Frequency of Patient Contact with Health Care Personnel and Visitors: Implications for Infection Prevention
Frequency of Patient Contact with Health Care Personnel and Visitors: Implications for Infection Prevention
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DOI：
10.1016/s1553-7250(12)38073-2
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发表时间：
2012-12-01
影响因子：
2.3
通讯作者：
Larson, Elaine
中科院分区：
文献类型：
--
作者：
Cohen, Bevin;Hyman, Sandra;Larson, Elaine
背景资料：与医护人员的接触可能是患者之间感染传播的重要途径，但人们对患者与医院工作人员和访客的接触模式知之甚少。在一项横断面研究中，频率，类型和持续时间的接触，由卫生保健工作者，其他医院工作人员，和游客在急性护理settings.Methods：患者进行了观察，在七个单位的三个学术医院，记录每个发生的人的进入病人的房间。记录了医护人员的角色、访视持续时间和最高级别的患者接触。工作人员还进行了调查，以确定他们的看法有多少病人每小时他们接触，他们花了多长时间与病人，和病人接触的水平发生。调查结果：每小时的房间条目范围从0到28每个病人（中位数，5.5），和病人接受访问从0到18个不同的人每小时（中位数，3.5）。护士进行了最多的访问（45%），其次是私人访客（23%），医务人员（17%），非临床工作人员（7%）和其他临床工作人员（4%）。访视持续1至124分钟（所有组的中位数为3分钟）。进入患者房间的人在房间内没有接触任何东西，只有22%，33%，27%和18%的时间分别接触环境，患者的完整皮肤或患者的血液/体液。医务人员估计平均每小时访问2.8个不同的病人（范围，0.5-7.0），和护理人员估计平均每小时访问4.5个不同的病人（范围，0.5-18.0）。结论：检查模式的患者接触可能会提高医院的传播动力学的理解。新的传播模型应该考虑到卫生保健工作者的作用，而不仅仅是为患者分配的护士和医生。
Background: Contact with health care workers may be an important means of infection transmission between patients, yet little is known about patterns of patient contact with staff and visitors in hospitals. In a cross-sectional study, the frequency, type, and duration of contacts made by health care workers, other hospital staff, and visitors to patients in acute care settings were documented.Methods: Patients were observed in seven units of three academic hospitals, with recording of each occurrence of someone's entry into the patient's room. The health care worker's role, the duration of the visit, and the highest level of patient contact made were noted. Staff were also surveyed to determine their perception of how many patients per hour they come into contact with, how long they spend with patients, and the level of patient contact that occurs.Findings: Hourly room entries ranged from 0 to 28 per patient (median, 5.5), and patients received visits from 0 to 18 different persons per hour (median, 3.5). Nurses made the most visits (45%), followed by personal visitors (23%), medical staff (17%), nonclinical staff (7%), and other clinical staff (4%). Visits lasted 1 to 124 minutes (median, 3 minutes for all groups). Persons entering patients' rooms touched nothing inside the room, only the environment, the patient's intact skin, or the patient's blood/body fluids 22%, 33%, 27%, and 18% of the time, respectively. Medical staff estimated visiting an average of 2.8 different patients per hour (range, 0.5-7.0), and nursing staff estimated visiting an average of 4.5 different patients per hour (range, 0.5-18.0).Conclusions: Examining patterns of patient contact may improve understanding of transmission dynamics in hospitals. New transmission models should consider the roles of health care workers beyond patients' assigned nurses and physicians.