van de Mortel T, Bourke R, Fillipi L, McLoughlin J, Molihan C, Nonu M, Reis M
School of Nursing and Health Care Practices, Southern Cross University, Lismore NSW.
Aust Crit Care. 2000 Aug;13(3):91-5. doi: 10.1016/s1036-7314(00)70630-8.
Handwashing following patient contact reduces the incidence of nosocomial infections. Despite this, handwashing rates by health care workers (HCWs) are often poor. Feedback on handwashing has been shown to significantly improve its rates. This study determined the optimum time to repeat performance feedback on handwashing rates of hospital staff in order to maximise its incidence. The baseline incidence of handwashing by staff following patient contact was determined by covert observation. This was followed by a period of feedback on handwashing performance by means of histograms displayed in the unit. Handwashing incidence was reassessed 6 and 12 months after the feedback ended. Performance feedback induced significant increases in handwashing incidence amongst nurses (p = 0.0433), resident medical officers (p = 0.0134), specialists (p = 0.0021) and radiographers (p = 0.0001). Non-significant increases were noted in handwashing rates amongst wardsmen/women and physiotherapists. Overall, handwashing incidence declined significantly (p = 0.0001) 12 months post feedback. This study demonstrated that feedback should be repeated within 12 months in order to maximise handwashing rates with the minimum intervention.
接触患者后洗手可降低医院感染的发生率。尽管如此，医护人员的洗手率往往很低。研究表明，关于洗手的反馈能显著提高洗手率。本研究确定了对医院工作人员洗手率重复进行绩效反馈的最佳时间，以使其发生率最大化。通过暗中观察确定工作人员接触患者后洗手的基线发生率。随后，通过在科室展示直方图的方式对洗手表现进行了一段时间的反馈。在反馈结束6个月和12个月后重新评估洗手发生率。绩效反馈使护士（p = 0.0433）、住院医师（p = 0.0134）、专科医生（p = 0.0021）和放射技师（p = 0.0001）的洗手发生率显著提高。勤杂工和物理治疗师的洗手率有不显著的提高。总体而言，反馈后12个月洗手发生率显著下降（p = 0.0001）。本研究表明，应在12个月内重复进行反馈，以便以最少的干预使洗手率最大化。
