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Updated: Jun 1, 2025
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Published on: September 18, 2017
Visualizing the WHO "My Five Moments for Hand Hygiene," framework: A virtual reality training program for improving
Jacob P Stuart1, Paige R Gannon1, Victoria R Dotto1
1Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA.
Background:
Health care-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 4 clinical scenarios. Sixty-eight registered nurses from 4 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=.02) and 68% (P<.001), respectively.
Conclusions:
Our findings support VR as an educational tool for enhancing hand hygiene practices of health care workers. Future research should assess the transfer of training to clinical settings and its impact on real-world adherence and HAIs.
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