Development of Hand Hygiene Training Virtual Reality Simulation and Evaluation of Its Effectiveness

Healthcare-associated infections (HAI), which have become a major problem in all countries, prolong hospital stay and increase treatment and care costs. In health care institutions, HAIs that occur directly or indirectly related to health services are among the most common causes of mortality and morbidity. A high level of hand hygiene compliance, which is the most basic step of infection control and precautions, is the first and most important step to prevent HAIs. However, it has been determined in the literature that the compliance rates of healthcare professionals with hand hygiene are low and that nurses' attitudes and behaviors regarding hand hygiene are not at the desired level. Well-structured training programs need to be developed to maintain and increase nurses' hand hygiene compliance rates. Different training methods and tools are needed to increase hand hygiene compliance, awareness and awareness. It is recommended that innovative training approaches such as virtual simulation be developed and evaluated to further internalize and encourage nurses' most effective hand hygiene practice behaviors. In recent years, the use of simulation methods in the training of healthcare professionals has been increasing as they facilitate the transfer of theoretical knowledge into clinical practice. One of these simulation methods is virtual reality (VR). The use of gamification in the virtual environment supports different learning styles, enabling learners to participate more intensively in education and increase their internal motivation. In this context, with VR support, entertainment and learning processes can be used to support each other. Considering the features of VR usage such as integrating knowledge and skills, creating a learning environment for the learner by doing, giving the opportunity to repeat until the correct application is made, reducing incorrect interventions in clinical practice and increasing patient safety, it is recommended that virtual simulation systems be used in nursing education. VR provides different opportunities to learners by enriching and diversifying learning environments. In these virtual environments, learners can have new experiences and these experiences remain permanent for the learners. As stated in the WHO Hand Hygiene Theme, it is important to develop innovative training programs, learning materials and measurement and evaluation tools regarding hand hygiene within the scope of infection control and prevention studies. VR simulation can be used to attract nurses' attention and awareness by increasing intrinsic motivation to perform hand hygiene, and can be used to support nurses in developing positive attitudes towards hand hygiene. Hand hygiene simulation scenarios created with virtual reality can contribute to greater awareness about the problems caused by microorganism transmission by increasing hand hygiene awareness. Thus, increasing attitudes and awareness regarding hand hygiene can have a positive effect on reducing the HAI rate by supporting the transformation of hand hygiene awareness into behavior. In the study, it was planned to develop, implement and evaluate a virtual reality hand hygiene simulation. It is thought that this virtual reality simulation will pave the way for the development of psychomotor skills for hand hygiene, increase the level of knowledge, and increase hand hygiene compliance by providing internal motivation to perform hand hygiene. In our country, no studies have been found on the development of virtual reality simulation in hand hygiene practice. The aim of this study is to develop and implement virtual reality hand hygiene simulation in teaching hand hygiene behaviors in nurses and to evaluate its effect on hand hygiene compliance.