Evaluation of hand hygiene adherence in a tertiary hospital
Evaluation of hand hygiene adherence in a tertiary hospital
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DOI：
10.1016/j.ajic.2007.03.007
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发表时间：
2007-12-01
影响因子：
4.9
通讯作者：
Castells, Xavier
中科院分区：
文献类型：
--
作者：
Novoa, Ana M.;Pi-Sunyer, Teresa;Castells, Xavier
背景资料：虽然手卫生是最重要的措施，在预防医院感染，坚持建议之间的卫生保健工作者（HCW）是低的评价遵守手卫生进行了西班牙教学hospital.Methods：在2005年。通过直接观察，收集关于在任何指示（手卫生的机会）时进行的手卫生的数据，在医院范围内评价对手卫生的坚持。依从性定义为根据医院方案洗手/消毒以保持手部卫生。结果进行了分析，使用混合效应模型，与HCW观察作为随机effect.Results：共1254手卫生的机会，观察247 HCWs。平均依从性为20%。尽管在不同类型的HCW之间观察到的差异很小。依从性根据医院区域（69%在重症监护室[ICU]）和患者接触时间（接触后的依从性是接触前的两倍）而变化。多变量分析显示ICU中不依从的保护性比值比（OR）（OR，0.04; 95%置信区间（95% CI）：0.01 - 0.10）和患者接触后（OR，0 - 25; 95%CI：0.17 - 0.38）。观察到的低坚持率表明，新的干预措施应侧重于改变保健工作者的习惯和态度，在以下几个层面开展工作：个人和机构。
Background: Although hand hygiene is the most important measure in the prevention of nosocomial infection, adherence to recommendations among health care workers (HCW) is low Evaluation of compliance with hand hygiene was carried out in a Spanish teaching hospital.Methods: In 2005. adherence to hand hygiene was evaluated hospital wide through direct observation, collecting data on hand hygiene carried out whenever indicated (opportunity for hand hygiene). Compliance was defined as handwashing/disinfection in an opportunity for hand hygiene according to hospital protocols. The results were analyzed using mixed effects models, with the HCW observed as the random effect.Results: A total of 1254 opportunities for hand hygiene were observed in 247 HCWs. Mean compliance was 20%. Although few differences were observed among types of HCW. compliance varied according to hospital area (69% in the intensive care unit [ICU]) and timing with respect to patient contact (compliance after contact was twice that before contact). Multivariate analyses revealed a protective odds ratio (OR) for nonadherence in ICUs (OR, 0.04; 95% confidence interval (95% CI): 0.01-0.10) and after patient contact (OR, 0-25; 95% Cl: 0.17-0.38).Conclusion: Low adherence observed suggests that new interventions should focus in modification of HCWs' habits and attitudes, working at several levels: individual and institutional.