Hand hygiene compliance monitoring: current perspectives from the USA
Hand hygiene compliance monitoring: current perspectives from the USA
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DOI：
10.1016/s0195-6701(08)60003-1
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发表时间：
2008-10-01
影响因子：
6.9
通讯作者：
Boyce, John M.
中科院分区：
文献类型：
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作者：
Boyce, John M.
监测手部卫生依从性并向医护人员提供有关其表现的反馈被认为是成功的手部卫生促进计划的组成部分。由受过训练的人员直接观察护理提供者目前被认为是黄金标准。优点包括能够确定是否在正确的时间进行手部卫生，建立卫生保健工作者类型的依从率，并评估手部卫生技术。然而，观察调查是耗时的，只允许观察所有手卫生机会的一小部分，并可能受到评分者间可靠性的影响。由于遵守标准和观察技术的标准化，比较通过观察调查获得的遵守率是有问题的。自我报告遵守情况的可靠性不足以发挥作用。监测手部卫生产品的使用需要更少的时间，并且可以持续进行，并且不太复杂。但是，它没有提供关于手部卫生习惯的适当性和质量或按卫生保健工作者类型分列的遵守率的信息。此外，尚不清楚产品使用与观察性调查所确定的遵守情况之间的关系。监测遵守情况的电子方法需要进一步评价，然后才能例行推荐。显然，需要进一步的研究来开发有效，可靠和可重复的方法来监测手部卫生依从性。(c)2008医院感染协会。由Elsevier Ltd.出版。保留所有权利。
Monitoring hand hygiene compliance and providing healthcare workers with feedback regarding their performance are considered integral parts of a successful hand hygiene promotion program. Direct observation of care providers by trained personnel is currently considered the gold standard. Advantages include the ability to determine if hand hygiene is being performed at the correct times, establish compliance rates by healthcare worker type, and assess hand hygiene technique. However, observation surveys are time-consuming, permit observation of only a small fraction of all hand hygiene opportunities, and can be influenced by inter-rater reliability. Comparison of compliance rates obtained through observation surveys is problematic due to tack of standardization of criteria for compliance and observation techniques. Self-reporting of compliance is not sufficiently reliable to be useful. Monitoring the usage of hand hygiene products requires much less time and can be performed on an ongoing basis, and is less complicated. However, it does not provide information about the appropriateness and quality of hand hygiene practices or compliance rates by health-care worker type. Furthermore, it is not clear how product usage correlates with compliance established by observational surveys. Electronic methods for monitoring compliance require further evaluation before they can be routinely recommended. Clearly, further research is needed to develop efficient, reliable, and reproducible methods for monitoring hand hygiene compliance. (c) 2008 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.