Birth attendants' hand hygiene compliance in healthcare facilities in low and middle-income countries: a systematic review.
Birth attendants' hand hygiene compliance in healthcare facilities in low and middle-income countries: a systematic review.
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DOI：
10.1186/s12913-020-05925-9
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发表时间：
2020-12-03
影响因子：
2.8
通讯作者：
Campbell OMR
中科院分区：
文献类型：
--
作者：
Gon G;de Barra M;Dansero L;Nash S;Campbell OMR
随着越来越多的妇女在低收入和中等收入国家的卫生保健机构分娩，卫生保健工作者在产房的手部卫生合规对预防感染至关重要。目前，没有关于助产士遵守手卫生的频率的估计，也没有关于中低收入国家卫生保健机构遵守手卫生的影响因素的估计。我们进行了一项系统回顾，以调查a)依从性水平，b)依从性的决定因素，以及c)改善中低收入国家卫生保健机构助产士在分娩和分娩期间手部卫生的干预措施。我们还旨在评估纳入研究的质量，并报告在多个机构进行的研究的群内相关性。我们在四个数据库中获得了797个结果，并审查了71个全文。其中15个符合我们的纳入标准。总的来说，纳入研究的质量特别受到描述不佳的抽样方法和定义的影响。不同研究的手部卫生依从性差异很大，从0到100%不等；然而，手卫生定义的异质性不允许我们将这些有意义的组合或比较。五项样本量较大、定义更明确的研究估计，无菌操作前的依从性机会较低（范围：1-38%）。三项研究描述了两种多组分干预措施，两者都被证明是可行的。对于样本量较大且定义明确的研究，手卫生依从性较低。这对在中低收入国家设施中预防分娩期间感染构成了重大挑战。我们还发现，许多研究的质量并不理想。未来对分娩病房手卫生依从性的研究应设计更好的采样框架，评估观察者之间的一致性，采取措施提高数据收集质量，并清楚地报告他们的手卫生定义。
With an increasing number of women delivering in healthcare facilities in Low and Middle Income Countries (LMICs), healthcare workers’ hand hygiene compliance on labour wards is pivotal to preventing infections. Currently there are no estimates of how often birth attendants comply with hand hygiene, or of the factors influencing compliance in healthcare facilities in LMICs. We conducted a systematic review to investigate the a) level of compliance, b) determinants of compliance and c) interventions to improve hand hygiene during labour and delivery among birth attendants in healthcare facilities of LMICs. We also aimed to assess the quality of the included studies and to report the intra-cluster correlation for studies conducted in multiple facilities. We obtained 797 results across four databases and reviewed 71 full texts. Of these, fifteen met our inclusion criteria. Overall, the quality of the included studies was particularly compromised by poorly described sampling methods and definitions. Hand hygiene compliance varied substantially across studies from 0 to 100%; however, the heterogeneity in definitions of hand hygiene did not allow us to combine or compare these meaningfully. The five studies with larger sample sizes and clearer definitions estimated compliance before aseptic procedures opportunities, to be low (range: 1–38%). Three studies described two multi-component interventions, both were shown to be feasible. Hand hygiene compliance was low for studies with larger sample sizes and clear definitions. This poses a substantial challenge to infection prevention during birth in LMICs facilities. We also found that the quality of many studies was suboptimal. Future studies of hand hygiene compliance on the labour ward should be designed with better sampling frames, assess inter-observer agreement, use measures to improve the quality of data collection, and report their hand hygiene definitions clearly.
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影响因子：
168.9
作者：
Kassebaum, N. J.;Bertozzi-Villa, A.;Coggeshall, M. S.
通讯作者：
Coggeshall, M. S.
影响因子：
3.1
作者：
Hoogenboom, Gabie;Thwin, May Myo;McGready, Rose
通讯作者：
McGready, Rose
影响因子：
4
作者：
Delaney, Megan Marx;Maji, Pinki;Firestone, Rebecca
通讯作者：
Firestone, Rebecca
影响因子：
34.3
作者：
Kruk, Margaret E.;Leslie, Hannah H.;Langer, Ana
通讯作者：
Langer, Ana
影响因子：
1.3
作者：
Asp, G.;Sandberg, J.;Pettersson, K. Odberg
通讯作者：
Pettersson, K. Odberg