Paper Type

Doctoral Project


Brooks College of Health

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Dr. Elizabeth McCarthy

Second Advisor

Dr. Carol Ledbetter

Third Advisor

Dr. John McDonough

Fourth Advisor

Maxine Lesser

Department Chair

Dr. Lillia Loriz

College Dean

Dr. Pamela Chally


Proper handwashing is one of the simplest, most affordable and effective means of stopping the spread of infection. Due to the close proximity of children in schools and child care settings, there is a high risk for the spread of infectious disease. The purpose of this project was to improve handwashing behaviors of three to six year old children in a community school setting by implementing an evidence based multi-activity handwashing education program. The objective was to increase understanding of the relationship between germs and handwashing, as well as increase the frequency and correct technique procedure of handwashing behavior in children in the community.

The evidence based handwashing education program was implemented over several weeks and included multiple activities that were found in the literature to be effective. These activities included a lecture and presentation, a return demonstration, a Glo Germ™ training device, and a video and story on handwashing. The results of the statistical analysis found that the program was effective in increasing both the frequency and correct technique procedure of the children. Most parents (80%) reported that they noticed an increase in how often their child washes his/her hands. A majority of parents (83%) noticed an increase in the duration of how long their child washes his/her hands; a larger majority (90%) noticed a decrease in how often they needed to prompt their child to wash his/her hands.

Nurses working collaboratively with other disciplines in the community can implement evidence based practice handwashing education programs in a variety of public child care settings. The effects of the handwashing programs may significantly decrease child healthcare costs associated with prescriptions, visits to the provider, hospital admissions and emergency room visits and influence positive health promotion behaviors in children. Implementing affordable and effective handwashing education programs can lead to a reduction in infectious diseases, absenteeism, antibiotic resistance and health care costs. By fostering positive health promotion practices, such as proper handwashing behaviors in children, habits may be instilled that carry into adulthood. These habits can increase the health of a child and the community.

Included in

Nursing Commons