Comprehensive survey of hand hygiene measurement and improvement practices in the Veterans Health Administration
Comprehensive survey of hand hygiene measurement and improvement practices in the Veterans Health Administration
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DOI：
10.1016/j.ajic.2013.04.016
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发表时间：
2013-11-01
影响因子：
4.9
通讯作者：
Perencevich, Eli
中科院分区：
文献类型：
--
作者：
Reisinger, Heather Schacht;Yin, Jun;Perencevich, Eli
工作背景：退伍军人健康管理局（VHA）是一个全国性的医疗保健系统，其设施中的手部卫生（HH）测量和改进实践各不相同。本次全国调查的目的是表征这种变异性，并确定机会standardization.Methods：调查涵盖了3个主要领域的HH：（1）测量HH合规性的方法，（2）干预措施，以提高HH合规性，（3）网站的具体目标HH compliance.Results：一百四十一（100%）VHA医疗中心返回的调查。大多数（98.6%）医疗中心进行直接观察以测量HH依从率。不到一半（45.3%）的人在一开始就验证了观察者的过程，更少的人（39.6%）继续验证观察者。被认为是HH机会的主要行为是进入房间（69.1%）和离开房间（71.9%）。改进干预措施包括海报（97.2%）、反馈（例如，98.6%向领导提供反馈）和改善HH产品的获取（例如，90.6%向员工提供个人洗手液）。88.5%的医疗中心开展了临床工作人员的义务教育方案。结论：尽管VHA医疗中心的卫生保健改善措施相对相似，但卫生保健的依从性监测存在差异。调查结果将有助于标准化的监督和手卫生政策在VHA的下一步。爱思唯尔公司出版我代表感染控制和流行病学专业人员协会，
Background: Veterans Health Administration (VHA) is a national health care system with variation in hand hygiene (HH) measurement and improvement practices across its facilities. The objective of this national survey was to characterize this variability and identify opportunities for standardization.Methods: Survey covered 3 major areas of HH: (1) methods of measuring HH compliance, (2) interventions to improve HH compliance, and (3) site-specific targets for HH compliance.Results: One hundred forty-one (100%) VHA medical centers returned the survey. A majority (98.6%) of the medical centers conduct direct observations to measure HH compliance rates. Fewer than half (45.3%) validate the observer process at the onset, and fewer still (39.6%) continue to validate observers. Main behaviors that are considered HH opportunities are room entry (69.1%) and exit (71.9%). Improvement interventions include posters (97.2%), feedback (eg, 98.6% to leadership), and improved access to HH products (eg, 90.6% provide individual hand sanitizers to staff). Mandatory education programs for clinical staff are conducted in 88.5% of the medical centers. The majority of the medical centers (77.3%) set their HH compliance target over 90%.Conclusion: Although HH improvement interventions are relatively similar across VHA medical centers, variation exists in compliance monitoring. Findings will assist in standardizing surveillance and next steps in hand hygiene policy in VHA. Published by Elsevier Inc. on behalf of the Association for Professionals in Infection Control and Epidemiology, Inc.