Hand-touch contact assessment of high-touch and mutual-touch surfaces among healthcare workers, patients, and visitors
Hand-touch contact assessment of high-touch and mutual-touch surfaces among healthcare workers, patients, and visitors
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DOI：
10.1016/j.jhin.2014.12.024
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发表时间：
2015-07-01
影响因子：
6.9
通讯作者：
Yuen, K. Y.
中科院分区：
文献类型：
--
作者：
Cheng, V. C. C.;Chau, P. H.;Yuen, K. Y.
背景：与直接接触患者身体不同，卫生保健工作者（HCWs）和探视者在接触患者环境后往往忽视手卫生。接触医院环境物品可能增加病原体传播的风险。目的：统计病人、医护人员及访客接触医院环境物品的次数。方法：采用直接观察的方法，在急症病房6个床位的小隔间内记录33个工作日的人与物品接触事件。分析医护人员、患者和访客高接触频率的高接触和互接触项目。结果：66小时共观察到1107例病例，6144例接触者（平均每小时16.8例病例，93.1例接触者）。在前10个高接触物品中，有8个被医护人员、患者和访客相互接触，包括床头柜、床头柜、患者身体、患者档案、床单、床帷、床架和储物柜。床头柜高居榜首，平均每小时有13.6例接触病例，床头柜次之（每小时12.3例接触病例）。以患者身体接触为参照，发现医护人员和护理人员接触床头柜（RR分别为1.741、1.427）和患者档案（RR分别为1.358、1.324）的次数多于患者身体，护理人员接触床边扶手的次数也多于患者身体（RR为1.490）。结论：患者的环境可能是医院感染传播的环节，因为医护人员、患者和访客经常接触和相互接触。因此，对于高接触性和互接触性物品，应加强手卫生教育、环境消毒等制度变革的重点。(C) 2015年卫生保健感染学会。Elsevier Ltd.出版。版权所有。
Background: Unlike direct contact with patients' body, hand hygiene practice is often neglected by healthcare workers (HCWs) and visitors after contact with patients' environment. Contact with hospital environmental items may increase risk of pathogen transmission.Aim: To enumerate the number of hand-touch contacts by patients, HCWs and visitors with any hospital environmental items.Methods: All contact-episodes between person and item were recorded by direct observation in a six-bed cubicle of acute wards for 33 working days. High-touch and mutualtouch items with high contact frequencies by HCWs, patients, and visitors were analysed.Findings: In total, 1107 person-episodes with 6144 contact-episodes were observed in 66 observation hours (average: 16.8 person-episodes and 93.1 contact-episodes per hour). Eight of the top 10 high-touch items, including bedside rails, bedside tables, patients' bodies, patients' files, linen, bed curtains, bed frames, and lockers were mutually touched by HCWs, patients, and visitors. Bedside rails topped the list with 13.6 contact-episodes per hour (mean), followed by bedside tables (12.3 contact-episodes per hour). Using patients' body contacts as a reference, it was found that medical staff and nursing staff contacted bedside tables [rate ratio (RR): 1.741, 1.427, respectively] and patients' files (RR: 1.358, 1.324, respectively) more than patients' bodies, and nursing staff also contacted bedside rails (RR: 1.490) more than patients' bodies.Conclusion: Patients' surroundings may be links in the transmission of nosocomial infections because many are frequently touched and mutually contacted by HCWs, patients, and visitors. Therefore, the focus of hand hygiene education, environmental disinfection, and other system changes should be enhanced with respect to high-touch and mutualtouch items. (C) 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.