Infection Control

This study will develop and evaluate a metaverse-based infection control room of errors education program (META-ICR) for nursing students. A metaverse is an interactive, three-dimensional online environment. In META-ICR, students use a computer and mouse to explore a virtual patient room through an avatar. The study will compare this program with a physical patient room arranged with the same infection control situations. The study will include approximately 110 first-year nursing students at Çankırı Karatekin University in Türkiye. Students will be assigned by chance to either the META-ICR group or the physical room of errors group. Both groups will examine the same patient scenario and identify appropriate and inappropriate infection control practices. Topics will include hand hygiene, protective equipment, isolation precautions, handling of clean and contaminated materials, waste and linen management, and urinary drainage systems. Students in the META-ICR group will record their observations and care decisions through a web-based interface. Students in the physical room group will use paper forms. Both groups will receive feedback with the same educational content and participate in a 15-minute guided discussion after the activity. Activities will take place under similar supervision in university laboratory settings. The study will compare infection control knowledge, perceptions of the metaverse, and satisfaction with learning between the groups. Knowledge will be assessed before education, immediately after the educational session and guided discussion, and four weeks later to assess retention. Metaverse perceptions will be assessed before and immediately after education. Learning satisfaction will be assessed after education. All research questionnaires and knowledge tests will be completed on paper in both groups. The findings will help determine how an interactive virtual room compares with a physical room of errors for teaching infection control to nursing students.

Hand, foot and mouth disease (HFMD) is endemic in Malaysia and disproportionately affects children in childcare settings, where institutional infection prevention and control (IPC) capacity is frequently inadequate. This study develops and evaluates two linked tools: CHIPCAT (Childcare Infection Prevention Capacity Assessment Tool), which generates the Infection Prevention Capacity Index (IPCI) as an institutional capacity score, and HFMD-PREP (HFMD Prevention and Response Enhancement Programme), a structured capacity-building intervention mapped to CHIPCAT domains. Following instrument development and validation, the intervention is evaluated using a stepped-wedge cluster randomised trial (SW-CRT) across 12 licensed childcare centres in Kota Kinabalu, Sabah, Malaysia. All centres receive HFMD-PREP by the end of the study; only the timing of crossover differs by randomised sequence. The primary outcome is the change in IPCI. Secondary outcomes are staff and parent knowledge, attitude and practice (KAP) scores. HFMD incidence is analysed as an exploratory secondary disease outcome. This study is also registered with the Malaysian National Medical Research Register (NMRR ID RSCH ID-26-05258-LQ3), with parallel ethics submission to the Ministry of Health Malaysia Medical Research Ethics Committee (MOH MREC).