Compliance with antiseptic hand rub use in intensive care units:: The Hawthorne effect
Compliance with antiseptic hand rub use in intensive care units:: The Hawthorne effect
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DOI：
10.1086/507294
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发表时间：
2006-09-01
影响因子：
4.5
通讯作者：
Rueden, Henning
中科院分区：
文献类型：
--
作者：
Eckmanns, Tim;Bessert, Jan;Rueden, Henning
目标。目的：确定霍桑效应对医护人员使用消毒手按摩(AHR)依从性的影响。观察性研究。背景。德国柏林一所大学医院的五个重症监护室。参与者。在有AHR使用指征的情况下，对医务人员进行两个阶段的AHR依从性监测。在第一阶段，这些人员不知道被监视。第二个观察期提前通知了重症监护病房的工作人员，并提供了关于观察员将监测什么的信息。AHR使用依从性的潜在混杂因素包括职业群体(护士、医生和其他医护人员)、重症监护病房以及在任何程序之前或之后使用AHR的适应症。数据收集自2,808个AHR使用适应症。第一阶段的总体依从率为29%(95%可信区间，26%~32%)，第二阶段为45%(95%可信区间，43%~47%)。有潜在混杂因素的Logistic回归分析显示，第2阶段与第1阶段的比较有显著的优势比。不同职业组(护士的依从性最高，医生的依从性中等)之间以及术前AHR使用指征与术后AHR使用指征之间的差异有统计学意义。霍桑效应对AHR的依从性有显著影响，显性观察的依从性增加了55%。这一结果在子组中是一致的。事实上，由于没有考虑霍桑效应的研究结果，AHR的依从率可能比我们想象的要低。这项研究的结果强调了感染控制小组尽可能多地在病房工作的必要性。
objective. To determine the influence the Hawthorne effect has on compliance with antiseptic hand rub ( AHR) use among healthcare personnel.design. Observational study.setting. Five intensive care units of a university hospital in Berlin, Germany.participants. Medical personnel were monitored in 2 periods regarding compliance with AHR use when there were indications for AHR use. In the first period, the personnel had no knowledge of being observed. The second observation period was announced to the staff of the intensive care units in advance and information about what the observer would be monitoring was provided. Potential confounders of compliance with AHR use included occupational groups ( nurses, physicians, and other healthcare workers), intensive care units, and indications for AHR use before or after any procedure.results. Data were collected from 2,808 indications for AHR use. The overall rate of compliance was 29% ( 95% confidence interval, 26% - 32%) in the first period and 45% ( 95% confidence interval, 43% - 47%) in the second period. A logistic regression analysis with potential confounders revealed a significant odds ratio for the comparison between period 2 and period 1. The differences in compliance with AHR use were statistically significant () between the occupational groups ( nurses had the highest compliance and physicians P !.001 had middle compliance) and between indication for AHR use before procedures and indication for AHR use after procedures.conclusions. The Hawthorne effect has a marked influence on compliance with AHR use, with a 55% increase of compliance with overt observation. This result is consistent throughout subgroups. The rate of compliance with AHR use may in fact be lower than we thought because of results from studies that did not take the Hawthorne effect into account. The results of this study underline the necessity for infection control teams to be on wards as often as possible.