Bittner M J, Rich E C
VA Medical Center, Omaha, NE 68105, USA.
Clin Perform Qual Health Care. 1998 Oct-Dec;6(4):179-82.
To determine whether handwashing surveillance could be conducted by measurements of soap and towel consumption.
In the medical intensive-care unit (MICU) of the Omaha Veterans' Affairs Medical Center, 10 4-hour day-time observation periods encompassing 409 handwashing episodes were scheduled in a 51-day period. In the surgical intensive-care unit (SICU), 7 4-hour periods encompassing 350 episodes were scheduled in a 49-day period. An observer measured paper towel height, towel weight, and soap weight at each sink. The observer also counted handwashing episodes and bed occupancy. Using handwashing episodes as a dependent variable, stepwise linear regression was performed with changes in towel height, towel weight, and soap weight as independent variables.
Mean handwashing episodes per hour per occupied bed were 2.39 +/- 0.80 (standard deviation) in the MICU and 2.83 +/- 0.72 in the SICU. Correlation r with handwashing episodes for MICU changes was 0.891 for towel height, 0.950 for towel weight, and 0.882 for soap weight. Corresponding correlations for the SICU were 0.881, 0.918, and 0.904. For both units, stepwise regression retained changes in the weight of towels and soap as independent variables (P < .0001), with R2 0.965 (MICU) and 0.981 (SICU).
Because soap and towel consumption measurements are closely related to handwashing frequency and because these measurements are easy to obtain, they offer a means of handwashing surveillance that can be sustained indefinitely. This can facilitate feedback-based interventions to improve handwashing frequency.
确定是否可通过测量肥皂和毛巾的消耗量来进行洗手监测。
在奥马哈退伍军人事务医疗中心的医学重症监护病房（MICU），在51天内安排了10个4小时的日间观察期，涵盖409次洗手事件。在外科重症监护病房（SICU），在49天内安排了7个4小时的观察期，涵盖350次洗手事件。一名观察者测量了每个水槽处纸巾的高度、毛巾的重量和肥皂的重量。观察者还统计了洗手事件和床位占用情况。以洗手事件为因变量，以毛巾高度、毛巾重量和肥皂重量的变化为自变量进行逐步线性回归。
MICU每占用床位每小时的平均洗手事件数为2.39±0.80（标准差），SICU为2.83±0.72。MICU中毛巾高度与洗手事件的相关系数r为0.891，毛巾重量为0.950，肥皂重量为0.882。SICU的相应相关系数分别为0.881、0.918和0.904。对于两个病房，逐步回归均保留毛巾和肥皂重量的变化作为自变量（P<0.0001），MICU的R²为0.965，SICU为0.981。
由于肥皂和毛巾消耗量的测量与洗手频率密切相关，且这些测量易于获取，它们提供了一种可无限期持续的洗手监测方法。这有助于基于反馈的干预措施来提高洗手频率。
