Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach over 13 Years in 51 Cities of 19 Limited-Resource Countries from Latin America, Asia, the Middle East, and Europe
Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach over 13 Years in 51 Cities of 19 Limited-Resource Countries from Latin America, Asia, the Middle East, and Europe
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DOI：
10.1086/669860
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发表时间：
2013-04-01
影响因子：
4.5
通讯作者：
Kuebler, Andrzej
中科院分区：
文献类型：
--
作者：
Rosenthal, Victor D.;Pawar, Mandakini;Kuebler, Andrzej
目标。目的评估国际医院感染控制联盟（INICC）多维手卫生方法在19个资源有限的国家的可行性和有效性，并分析手卫生依从性差的预测因素。一项从1999年4月至2011年12月的观察性、前瞻性、队列、干预性、前后对照研究。研究分为2个阶段：3个月的基线期和7年的随访期。来自阿根廷、巴西、中国、哥伦比亚、哥斯达黎加、古巴、萨尔瓦多、希腊、印度、黎巴嫩、立陶宛、马其顿、墨西哥、巴基斯坦、巴拿马、秘鲁、菲律宾、波兰和土耳其的99名国际刑事法院重症监护病房成员。国际传染病学会99名ICU成员的医护人员。采用了多维手卫生方法，包括(1)行政支持，(2)用品供应，(3)教育和培训，(4)工作场所提醒，(5)过程监督，(6)绩效反馈。在随机选择的30分钟时间内，对每个ICU的手卫生依从性进行观察。共观察到149,727个手部卫生机会。总体手卫生依从性由48.3%提高到71.4% （P < 0.01）。单因素分析表明，有几个变量与不良的手卫生依从性显著相关，包括男性与女性（63%对70%，P < 0.001）、医生与护士（62%对72%，P < 0.001）、成人与新生儿icu（67%对81%，P < 0.001）等。采用INICC方法，坚持手卫生的人数增加了48%。应实施具体的方案，以改善手卫生变量，这些变量被发现是手卫生依从性差的预测因素。感染控制医院流行病学杂志2013；34 (4): 415 - 423
OBJECTIVE. To assess the feasibility and effectiveness of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene approach in 19 limited-resource countries and to analyze predictors of poor hand hygiene compliance.DESIGN. An observational, prospective, cohort, interventional, before-and-after study from April 1999 through December 2011. The study was divided into 2 periods: a 3-month baseline period and a 7-year follow-up period.SETTING. Ninety-nine intensive care unit (ICU) members of the INICC in Argentina, Brazil, China, Colombia, Costa Rica, Cuba, El Salvador, Greece, India, Lebanon, Lithuania, Macedonia, Mexico, Pakistan, Panama, Peru, Philippines, Poland, and Turkey.PARTICIPANTS. Healthcare workers at 99 ICU members of the INICC.METHODS. A multidimensional hand hygiene approach was used, including (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance, and (6) performance feedback. Observations were made for hand hygiene compliance in each ICU, during randomly selected 30-minute periods.RESULTS. A total of 149,727 opportunities for hand hygiene were observed. Overall hand hygiene compliance increased from 48.3% to 71.4% (P < .01). Univariate analysis indicated that several variables were significantly associated with poor hand hygiene compliance, including males versus females (63% vs 70%; P < .001), physicians versus nurses (62% vs 72%; P < .001), and adult versus neonatal ICUs (67% vs 81%; P < .001), among others.CONCLUSIONS. Adherence to hand hygiene increased by 48% with the INICC approach. Specific programs directed to improve hand hygiene for variables found to be predictors of poor hand hygiene compliance should be implemented. Infect Control Hosp Epidemiol 2013;34(4):415-423