healthcare associated infections
nursing students
hand hygiene
standard precautions


Introduction: Hospital infections, or “healthcare associated infections” (HAI) represent the most frequent and serious complications of health care. Hence, there is a necessity to adopt safe care practices which are able to prevent or control the transmission of infections both in hospitals and in all non hospital healthcare facilities. The aim of this investigation is to assess the knowledge of the risk and the most effective means of prevention of HAI in the University of Ferrara nursing school students, giving particular attention to hand hygiene practices and the use of standard prophylactic precautions. Methods: The study enlisted a sample consisting of 339 students by first, second and third year nursing school students of the same academic year. An anonymous questionnaire was administered in order to investigate the knowledge of the students about three specific areas: infections associated with care practices (HAI), standard precautions (SP) and hand hygiene (HH). Results: The results showed a sufficient level of knowledge by all three groups of students, only in the section regarding SP. A barely sufficient score was reached only by the third year students with regard to the correct HH. For all the other answers, the level of knowledge shown by the students was inadequate. This is affirmed particularly for the section regarding the HAI. Conclusions: Literature data confirm that the knowledge of nursing students is often inadequate. It would be advisable to periodically check the knowledge of the students to improve training, to reduce HAI and increase their compliance with prevention.



Bello AI, Asiedu EN, Adegoke BO, Quartey JN, Appiah-Kubi KO, Owusu-Ansah B. Nosocomial infections: knowledge and source of information among clinical healthcare students in Ghana. Int J Gen Med 2011;4:571–574. doi: 10.2147/IJGM.S16720.

Pittet D. Infection control and quality health care in the new millennium. Am J Infect Control 2005;33(5):258-67. doi: 10.1016/j.ajic.2004.11.004.

Epicentro. Infezioni Correlate all’Assistenza. Avalaible at: Accessed on 25/10/2016.

Stefanati A, Boschetto P, Previato S, Kuhdari P, De Paris P, Nardini M, Gabutti G. [A survey on injuries among nurses and nursing students: a descriptive epidemiologic analysis between 2002 and 2012 at a University Hospital]. Med Lav. 2015 May 4;106(3):216-29.

European Centre for Disease Prevention and Control. Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals. Stockholm: ECDC 2013. doi 10.2900/86011.

Antonioli P, Manzalini MC, Stefanati A, Bonato B, Verzola A, Formaglio A, Gabutti G. Temporal trends of healthcare associated infections and antimicrobial use in 2011-2013, observed with annual point prevalence surveys in Ferrara University Hospital, Italy. J Prev Med Hyg. 2016 Sep;57(3): E135-E141.

World Health Organization. Health care without avoidable infections The critical role of infection prevention and control. Avalaible at: Accessed on 06/03/2017

World Health Organization. WHO Guidelines on Hand Hygiene in Health Care. First Global Patient Safety Challenge Clean Care is Safer Care. Available at: Accessed on:06/03/2017.

World Health Organization. Summary Report: Hand Hygiene Self-Assessment Framework Survey 2015/2016. WHO 2016. Avalaible at: Accessed on 06/03/2017.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20(4):250-78; quiz 279-80. doi: 10.1086/501620.

Epicentro. Infezioni correlate all’assistenza. Avalaible at: Accessed on 25/10/2016.

Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices Advisory Committee, 2007. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Avalaible at: Accessed on 06/03/2017.

Yokoe DS, Mermel LA, Anderson DJ, Arias KM, Burstin H, Calfee DP, Coffin SE, Dubberke ER, Fraser V, Gerding DN, Griffin FA, Gross P, Kaye KS, Klompas M, Lo E, Marschall J, Nicolle L, Pegues DA, Perl TM, Podgorny K, Saint S, Salgado CD, Weinstein RA, Wise R, Classen D. A compendium of strategies to prevent health care associated infections in acute care hospitals. Infect Control Hosp Epidemiol 29:S12-S21. doi: 10.1086/591060.

World Health Organization. Health worker occupational health. Available at: Accessed on: 06/03/2017.

Tavolacci MP, Ladner J, Bailly L, Merle V, Pitrou I, Czernichow P. Prevention of nosocomial infection and standard precautions: knowledge and source of information among healthcare students. Infect Control Hosp Epidemiol 2008;29(7):642-7. doi: 10.1086/588683.

Mitchell BG, Say R, Wells A, Wilson F, Cloete L, Matheson L. Australian graduating nurses’ knowledge, intentions and beliefs on infection prevention and control: a cross-sectional study. BMC Nursing 2014;13(1):43. doi: 10.1186/s12912-014-0043-9.

Bergamini M, Cucchi A, Stefanati A, Cavallaro A, Gabutti G. Knowledge of preventive measures against occupational risks and spread of healthcare-associated infections among nursing students. An epidemiological prevalence study from Ferrara, Italy. J Prev Med Hyg 2009;50(2):96-101.

D'Alessandro D, Agodi A, Auxilia F, Brusaferro S, Calligaris L, Ferrante M, Montagna MT, Mura I, Napoli C, Pasquarella C, Righi E, Rossini A, Semeraro V, Tardivo S; GISIO. Prevention of healthcare associated infections: medical and nursing students' knowledge in Italy. Nurse Educ Today 2014;34(2):191-5. doi: 10.1016/j.nedt.2013.05.005.

Cheung K, Chan CK, Chang MY, Chu PH, Fung WF, Kwan KC, Lau NY, Li WK, Mak HM. Predictors for compliance of standard precautions among nursing students. Am J Infect Control 2015;43(7):729-34. doi: 10.1016/j.ajic.2015.03.007.

Zhang R. Investigating the prevention of hospital-acquired infection through standardized teaching ward rounds in clinical nursing. Genet Mol Res 2015;14(2):3753-9. doi: 10.4238/2015.