Assessment of Teacher Knowledge of Effective Infection Prevention Interventions in an Archdiocesan Elementary School Setting Open Access

Satchell, Lauren (Spring 2020)

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School aged children and teachers miss millions of school days each year due to upper respiratory and gastrointestinal viral infections.  As a result, these acute infections can lead to increased time away from work or school, loss of wages, increased healthcare costs, and decreased productivity.  With many elementary schools dealing with a shortage of school nurses, students have come to rely on teachers and school administrators for health related concerns and education. Because of this, it has become increasingly important for elementary school teachers to understand upper respiratory and gastrointestinal transmission and basic infection prevention practices in elementary schools. In order to understand what elementary school teachers understand about upper respiratory and viral transmission, we developed and distributed a quantitative survey to Archdiocesan elementary school teachers in Delaware County Pennsylvania, with a focus on Kindergarten through 8th grade teachers. Questions included basic infection prevention practices about hand hygiene, cleaning and disinfection, and viral transmission and one question about influenza vaccinations.

              67 out of 281 survey responses were submitted and analyzed. More than half of the respondents (54%) were primary elementary school teachers with at least 11 years of experience. Almost all (93%) of participants had access to hand hygiene products and/or soap and water and sink, tissues, and disinfecting product. Most of the elementary school teachers (99%) were knowledgeable about fomite transmission.  However, very few participants (40%) correctly answered questions on proper hand hygiene techniques and also other transmission based questions (17%). Of the teachers who did not receive the flu vaccine, slightly less than half (46%) listed that the flu vaccine will make them sick with influenza or that flu vaccines do not work as their reason for not receiving the influenza vaccine.

There are additional opportunities for education on infection prevention practices and respiratory and gastrointestinal viral transmission for elementary school teachers of grades Kindergarten through 8th grade in Delaware County, PA. 

Table of Contents

Abstract iv

CHAPTER 1: Introduction. 1

1.     Background and Significance. 1

1.2 Delaware County, Pennsylvania. 3

1.3 Problem Statement 5

1.4 Purpose statement 7

1.5 Research questions: 8

1.6 Theoretical framework. 8

The Health Belief Model 9

Ecological model 11

1.7 Significance Statement 12

1.8 Definition of terms. 14

CHAPTER 2: Literature Review.. 15

2.1 Overview of respiratory and gastrointestinal illnesses. 15

Gastrointestinal Illness. 15

Gastrointestinal Viral Illness. 16

Bacterial and Parasitic gastrointestinal illness. 17

Influenza. 18

Respiratory Viral Illnesses. 19

2.2 Impact of gastrointestinal and upper respiratory viral infection on school aged children in the United States. 23

2.3 School nursing shortage. 24

2.4 Prevention of upper respiratory and gastrointestinal infection transmission in the community and schools. 25

2.5 Delaware County, PA and the Archdiocese of Philadelphia. 27


3.1 Study Design. 29

3.2 Protection of Human Subjects. 29

3.3 Population and Sample. 29

3.3 Study Instrument (Survey) 31

Distribution and follow-up. 32

Data Analysis and Methodology. 32

CHAPTER 4 Results. 33

4.1 Introduction. 33

4.2 Key Findings. 33

4.3 Other Findings. 36


5.1 Introductory Paragraph. 39

5.2 Main discussion points. 39

Access to respiratory etiquette supplies and hand hygiene challenges. 39

Results from transmission based questions. 41

Perception and Misconceptions about influenza vaccine. 41

5.4 Strengths and limitations. 42

5.5 Implications. 43

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