IJNHCR

Introduction

As a key area for hospital infection control, the cleanliness and final disinfection quality of the operating room directly affect the safety of surgical patients and the incidence of hospital infections. Numerous studies have shown that outbreaks of infections related to environmental cleanliness and quality in medical institutions have good cost-effectiveness in reducing patient infection rates [1]. The operating room is one of the high-risk departments for hospital infections. Proper handling of postoperative dressings, instruments, and operating rooms can effectively reduce cross infection [2]. There are studies indicating that effective terminal disinfection and prevention measures can greatly reduce the transmission rate of pathogenic microorganisms in surgical infections [3]. Therefore, enhancing the quality of terminal disinfection has a positive effect on the prevention and control of postoperative infections. Therefore, in order to further control hospital acquired infections, it is essential to carry out terminal disinfection. The main purpose of this study is to investigate the status and influencing factors of knowledge, attitude, and practice of surgical terminal disinfection among operating room nurses. The specific situation is as follows

Data and Methods

Survey Subjects

Using convenience sampling method, a survey was conducted on 100 operating room nursing staff from a tertiary Grade A comprehensive hospital in Guangzhou from May 2025 to August 2025. Inclusion criteria: 1. Operating room nurse with at least 1 year of work experience in the operating room; 2. Obtained a clinical nurse practice certificate; 3. Voluntarily participate in this survey research. Exclusion criteria: 1. Internship and training nurses; 2. Due to various reasons, I am unable to cooperate in completing the investigation and research.

Method

General Information Collection

According to a self-designed survey questionnaire, collect the gender, age, education level, professional title, work experience, professional title, whether they have received specialized training in terminal disinfection, and the number of special infection surgeries they have participated in in in the past year for all survey respondents.

Investigation on Knowledge, Beliefs and Practices of Terminal Disinfection.

Based on the actual situation of the hospital, a survey questionnaire titled “Knowledge, Attitude, and Practice Scale for Terminal Disinfection of Operating Room Nursing Staff” was developed. The questionnaire mainly refers to documents such as “Technical

Specifications for Disinfection in Medical Institutions”, “Technical Specifications for Hospital Isolation”, “Technical Specifications for Disinfection in Medical Institutions”, and “Scoring Standards for Terminal Disinfection Inspection in Operating Rooms”. The content includes knowledge, attitude, and behaviour (KAP), and the scale consists of three dimensions: knowledge (15 items), attitude (8  items), and behaviour (12 items), with a total of 35 items. Using the Likert 5-point rating system, the higher the score, the better.

Quality Control

Distribute basic information survey forms to operating room nurses and conduct a knowledge, belief, and behaviour survey. Before filling out the survey form, provide a detailed introduction to the content and precautions. After filling out the form, collect it uniformly and proofread the collected survey questionnaire content. A total of 100 questionnaires were distributed in this survey, and 100 were effectively collected, with an effective response rate of 100%.

Statistical Methods

SPSS 24.0 was used for statistical analysis. Quantitative data is represented by (`x ± s) and subjected to t-test or analysis of variance for statistical analysis. Logistic regression analysis was used to investigate the influencing factors on the knowledge, beliefs, and practices of terminal disinfection among operating room nursing staff. P<0.05 indicates statistical significance of the difference.

Results

Score of Knowledge, Belief and Practice of Terminal Disinfection for Operating room Nursing Staff

This study conducted descriptive statistical analysis on the score status of KAP in various dimensions of the research subjects. The results showed that nursing staff had the highest score rate in the behavioural dimension (93.7%), followed by the knowledge dimension (87.5%), and the attitude dimension had the relatively lowest score rate (78.2%), but all three were above a good level. It is worth noting that there is a significant structural imbalance within the knowledge dimension, with an overall difference of “partially weak and partially solid”. Specifically, practical knowledge modules directly related to clinical operations, such as “Disinfectant Use” (80.0%), “Clean Disinfectants” (81.3%), and “Special Infection Medical Waste Treatment” (82.7%), have a high scoring rate. However, in the basic theoretical knowledge modules such as “Basic Knowledge of Infectious Surgery” (32.3%) and “Classification of infectious diseases” (34.0%), the scoring rate

was significantly lower. This phenomenon suggests that the research subjects may exhibit strong adherence to operational procedures, but there are significant shortcomings in the deep theoretical understanding that supports their behaviour. Although a positive professional attitude (with scores above 82% for each sub item) and highly standardized operating procedures ensure high-level performance at the behavioural level, the lack of basic theoretical knowledge may pose potential risks when dealing with non-standardized or sudden infection control situations. Table 1.

Table 1: Descriptive Statistical Analysis of the Status of Knowledge, Beliefs, and Practices of Terminal Disinfection among Operating Room Nursing Staff.

Single Factor Analysis of Final Disinfection of Operating Room Nursing Staff

The single factor analysis of this study aims to preliminarily screen for relevant factors that may affect the final disinfection KAP level of operating room nursing staff. The analysis clearly reveals that variables related to postnatal career development, rather than demographic characteristics, are the main reasons for the differences in KAP levels. The results showed that there was no statistically significant difference (P>0.05) in the scores of KAP dimensions for variables such as gender, professional title, and education level. In contrast, the variables of receiving specialized training, participating in special infection surgeries in the past year, and years of work experience showed significant positive effects on all dimensions of KAP (P<0.05). Specifically, nursing staff who received specialized training had significantly higher average scores in knowledge, attitude, and behaviour compared to non-recipients (P<0.001), confirming the fundamental role of systematic education. The cumulative effect of practical experience is also significant.

Nurses who participate in special infection surgeries ≥ 7 times have significantly better knowledge and behavior scores than those who participate less frequently (P ≤ 0.001), highlighting the key value of high-frequency practice in knowledge consolidation and skill transformation. In addition, as a reflection of long-term experience, the influence of work experience shows a trend of increasing with age (P<0.05), indicating the long-term internalization effect of professional experience. In summary, the results of the univariate analysis indicate that establishing a theoretical foundation through systematic training, consolidating it through high-frequency clinical practice, and continuously internalizing it in long-term careers are the core paths to enhance the professional competence of nursing staff in terminal disinfection. Please refer to Table 2 for details.

Table 2: Single Factor Analysis of Factors Influencing Knowledge Attitude Behaviour Scores.

Logistic Regression Analysis of Final Disinfection of Operating Room Nursing Staff

To further explore the independent influencing factors on the final disinfection KAP level of operating room nursing staff, this study divided them into high and low scores of knowledge, attitude, and behaviour as dependent variables, and included variables with statistical significance in univariate analysis into a multivariate logistic regression model. The regression analysis identified that years of work experience, whether or not they received specialized training, and the number of times they participated in special infection surgeries were common and independent predictive factors affecting the three dimensions of KAP (all P<0.05). Among them, the effect of specialized training is particularly significant, with the odds ratio (OR) of knowledge scores in the high group of trainees being 6.56 times higher than that of non-trainees (95% CI: 2.140-20.079). Similarly, the increase in work experience and number of surgeries significantly increased the probability of KAP scores entering the high group. This discovery provides clear evidence-based support for managers: the key to improving the professional level of terminal disinfection for nursing staff lies in implementing systematic training and providing sufficient clinical practice opportunities Table 3 for details.

Table 3: Multivariate Logistic Regression Analysis of Nurses’ Knowledge Attitude Behaviour in Terminal Disinfection.