Twenty-four-hour observational study of hospital hand hygiene compliance
Twenty-four-hour observational study of hospital hand hygiene compliance
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DOI：
10.1016/j.jhin.2010.06.027
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发表时间：
2010-11-01
影响因子：
6.9
通讯作者：
Vaughan, N.
中科院分区：
文献类型：
--
作者：
Randle, J.;Arthur, A.;Vaughan, N.
这项观察性研究使用“手部卫生五个时刻”观察工具在两个医院病房测量了24小时内医护人员（HCWS），患者和访客的手部卫生依从性。手卫生被认为是减少医疗相关感染的最有效措施，但研究报告称，遵守情况不佳。大多数研究使用随机观察时间段收集数据，这受到了批评。我们共监测了823个手部卫生机会（HCW，N = 659;患者和访客，N = 164）。在医务工作者中，医生的依从性为47%，护士为75%，专职医疗人员为78%，辅助人员和其他工作人员为59%（P < 0.001）。患者和访视者的依从性无差异（56% vs 57%，P = 0.87）。手部卫生依从性因卫生保健员进行的五次卫生保健中的哪一次而异（P < 0.001），无菌操作前依从性100%（3/3），体液接触后依从性93%（86/93），患者接触后依从性80%（10/10）（114/142）;接触病人前68%（196/290）;接触周围环境后50%（65/129）。早班医护人员的依从性较低（P < 0.001）。对于病人和来访者来说，没有证据表明卫生和依从性之间存在关联。遵守情况高于以前报告的估计数。医务人员的遵守率最低，这仍然是一个值得关注的问题，需要今后采取具体的干预措施。(C)2010年医院感染学会。由爱思唯尔有限公司出版。保留所有权利。
This observational study measured healthcare workers' (HCWs'), patients' and visitors' hand hygiene compliance over a 24 h period in two hospital wards using the 'five moments of hand hygiene' observation tool. Hand hygiene is considered to be the most effective measure in reducing healthcare-associated infections but studies have reported suboptimal levels of compliance. Most studies have used random observational time-periods for data collection and this has been criticised. We monitored a total of 823 hand hygiene opportunities ( HCWs, N = 659; patients and visitors, N = 164). Among HCWs, compliance was 47% for doctors, 75% for nurses, 78% for allied health professionals, and 59% for ancillary and other staff ( P < 0.001). There was no difference in compliance between patients and visitors ( 56% vs 57%, P = 0.87). Hand hygiene compliance varied depending on which of the five moments of hygiene HCWs had undertaken ( P < 0.001), with compliance before an aseptic task being 100% ( 3/3); after body fluid exposure 93% ( 86/93); after patient contact 80% ( 114/142); before patient contact 68% ( 196/290); and after contact with surroundings 50% ( 65/129). Lower levels of compliance were found for HCWs working during the early shift ( P < 0.001). For patients and visitors there was no evidence of an association between moments of hygiene and compliance. Levels of compliance were higher compared with previous reported estimates. Medical staff had the lowest level of compliance and this continues to be a concern which warrants specific future interventions. (C) 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.