Clinical glove use: healthcare workers' actions and perceptions
Clinical glove use: healthcare workers' actions and perceptions
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DOI：
10.1016/j.jhin.2013.11.003
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发表时间：
2014-02-01
影响因子：
6.9
通讯作者：
Wilson, J.
中科院分区：
文献类型：
--
作者：
Loveday, H. P.;Lynam, S.;Wilson, J.
背景：不正确使用临床手套以及在手术之间未能更换手套会增加交叉传播的风险。人们非常关注手部卫生的遵守情况。目的：调查手套的使用、交叉污染的可能性以及影响医护人员 (HCW) 佩戴手套的决定的因素。方法：在英国一家信托医院的六个病房中观察手套的使用情况。交叉污染的风险被定义为在使用手套期间违反“手部卫生时刻”。对观察审计中包含的病房的 25 名医护人员进行了访谈，以确定戴手套的司机。调查结果：在 13 小时内，总共观察到 163 次戴手套事件。在 163 起事件中，有 69 起 (42%) 事件中手套使用不当，其中手套通常不恰当地用于低风险操作 (34/37；92%)。在 163 次使用手套的事件中，有 60 次 (37%) 存在交叉污染风险，其中大多数 (48%) 与未脱下手套或使用后未进行手部卫生有关。医护人员的采访表明，戴手套的决定受到社会化和情感的影响。主要情绪是厌恶和恐惧。患者更喜欢使用手套的假设、对何时佩戴手套的困惑以及社会规范和同伴压力也是重要的影响。结论：手套的使用与交叉污染的风险相关，应更明确地纳入手部卫生政策中。需要了解手套使用行为的驱动因素来设计干预措施以减少误用和过度使用。 (C) 2013 年医疗保健感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: The incorrect use of clinical gloves and the failure to change them between procedures increases the risk of cross-transmission. Much attention has been focused on compliance with hand hygiene.Aim: To investigate the use of gloves, their potential for cross-contamination, and factors that influence the decision of healthcare workers (HCWs) to wear them.Methods: The use of gloves was observed in six wards in a single UK hospital trust. Risk of cross-contamination was defined as a violation of a 'moment of hand hygiene' during the glove-use episode. Twenty-five HCWs from the wards included in the observational audit were interviewed to identify the drivers for glove use.Findings: A total of 163 glove-use episodes were observed over a period of 13 h. Glove use was inappropriate in 69 out of 163 (42%) episodes, with gloves commonly used inappropriately for low-risk procedures (34/37; 92%). In 60 out of 163 (37%) episodes of glove use there was a risk of cross-contamination, most (48%) being associated with failure to remove gloves or with performing hand hygiene after use. HCW interviews indicated that the decision to wear gloves was influenced by both socialization and emotion. Key emotions were disgust and fear. Assumptions that patients preferred gloves to be used, confusion about when to wear them, and social norms and peer pressure were also important influences.Conclusion: Glove use is associated with risk of cross-contamination and should be more explicitly integrated into hand hygiene policy. An understanding of the drivers of glove-use behaviour is required to design interventions to reduce misuse and overuse. (C) 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.