The misuse and overuse of non-sterile gloves: application of an audit tool to define the problem.
The misuse and overuse of non-sterile gloves: application of an audit tool to define the problem.
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DOI：
10.1177/1757177414558673
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发表时间：
2015-01-01
影响因子：
1.2
通讯作者：
Loveday, Heather
中科院分区：
文献类型：
--
作者：
Wilson, Jennie;Prieto, Jacqui;Loveday, Heather
背景技术背景：非无菌手套（NSG）的使用已成为医疗保健服务中的常规，通常用于不需要手套的程序;它们的使用可能会增加交叉污染的风险，并且通常不会纳入手部卫生审核。本文介绍了一个小规模的应用和验证的观察审计工具，旨在确定不适当的使用NSG和潜在的交叉contamination.METHODS：两个观察员同时观察使用NSG在急性医院环境中的护理事件。评估者间的可靠性（IRR）的审计工具进行测量，纠正机会协议使用Kappa.RESULTS：共22集的护理使用NSG进行了观察。在68.6%（24/35）的手术中，未接触血液/体液;在54.3%（19/35）的手术中，NSG使用不当。该工具12个组成部分中有8个的内部收益率为100%。对于NSG去除前后的手部卫生，分别为82%（Kappa = 0.72）和95%（Kappa = 0.87）。结论：在这种小规模应用手套使用审计工具中，我们证明了过度使用和误用NSG以及戴手套双手交叉传播的可能性。审计工具提供了一个有效的机制，将手套的使用纳入手部卫生行为的审计。
BACKGROUND: The use of non-sterile gloves (NSG) has become routine in the delivery of health care, often for procedures for which they are not required; their use may increase the risk of cross contamination and is generally not integrated into hand hygiene audit. This paper describes a small-scale application and validation of an observational audit tool devised to identify inappropriate use of NSG and potential for cross contamination.METHODS: Two observers simultaneously observed the use of NSG during episodes of care in an acute hospital setting. The inter-rater reliability (IRR) of the audit tool was measured corrected for chance agreement using Kappa.RESULTS: A total of 22 episodes of care using NSG were observed. In 68.6% (24/35) of procedures there was no contact with blood/body fluid; in 54.3% (19/35) NSG-use was inappropriate. The IRR was 100% for eight of 12 components of the tool. For hand hygiene before and after NSG removal it was 82% (Kappa = 0.72) and 95% (Kappa = 0.87).CONCLUSIONS: In this small-scale application of a glove-use audit tool we demonstrated over-use and misuse of NSG and potential for cross transmission on gloved hands. The audit tool provides an effective mechanism for integrating glove use into the audit of hand hygiene behaviour.