Graduation Year


Document Type

Senior Thesis


Bachelor of Science in Nursing

Primary Major


Thesis Advisor

Patricia Harris, PhD, RN, CNS


During our community health clinical rotation in a public school, we observed abundant absences in the kindergarten class, which led us to inquire: What is the possible cause for the multiple absences? Further, we noticed that the students had a hand hygiene knowledge deficit. These observations led us to hypothesize that due to direct contact transmission many absences were related to infection-related illnesses, and without proper technique and understanding of hand washing, infectious diseases will continue to have a high probability of transmission in schools. The objective of our investigation is to identify the prevalence of this issue in communities and identify a program that can be implemented to enhance the youth’s understanding of and compliance with proper hand washing.

We performed a literature review and found that evidence supports our observations about school absenteeism and our hypothesis that implementing a hand hygiene program in schools may lead to a decrease in the prevalence. Therefore, the additional research question we are focusing on is, “Does an education program on infection precautions decrease absentee rates in schools?” We carefully reviewed twelve articles examining infection transmission and hand-washing education. We found that students who do not receive educational interventions are more likely to get sick than the students who did receive the intervention. Interventions include hand-washing tips, a curriculum for infection prevention, and posters. To test our hypothesis, a mixed-method, comparative study is proposed that will provide a hand hygiene program and questionnaire to schools in Marin County. Our prospective study will compare school absentee outcomes for an intervention group and a control group to see how the two differ when provided with the current practice of informal recommendations, as needed, versus a structured educational plan over the course of one school year. We also will examine satisfaction with the handwashing educational intervention.