable disease questionnaire. It was developed based on the Disease-Free Child Care Centers Policy from the Department of Disease Control, Thailand Ministry of Public Health, to assess Thai CCWs. The original questionnaire consists of 15 items with five-point Likert scales. The IOC was evaluated by five experts, resulting in a score of 0.744, and internal consistency was assessed with a Cronbach's α of 0.71 (n = 30).; In this study, the researchers added five questions regarding practice of vaccination monitoring, the use of personal protective equipment (PPE), handling food and feeding, and waste management. Therefore, the final version of this questionnaire consists of 20 items with five-point Likert scales. The total score will be calculated, with higher scores indicating higher levels of IPC practices.
Infection prevention and control self-efficacy	From enrollment to the end of the programme at immediatly, 1 month, 3 months, and 6 months	This questionnaire was translated and adapted from and existing validated tool, the infectious diseases prevention self-efficacy questionnaire. It was originally used to assess self-efficacy in infectious disease prevention among Korean daycare center administrators. The questionnaire consists of 15 items with five-point Likert scales. The original tool demonstrated internal consistency with a Cronbach's α of 0.91 (n = 172).; In this study, the original questionnaire was translated from English to Thai by following the WHO guidelines for the process of translation and adaptation of instruments. Additionally, the researchers removed questions that were outside the conceptual definition and added items regarding confidence in the use of PPE, handling food and feeding, and waste management. The final version of the questionnaire still consists of 15 items with five-point Likert scales. The total score will be calculated, with higher scores indicating higher levels of IPC self-efficacy.

Secondary Outcome Measures

Name	Time	Method
Hand hygiene intention	From enrollment to the end of the programme at immediatly, 1 month, 3 months, and 6 months	This questionnaire was translated from an existing validated tool, the hand hygiene intention questionnaire. It was originally developed based on the Theory of Planned Behavior and identified through focus group discussions with caregivers and managers of DCCs to assess hand hygiene intention among CCWs in the Netherlands. The questionnaire consists of 2 items with seven-point Likert scales. The internal consistency was measured with a Cronbach's α of 0.90 (n = 350). The total score will be calculated, with higher scores indicating greater levels of hand hygiene intention.
Hand hygiene compliance	From enrollment to the end of the programme at immediatly, 1 month, 3 months, and 6 months	This questionnaire was translated and adapted from and existing validated tool, the hand hygiene compliance questionnaire. It was originally developed and commonly used in hand hygiene surveys of caregivers in Netherlands DCCs. The questionnaire consists of 18 items with eleven-point rating scales. It was later used to assess hand hygiene compliance among Chinese kindergarten teachers, reporting an internal consistency with a Cronbach's α of 0.83 (n = 95).

Trial Locations

Locations (1)

Suan Sunandha Rajabhat University; 🇹🇭 Bangkok, Dusit, Thailand