Prevention of nosocomial infections and multidrug-resistant bacteria through an initiative of patient empowerment and participation in infection control

背景该项目旨在调查积极将患者纳入预防医疗保健相关感染(HAI)和多药耐药生物(MDRO)的感染控制措施的效果。病人参与是卫生保健领域公认的概念。患者参与感染控制的积极性很高。提高手部卫生依从性已成为以患者为中心的感染控制措施的既定目标。我们假设，这样的干预对HAI和MRO的传播具有迄今未被调查的缓解效果。研究设计在为期10个月的控制期内，将在骨科病房测量HAI和院内万古霉素耐药肠球菌(VRE)定植的比率。在两个月的时间内，将建立以下倡议：患者入院时将定期收到告知手部卫生措施的传单。此外，工作人员会佩戴欢迎病人的纽扣，提醒医护人员注意手部卫生习惯。在干预持续十个月期间，将再次测量HAI和VRE殖民率，并与控制期的比率进行比较。在取得积极成果的情况下，该项目将以多中心的方式加以扩展，目的是制定一个可应用于各种保健环境的概念。如果结果是否定的，进一步的调查将集中于检查导致更好地接受以患者为中心的感染控制措施的因素。

BackgroundThe project aims at investigating the effects of actively integrating patients in infection control measures for the prevention of healthcare associated infections (HAI) and multidrug-resistant organisms (MDRO). Patient participation is a well recognized concept in health care. Patients are highly motivated to participate in infection control. The improvement of hand hygiene compliance has been an established goal of patient-centered infection control measures. We hypothesize that such an intervention has a heretofore uninvestigated mitigating effect on HAI and the spread of MRO.Study DesignDuring a control period of ten months the rate of HAI and nosocomial Vancomycin-resistant Enterococci (VRE)-colonizations will be measured on an orthopaedic ward. During a period of two months the follwing initiave will be established: patients will regularly receive flyers upon admission that inform about hand hygiene measures. In addition, staff will wear buttons that welcome patients to remind health care personal of hand hygiene practices. HAI and VRE-colonization rates will again be measured and compared to rates in the control period while the intervention continues for ten month. In the case of a positive outcome the project will be extended in a multicenter approach with the objective of developing a concept that can be applied in various health care settings. If the outcome is negative, further investigations will concentrate on examining factors that lead to a better acceptance of patient-centered infection control measures.