Interaction of healthcare worker hands and portable medical equipment: a sequence analysis to show potential transmission opportunities.
Interaction of healthcare worker hands and portable medical equipment: a sequence analysis to show potential transmission opportunities.
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DOI：
10.1186/s12879-017-2895-6
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发表时间：
2017-12-28
影响因子：
3.7
通讯作者：
Stibich M
中科院分区：
文献类型：
--
作者：
Jinadatha C;Villamaria FC;Coppin JD;Dale CR;Williams MD;Whitworth R;Stibich M
虽然研究已经证明了清洁医疗环境的重要性，但缺乏对便携式医疗设备（PME）在医疗获得性感染（HAI）传播周期中所起作用的研究。本研究调查了医院环境中医护人员、患者、表面和医疗设备之间接触事件的模式和顺序。研究人员在六个不同的医院单位观察了六个不同的24小时内的患者护理事件。每次遭遇被记录为一系列事件，并使用序列分析进行分析，并通过网络图直观地表示。此外，从车轮上的计算机（COW）中采集点流行微生物样本。患者护理过程中最常接触的物品是患者个人（850）、床（375）、床面（302）和床边桌（223）。前十名最常见的干扰中有三个包括触摸PME和患者：轮上计算机触摸患者（274个序列中的62个，22.6%，包含该序列），患者触摸COW（20.4%）和患者触摸IV泵（16.1%）。网络图显示了房间中的对象、患者、PME和医护人员之间的巨大互连性。我们的研究结果表明，PME（如COW和IV泵）是患者护理过程中接触最多的两个项目。即使有适当的手部消毒和个人防护设备，这种序列分析也揭示了从患者和环境到载体（如便携式医疗设备）并最终到医院中的另一名患者的污染潜力。本文的在线版本（10.1186/s12879-017-2895-6）包含补充材料，可供授权用户使用。
While research has demonstrated the importance of a clean health care environment, there is a lack of research on the role portable medical equipment (PME) play in the transmission cycle of healthcare-acquired infections (HAIs). This study investigated the patterns and sequence of contact events among health care workers, patients, surfaces, and medical equipment in a hospital environment. Research staff observed patient care events over six different 24 h periods on six different hospital units. Each encounter was recorded as a sequence of events and analyzed using sequence analysis and visually represented by network plots. In addition, a point prevalence microbial sample was taken from the computer on wheels (COW). The most touched items during patient care was the individual patient (850), bedrail (375), bed-surface (302), and bed side Table (223). Three of the top ten most common subsequences included touching PME and the patient: computer on wheels ➔ patient (62 of 274 total sequences, 22.6%, contained this sequence), patient ➔ COW (20.4%), and patient ➔ IV pump (16.1%). The network plots revealed large interconnectedness among objects in the room, the patient, PME, and the healthcare worker. Our results demonstrated that PME such as COW and IV pump were two of the most highly-touched items during patient care. Even with proper hand sanitization and personal protective equipment, this sequence analysis reveals the potential for contamination from the patient and environment, to a vector such as portable medical equipment, and ultimately to another patient in the hospital. The online version of this article (10.1186/s12879-017-2895-6) contains supplementary material, which is available to authorized users.
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