Dissemination of the CDC's hand hygiene guideline and impact on infection rates
Dissemination of the CDC's hand hygiene guideline and impact on infection rates
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DOI：
10.1016/j.ajic.2006.10.006
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发表时间：
2007-12-01
影响因子：
4.9
通讯作者：
Lin, Susan X.
中科院分区：
文献类型：
--
作者：
Larson, Elaine L.;Quiros, Dave;Lin, Susan X.
背景：国家循证实践指南的传播及其对患者结果的影响往往无法衡量。方法：我们的目标是（1）评估新的疾病控制和预防中心（CDC）手部卫生指南中推荐的临床实践的实施和依从性，（2）比较指南建议实施前后医疗保健相关感染（HAI）的发生率，以及（3）检查HAI发生率变化的模式和相关性。我们对 40 家美国医院（国家医院感染监测系统成员）进行了指南实施前后的现场访问和调查，测量了 CDC 指南发布前后一年的 HAI 率，并直接观察了手部卫生合规性和指南实施分数。 结果：所有研究医院都改变了政策和程序，并提供了符合指南建议的产品。 接受匿名调查的 1359 名工作人员中，有 89.8% 表示他们熟悉该指南。然而，在 44.2% 的医院 (19/40) 中，没有证据表明采取多学科计划来提高依从性。手部卫生率仍然很低（平均 56.6%）。手部卫生率较高的医院中，中心静脉插管相关血流感染率显着较低（P
Background: The diffusion of national evidence-based practice guidelines and their impact on patient outcomes often go unmeasured.Methods: Our objectives were to (1) evaluate implementation and compliance with clinical practices recommended in the new Centers for Disease Control and Prevention (CDC) Hand Hygiene Guideline, (2) compare rates of health care-associated infections (HAI) before and after implementation of the Guideline recommendations, and (3) examine the patterns and correlates of changes in rates of HAI. We used pre- and post-Guideline implementation site visits and surveys in the setting of 40 US hospitals-members of the National Nosocomial Infections Surveillance System-and measured HAI rates I year before and after publication of the CDC Guideline and used direct observation of hand hygiene compliance and Guideline implementation scores.Results: All study hospitals had changed their policies and procedures and provided products in compliance with Guideline recommendations 89.8% of 1359 staff members surveyed anonymously reported that they were familiar with the Guideline. However, in 44.2% of the hospitals (19/40), there was no evidence of a multidisciplinary program to improve compliance. Hand hygiene rates remained low (mean, 56.6%). Rates of central line-associated bloodstream infections were significantly lower in hospitais with higher rates of hand hygiene (P