Decreasing Hospital-Associated Rotavirus Infection: A Multidisciplinary Hand Hygiene Campaign in a Children's Hospital
Decreasing Hospital-Associated Rotavirus Infection: A Multidisciplinary Hand Hygiene Campaign in a Children's Hospital
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减少医院相关轮状病毒感染：儿童医院的多学科手部卫生运动
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
E. Bennett
中科院分区：
文献类型：
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作者：
D. Zerr;Amanda L Allpress;J. Heath;Rena Bornemann;E. Bennett
目的：手卫生是预防医院感染的有效手段，但医护人员的依从性较差。很少有旨在提高医院环境中手部卫生的研究表明医院相关感染持续改善并同时减少，在儿科环境中进行的研究更少。方法：我们实施了手部卫生计划，希望改善手部卫生并降低医院相关的轮状病毒感染率。一个多学科小组发起了一项医院支持的全院范围内的活动。在 5 个时期内观察了手部卫生的机会。通过审查实验室记录来跟踪医院相关轮状病毒感染的频率。使用多元逻辑回归研究手部卫生的相关性。结果：总体手部卫生依从性从第 1 阶段的 62% 提高到第 5 阶段的 81% (P < 0.001)。肥皂和水是最常用的手部卫生方法，在第一个观察期和最后一个观察期之间，酒精洗手液的使用率从 4% 增加到 29% (P < 0.001)。医院相关轮状病毒感染率从2001年的每1000名出院患者5.9次下降到2004年的每1000名出院患者2.2次（P=0.01）。观察时间、医院病房、护理人员类型和执行的护理类型均与手卫生独立相关（调整后的 P ≤ 0.02）。结论：改善手部卫生是医疗机构的一个重要目标。这些数据可用于制定旨在改善手部卫生的干预措施。
Objective: Hand hygiene is an effective means of preventing hospital-associated infection, but compliance among health care workers is poor. Few studies aimed at increasing hand hygiene in the hospital setting have shown sustained improvement and concurrent decreases in hospital-associated infections, and even fewer have been performed in the pediatric setting. Methods: We implemented a hand hygiene program with the hopes of improving hand hygiene and decreasing hospital-associated rotavirus infection rates. A multidisciplinary group developed a hospital supported, house-wide campaign. Opportunities for hand hygiene were observed during 5 periods. The frequency of hospital-associated rotavirus infection was tracked over time by review of laboratory records. Correlates of hand hygiene were investigated with the use of multivariate logistic regression. Results: Overall hand hygiene compliance improved from 62% in period 1 to 81% in period 5 (P < 0.001). Soap and water was the most common method for practicing hand hygiene, and alcohol hand gel use increased from 4% to 29% between the first and last observation periods (P < 0.001). The rate of hospital-associated rotavirus infection decreased from 5.9 episodes per 1000 discharged patients in 2001 to 2.2 episodes per 1000 discharged patients in 2004 (P = 0.01). Period of observation, hospital ward, type of care provider and type of care performed were all independently associated with hand hygiene (adjusted P ≤ 0.02 for all). Conclusion: Improving hand hygiene is an important goal for health care institutions. These data can be useful for development of interventions aimed at improving hand hygiene.