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Yalcin Atar and Koc (2024) conducted a study based on The Effect of Simulation-Based Training on the Hand Hygiene Knowledge and Practices of Palliative Caregivers. The participants were all caregivers and over 18 years old. The criteria were to be literate, be able to communicate verbally, and be able to fill in data collection forms completely.

The author described that the main aim of palliative care is to increase the patient's quality of life and is done so by reducing pain, managing symptoms, and ensuring that the needs of the family are met. The article explains the importance of hand hygiene for caregivers and shows a belief that there is a need for further training. They believe this is the first study to apply a simulation-based hand hygiene training session in respect of caregivers of palliative care patients. Yalcin Atar and Koc (2024) found that these simulations significantly improved hand hygiene knowledge compared to caregivers that had not received the training.

To conclude, this study suggests the reason why family-centered care is important in relation to infection control and care givers should be provided with appropriate and relevant training to effectively perform hand hygiene.

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The study was only completed in one hospital over a short period of time

Hand hygiene knowledge form scoring system 23-90. This shows a scale shows a wide knowledge range.

Both questionnaires are  verified by 8 experts and the standards to follow are from the WHO organization

The samples where randomized meaning mix of people were targeted

More education were given to the caregivers than professionals

Care givers were educated middle aged women

Population is small to gain a true result

Strength is a controlled and non controlled group

Same characteristics in both groups

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The study undertaken was hand hygiene adherence in a palliative care setting.The study used more females than males and was only observed in one clinical setting.The study found that simulation was more effective than just training as the hand hygiene compliance was greater.The social determinants of health were took into consideration and did not pose any barriers,consent was given written and verbally and it was inclusive of ethical clearance.The study was conducted over along period of time so participants were aware they were being observed so theyc would be inclined to wash their hands more this could justify as bias results.60 participants took part and the trail was also registered as clinically approved. Therefore it could be used to implement new strategies, training or policies for improved hand hygiene. Before the study training was given and a flow chart was implemented to follow the correct hand washing steps and was based on a score system between 0-18 for poor or good hand washing.This article identifies that simulation is more effective than training as demostrating hand hygiene correctly and having the correct education significantly improves hand hygiene adherance which is supported by the ANCOVA hand hygiene post knowledge simulation training. Overall there were limitations as more females were used than males,a small selection of people were used and only one clinical setting was used.

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The purpose of the study is to see the effects of simulation based hand hygiene training, results have shown that these simulations are effective and in turn reduce HAI (healthcare associated infection). The downside to this study is that the participants are aware of the aims and therefore behaviours could be unreliable, for ethical reasons the participants would need to be aware that they are part of the study and to be able to give consent, however I feel that if the participants had been randomly spot checked or observed unknowingly the results may be different. In palliative care the patients maybe at home and therefore being cared for mostly by family and friends who have not received the same training in hand hygiene, even in a hospital setting there may be patient contact with persons other than healthcare staff and this can affect the infection rate. Another limitation of the study is that is it confined to one healthcare setting and behaviours and cultures can differ depending on the workplace, the leadership or in different parts of the country/world, therefore it would be beneficial to conduct further research in different settings and in different areas to compare the effects of hand hygiene with regards to differences and similarities in training methods, and the results.

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Atar and Koc (2024) study is on the effect of simulation-based training on hand hygiene knowledge and practices of palliative caregivers. It is well established that handwashing reduces the spread of infection (REFS needed) A strength of this study is it is up to date and has been quickly published after the initial study (ref required). The gold standard of research is double-blind, randomised controlled (REF needed), which means there is a comparison between a group that where given simulation intervention and a group that were only given theoretical training. However, it is only a single centre study limits and low numbers so ideally it should be repeated elsewhere (ref needed). Atar and Koc do recognise the single centre study is a limitation. The demographic only show sex, mean age, education level and income level. Other demographic characteristics could affect the outcome of the study such as ethnicity (ref needed). As Atar and Koc state the control group and intervention group is well matched for being nearly equal in all the noted characteristics with the exception of male sex so could be considered not biased in either way to the control or intervention group because the majority of caregivers are women (ref needed). The same study patient (SP) was used throughout which would allow for better control however, in practicing the scenario with the first group onwards could make the study patient better or more lackadaisical depending on the SP (ref needed). However, keeping the same SP throughout is a strength of the study despite effects of human error that could occur with the study patient acting different to different groups. The number of participants is small but there is scope to repeat the study elsewhere because the outcomes are positive as simulation-based training on top of theoretical training showed it improves knowledge and adherence to handwashing compared to the controlled group. The study only retested at 4 weeks, so this is a limitation of the study. The study is inline with other research studies where student nurses have increased knowledge and their adherence to handwashing but they have followed up at 6 months. This could be where the study is improved by following up again at a later date.

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The aim of this study was to look at the effectiveness on hand hygiene knowledge through simulation based training amongst palliative care caregivers. The research methodology used in this study is mixed method consisting of quantitative and qualitative data. The study was conducted in a palliative care clinic based in a public hospital between the period of December 2022 and September 2023. A strength to this study is that the findings was published quickly after the study was completed and it is up to date. However, there are limitations to this study which found there was more females that participated than males which could result in gender bias and be classed as a small sample, also the the study was only conducted in one place. Another limitation to the study is that it stated participants must be over 18 years old, but didn't have a limit to age to compare results which may have been different depending on the ages. Another strength to this study is that it has been clinically and ethically approved and written consent was obtained from participents. A weakness to the study is that the caregivers and participants was prepared for the study, training was given and the use of a flow chart was implemented allowing them to follow procedures therefore the results have been contradicted and not reliable as without the preparation the results may have been different. The findings from this study found that simulation based hand hygiene training increased the knowledge and adherence of hand hygiene compared to theory based training which is suggestively supported by other authors in this article , however this article does state that there is no previous studies implementing hand hygiene simulation based training which is a limitation.

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The aim of this study was to investigate the effectiveness of simulation training on had hygiene for those working in a palliative care setting. This study conducted of 60 caregivers which were divided into 2 groups, randomly to make the study fair. Each group received the same education and hand hygiene demonstration to also make the test fair.

The study stated that hand hygiene is the most basic infection and control measure in care settings and caregivers should be able to perform this effectively, if the simulation based training is effective, it will increase the care givers knowledge and practices. The study found that those who lack appropriate training can be the cause of healthcare associated infections. It has been found that 5-10% of patients in the USA and 6-9% in Europe develop healthcare associated infections annually due to poor hand hygiene.

When hand hygiene is carried out appropriately, it can cleanse the hands of micro-organisms and diseases which can cause potential of the decrease of healthcare associated infections.

This study was specifically adapted to the context of palliative care, making it specific to the healthcare setting makes the study appropriate and allows the effectiveness of it to be accurate.

To ensure it is effective the study was based on the WHO guidelines and was submitted to eight experts who all approved of the study.

This checklist was used to assess the caregivers adherence to hand hygiene guidelines during the interventions performed on patients, this is to help maintain patient safety.

Those who scored higher scores indicated better adherence towards hand hygiene.

All those who met the criteria were informed about the study’s purpose and procedures meaning this was not a bind study, they all knew what they would be doing all received the same fair training before taking part.

All participants were given a 10 minute education and a 5 minute hand hygiene demonstration before taking part in the simulation meaning they all received the same fair advantage.

Anyone who took part in the study was re-assessed 4 weeks after the simulation, this was carried. Out. To see if the participants had learnt from the simulation and to see whether they still adhered to appropriate hand hygiene.

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Atar and Koc (2024) released publication relating to a double blinded, randomised, controlled single centred study on hand hygiene in a palliative care setting in Istanbul with the primary goal to investigate the effectiveness of simulation -based education for the knowledge and application of handwashing for palliative care workers. The article produced by Atar and Koc (2024) gave a background to the topic ensuring the reader would understand the importance of effective handwashing practices in a palliative care setting. The article utilised three separate forms to collect data, a personal information form for participant characteristics and beliefs on their own handwashing habits, a hand hygiene knowledge form to identify the knowledge of when hand hygiene is required for patient interventions, and a hand hygiene practice form (HHPF) to capture when the palliative care workers are performing appropriate hand hygiene.

It is noted that ethical approval was considered and sought allowing this trial to be completed in a way that benefits patients and participants. By completing it as a double-blind, randomised trial this counteracts any unconscious or conscious bias. Atar and Koc (2024) state that a nurse completed the HHPF, however do not state how the nurse was the one chosen to complete the form. Atar and Koc (2024) concluded that simulation-based hand hygiene training has proven beneficial in this study albeit in  a small participation group at only one location and has identified a gap in research pertaining this. Grammatical errors have been noted throughout the article in multiple instances, which should have been corrected before publishing to allow for readers ease. Atar and Koc (2024) have utilised a significant number of references to enforce their points, however many of these appear to be outdated and the authors could have benefitted from keeping their references within a 10-year time frame.

Overall, the methodology and structure of the article is clear and appropriate and allows the reader to find the area of text they are looking for with ease. The article also reinforces the need for this topic to be explored further with the importance reiterated multiple times throughout.

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Yalcin Atar and Koc 2024, are the two research authors who conducted a study on simulation based training on hand hygiene knowledge, and practices on palliative caregivers. this study was conducted by 60 caregivers between December 2022 and September 2023 with the participants all being 18 and over. the participants had all to be able to communicate verbally, be liberate and all had to fill in the data collection forms completely. this study used more females than males which could be classed as gender biased and was observed in a clinical setting in Istanbul. the study shows that simulation based training was more effective than the normal hand hygiene training. as this study was done during 10 months, the participants knew they were being observed so they would be more aware and inclined to wash their hands. this article suggests that caregivers are overlooked as vectors of infection and many of them need the knowledge of hand hygiene as they often do not receive any training.

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The author of this article, Nurdan Yalcin Atar and Murat Koc conducted a study in Istanbul, Turkey on the effect of simulation based training on hand hygiene knowledge. The study was produced as a double-blind, randomised controlled single centre study which means that it is a mixed research study. Participants included 60 caregivers from a palliative care clinic where the group was divided into two groups through randomisation. The study showed that simulation based hand hygiene training significantly increased hand hygiene knowledge and that it was much more effective than theoretical training. An increase from 40.8% to 59.2% concluded to the author that the study proved effectiveness of hand hygiene training interventions. However, some limitations of the study is that only a small population was used in a small centre. Therefore, findings may not be a true result of the question at hand.

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Atar and Koc (2024) completed a study about the effects of simulation-based training when it comes to handwashing in a single, palliative care setting. Atar and Koc (2024) conducted their study for around 9 months and across 60 caregivers. The study presents several findings from the research they gathered, presenting some contradicting ideas and results. Atar and Koc (2024) primarily focuses on simulated-based training for hand hygiene to improve. They focus on this throughout the study. Atar and Koc (2024) reinforces the idea that by having simulated-based training can enhance caregivers’ knowledge around hand hygiene and be able to be affected stop the spread of infections and improve the quality of life for palliative patients. Atar and Koc (2024) provided hand-washing presentations before the study was conducted, and they state that this improved the over-all knowledge surrounding hand hygiene and its importance. However, the study does present opposing arguments that may been seen as bias. Atar and Koc (2024) produced results on the effective use of handwashing after training has been given. As a result, this gives a false reading and can be argued invalid representation of proper use of handwashing. Also, Atar and Koc (2024) conducted their study based off a small area. Atar and Koc (2024) went on to say they went to one single facility and focused on palliative care across 60 workers, and stated they looked at one room with a sink. It can be disputed that this is a quite small area to study and may be that not all the staff have used this sink to perform hand hygiene, and therefore may not include all the staff involved in the care of patients. Finally, Atar and Koc (2024) provided training to at least a few staff members before the study was conducted, and caregivers were placed in randomised groups where the integrity of the study being blind may have been affect and jeopardised. It can be argued that the results of the study can be seen as bias and aiming for perfection for the study to thrive and achieve its goal. To conclude, the study by Atar and Koc (2024) presents the importance of hand washing and focuses on stimulated-based training and how this can provide caregivers with the appropriate knowledge around hand hygiene. However, the results can be seen as bias as training was provided beforehand, and the integrity of the study may have been compromised throughout the 9 months of the study.

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Nurdan Yalcin Atar, Murat Koc (2024) conducted a study on the effectiveness of simulation-based training on the hand hygiene knowledge and practices of Palliative Caregivers. This study was a double blind, randomized, controlled single – center study. 60 caregivers from a palliative care clinic took part in the study and were divided into two groups by simple randomization. Both groups received the same theoretical and demonstration of the hand hygiene training.

Participants had to be of a certain age over 18, literate and able to verbally communicate. They also had to complete data collection forms and once committed to the study, they could not decline any part of it.

Present studies show that there are no significant differences in the control groups in terms of sociodemographic characteristics such as education levels, age, gender, incomes, and this suggests that these have no influence over the hand hygiene knowledge and practices.

The simulation-based training that was given on hand hygiene proved to be more effective than theoretical training and was successful in increasing adherence from 40.8% to 59.2% at 6 months after the training was given. These statistics demonstrate that simulation training interventions are more effective, however repetition and frequent information given to caregivers around hand hygiene can also have a positive effect.

The limitations to this study are that it was a single center with a small population, but there are positives to the study being randomized, and the training was given by simulation professional trainers.

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Article Review

The author of the article, Nardan Yalcin Atar conducted a study on the effect of simulation-based training o the hand hygiene knowledge and practices of palliative caregivers:a double blind, randomised and controlled single centre study. The study was taken place at the palliative care unit in Istanbul Turkey at the Sulatnbeyli hospital, where 60 caregivers from the palliative care clinic took part. The criteria for the caregivers taking part was being over 18 years of age, being literate and be able to communicate verbally, and filling in the data collection forms completely. The duration of the study was between December 2022 and September 2023. The study data was collected using a hand hygiene knowledge form, personal information and hand hygiene practices using a pre and post test method. A few limitations included the use of more females than males. The study was taken part in one hospital which does not allow the findings to be accurate. Participants knew they were being watched and would be more cautious to wash their hands accurately which wouldn’t show accurate findings.

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The author of the article Yalcin Atar and Koc 2024 conducted a study about the effectiveness of simulation based training and hand hygiene education.

A randomised single centred approach was used to conduct the findings of this article. The study was conducted with 60 caregivers in one palliative care clinic in Istanbul. only studying one clinic in Istanbul would be a limitation as 1 hospitals results may not apply to all hospitals who may have different training, education and resources.

this study found that educating caregivers about hand hygiene can prevent healthcare associated infections and lack of knowledge and training has been proven to have increase the rate of infections. the study found that theoretical education is not as impactful than using a simulation based training method in addition to the theoretical education. however the use of 60 caregivers is a small sample size and the population is too small to gain an accuarte result. They gathered data from adults over the age of 18, who were literate and able to communicate, which may be contradictory because healthcare professionals who do not fall into these categories are likely to be unaware of the significance of hand hygiene and to do it incorrectly.

The study was carried out from december 2022 till september 2023 which is a good duration to conduct a study to get accurate finding on the long term effects of effective hand washing and how it would be maintained post training.

65% were female and 82.6% were high school graduates showing that the results would not apply to those caregivers who have been working a while.

To conclude there were areas of thsi study which could have been improved and if all the areas had been examined, the results may have been different.

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The study was carried out in Istanbul, Turkey by Nurdan and Murat, 2024. The main objective of this study was to determine whether simulation-based training on hand hygiene knowledge and practices relating to palliative caregivers is better than theoretical training. This was a double blinded, randomized and controlled single centre study. It consisted of 60 caregivers in a palliative clinic between December 2022 and September 2023. The participants were spilt into two groups by randomisation, each group received the hand hygiene theoretical education and the same demonstration. The data was collected with hand hygiene knowledge, hand hygiene practice forms and personal information from the caregivers. The practice forms consisted of 15 questions about the caregivers' descriptive characteristics which included age, gender marital status, hygiene habits, education level, income level and employment status. Written consent was gained by all participants who agreed to be a part of the study. The simulation consisted of training interventions of groups of 5-6 people. 65% were female and 82.6% were high school graduates which is seen as a limitation due to the sample not being more diverse in the aspect of there being more females than males being tested and most candidates were educated. The education level of caregivers has shown to have an important role in the patients care and their wellbeing, this due to the increased risk of infection that has been shown by caregivers not having the right knowledge on hand hygiene. It has shown that simulation training has more benefits to hand hygiene than theoretical based training. Over 6 months after simulation-based training of hand hygiene it has shown an increase from 40.8% to 59.2%. A limitation of the study is that the sample size is small and that it is only a single centre. The benefits of this study have shown that random assignment of caregivers ensures there are no differences in characteristics between the groups.

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The Effect of Simulation-Based Training on the Hand Hygiene Knowledge and Practices of Palliative Caregivers: A Double-Blind, Randomized, Controlled Single-Center Study by Nurdan Yalcin (2024).

Nurdan Yalcin (2024) aims to investigate the effect of stimulation-based training on hand hygiene knowledge and practice among palliative caregivers. The participant was divided into two groups by the use of randomisation which includes 60 caregivers in a palliative care clinic between December 2022 and September 2023 in Turkey. The author utilises personal information form, hand hygiene knowledge form and hand hygiene practices form to collect for data collection. It is qualitative method.

Nurdan Yalcin (2024) states that stimulation-based training for healthcare professionals improves hand hygiene knowledge and practices. However, there is no structure search of literature to examined palliative caregivers in the chain of infection and support to ensure hand hygiene.

Some of the implementations the author uses are theoretical and practical training which enable participants to have a 10 minutes education via PowerPoint. Nurdan Yalcin (2024) emphasises that despite increased risk of infection with caregivers undertaking certain care duties without sufficient knowledge and equipment, education methods based on theoretical knowledge are often inadequate foe behavioural modification. Therefore, it is known that active learning is an effective method. The finding shows that training interventions can increase the adherence to hand hygiene  guidelines however, there is need of frequent repetition about hand hygiene adherence. The author emphasises the use of binding and administrations of stimulations based training by professionals, control group with random assignment to analyse the scores. However, the population is small with a single centre.

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The effect of simulation-based training on the hand hygiene knowledge and practices of palliative caregivers: A double-blind, randomized, controlled single-center study

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The effect of simulation-based training on the hand hygiene knowledge and practices of palliative caregivers: A double-blind, randomized, controlled single-center study

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The articles by Nurdan Yalcin Atar and Murat Koc (2024) look at hand hygiene practices of palliative caregivers through a simulation-based training. Between December 2022 and September 2023, 60 palliative caregivers over 18 years were part of the randomised study and divided them into two groups.

Qualitative research: The study was conducted to investigate palliative caregivers’ knowledge and practices on hand hygiene. It aimed to ensure there is continuation of palliative care after they have been discharged.

The main problem with this study is that it was only conducted in a single study. With that said, there was no difference between the two groups regarding descriptive characteristics. Analysing the posttet scores by using ANCOVA gave the strength of the study by using tools based on guidelines and expert opinions.

In conclusion, with the emphasis of the WHO guidelines in practising hand hygiene, there are still gaps in palliative care as some of the caregivers lack appropriate training which may lead to HAIs. There was also no other literature that conducted a structured study in hand hygiene for palliative caregivers.

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The study "The Effect of Simulation-Based Training on the Hand Hygiene Knowledge and Practices of Palliative Caregivers" looks at how simulation training can help caregivers improve their hand hygiene. Conducted between December 2022 and September 2023, it involved 60 caregivers who were divided into two groups. One group received simulation training, while the other only got theoretical education.

The study found that caregivers who participated in simulation training had better knowledge and practices related to hand hygiene than those who did not. The research was well-organised , using realistic scenarios and a standardised patient to help caregivers learn.

However, there are some weaknesses in the study. The sample size of 60 participants is relatively small, which may limit how widely the results can be applied. Larger studies could provide stronger evidence. Also, the study mainly focuses on short-term improvements in knowledge and skills, without checking if these improvements last over time.

Using simulation training is a strong point of the study because it allows caregivers to practice in a safe setting, making the training more relevant. Still, it would be useful to see how effective this training is in real-life situations where caregivers face different challenges.

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Nurden Yalcin Atar and Murat Koc conducted a study in a clinic providing palliative care in a clinic in Istanbul, Turkey.  The purpose of the study was to see if simulation-based training around handwashing was more beneficial than theoretical learning alone hey had 60 caregivers taking part in the study. They needed to be over 18, literate, able to communicate, and to be able to complete the data forms to be eligible for participation. The subjects were randomly split into two groups, half were given the simulation training. The study confirmed that the participants with the simulation-based training carried out better hand hygiene techniques. There were strengths to the study as it was carried out recently and ethics were considered as all participants were informed and consent forms were signed. The hand simulation practice was sourced from a credible organisation (world health organisation). However, the study only consisted of a small sample group which had more females than males. They were prepared for the test and was able to speak to each other. This could give false results as it is not a true simulation of real-life scenarios. They are also being observed, which would encourage participants to behave differently. There is not another study that they have compared results with. There are other care givers than just the participants, professionals, family members as an example. They also could spread infections between patients and also require training.

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The author Nurdan Yalsin (2024) conducted research on the effect of simulation-based training on the hand hygiene knowledge and practices of palliative caregivers. There aim was to provide a support and therapeutic services to manage symptoms and improve the quality of life of patients.

The study was conducted in a palliative care clinic between December 2022 and September 2023 and 60 caregivers were involved in Turkey.

The participant was those over 18 years of age, who can read and communicate verbally and record all the data collection forms correctly.

The tools used were a personal information form, hand hygiene knowledge form and hygiene practice form. Following the personal information there are 15 questions regarding characteristics which includes gender age and education level and belief in in the effectiveness of hand hygiene in preventing infection.  Caregivers were later assigned to intervention groups and the research informed them of the study and obtain their consent.

The result had a mean range of 43.85 13.64 years, and 65% were female demographics and mainly school graduate, and intervention and control groups had similar sociodemographic.

However other studies suggest that training intervention increase adherence to hand hygiene and limitation on this study is that it is a single centre and the population is small.

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The Effect of Simulation-Based Training on the Hand Hygiene Knowledge and Practices of Palliative Caregivers: A Double-Blind, Randomized, Controlled Single-Center Study

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The Effect of Simulation-Based Training on the Hand Hygiene Knowledge and Practices of Palliative Caregivers: A Double-Blind, Randomized, Controlled Single-Center Study

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The article by Nurdan Yalcin Atar and Mural Koc (2024) and participates: The Effect of Simulation-Based Training on the Hand Hygiene Knowledge and Practices of Palliative Caregivers: A Double-Blind, Randomized, Controlled Single-Center Study. The study can be condemned as biased as it only involved ladies within one hospital, and it was approved for everyone. Education was meant to be adhered to but today there are gaps of misunderstanding the principles even though was successfully improved. there is still missing information on the continuity in guidelines

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The Effect of Simulation-Based Training of the Hand Hygiene Knowledge and Practices of Palliative Caregivers: A Double -Blind, Randomized, Controlled Single-Center Study

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The Effect of Simulation-Based Training of the Hand Hygiene Knowledge and Practices of Palliative Caregivers: A Double -Blind, Randomized, Controlled Single-Center Study

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This qualitative study was conducted by Nurdan Yacin Atar and Murat Koc in Turkey by the Department of Fundamental Nursing at the University of Health Sciences. This investigation intends to evaluate the effectiveness of hand hygiene knowledge and practices among 60 palliative carers in one of the palliative care clinic. This study also aimed to increase the quality of life by improving their educational theory and practice on hand hygiene to reduce the risk of health infections, of which 16.5% of deaths are reported. This trial was carried during 9-months period, on two small groups middle aged health givers mainly female to ensure their receive the same hand hygiene training in line with World Health Organisation. In conclusion, good practice of hand hygiene can prevent health associated infections and safe lives.

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Topic: The effect of stimulation- based training on the hand hygiene knowledge and practices of palliative caregivers: A double blind, randomized, controlled single- centre study.

The name of the Author is Nurdan Yalcin Atar of the department of fundamentals of nursing, University of Health sciences Istanbul Turkey in a palliative care unit. The aims of this research was to investigate the effect of stimulation-based training on hand hygiene knowledge and practices among palliative caregivers. It was conducted with 60 caregivers in a palliative care unit. According to the writer, the intervention group received additional simulation based on hand hygiene practices recommended by the World health organisation.

Also, the author stated that palliative care involves patients and their families in a comprehensive framework that include the provision of support, communication and education. The education aspect of palliative care services provides necessary information of patients and caregivers should be able to practice hand hygiene.

The method used a prospective, double-blind, randomised controlled trail method to evaluate the effect of simulation-based hand hygiene training of palliative caregivers and the study was designed in accordance with the CONSORT. The participate was 18 years of age, being literate and able to communicate verbally and filling in the data forms completely. The sample size was determined by power analysis using the G power version 3.1 program and data collection tools use in the article was a personal information form, hand hygiene knowledge HHKF and hand hygiene practices HHPF.

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Topic: The effect of stimulation- based training on the hand hygiene knowledge and practices of palliative caregivers: A double blind, randomized, controlled single- centre study.

The name of the Author is Nurdan Yalcin Atar of the department of fundamentals of nursing, University of Health sciences Istanbul Turkey in a palliative care unit. The aims of this research was to investigate the effect of stimulation-based training on hand hygiene knowledge and practices among palliative caregivers. It was conducted with 60 caregivers in a palliative care unit. According to the writer, the intervention group received additional simulation based on hand hygiene practices recommended by the World health organisation.

Also, the author stated that palliative care involves patients and their families in a comprehensive framework that include the provision of support, communication and education. The education aspect of palliative care services provides necessary information of patients and caregivers should be able to practice hand hygiene.

The method used a prospective, double-blind, randomised controlled trail method to evaluate the effect of simulation-based hand hygiene training of palliative caregivers and the study was designed in accordance with the CONSORT. The participate was 18 years of age, being literate and able to communicate verbally and filling in the data forms completely. The sample size was determined by power analysis using the G power version 3.1 program and data collection tools use in the article was a personal information form, hand hygiene knowledge HHKF and hand hygiene practices HHPF.