Galway Robyn, Harrod Mary Ellen, Crisp Jackie, Donnellan Robyn, Hardy Jan, Harvey Alice, Maurice Lucy, Petty Sheila, Senner Anne
University of New South Wales, Sydney Children's Hospital.
Paediatr Nurs. 2003 Dec;15(10):14-8. doi: 10.7748/paed2003.12.15.10.14.c825.
This study examined variability in handwashing policy between hospitals, variability in handwashing practices in nurses and how practice differed from policy in tertiary paediatric hospitals in Australia and New Zealand. Eight of the possible nine major paediatric hospitals provided a copy of their handwashing and/or central venous access device (CVAD) policies, and 67 nurses completed a survey on their handwashing practices associated with CVAD management. A high degree of variability was found in relation to all the questions posed in the study. There was little consistency between policies and little agreement between policies and clinical practice, with many nurses washing for longer than required by policy. Rigour of handwashing also varied according to the procedure undertaken and the type of CVAD with activities undertaken farther from the insertion site of the device more likely to be performed using a clean rather than an aseptic handwashing technique. As both patients and nursing staff move within and between hospitals, a uniform and evidence-based approach to handwashing is highly desirable.
本研究调查了澳大利亚和新西兰三级儿科医院之间洗手政策的差异、护士洗手行为的差异以及实际行为与政策的不同之处。九家主要儿科医院中，有八家提供了其洗手和/或中心静脉通路装置（CVAD）政策的副本，67名护士完成了一项关于其与CVAD管理相关洗手行为的调查。研究提出的所有问题都存在高度差异。政策之间缺乏一致性，政策与临床实践之间也缺乏共识，许多护士洗手时间超过政策要求。洗手的严格程度也因所进行的操作和CVAD的类型而异，在距离装置插入部位较远的地方进行的操作更有可能采用清洁而非无菌的洗手技术。由于患者和护理人员在医院内部和之间流动，因此非常需要采用统一且基于证据的洗手方法。
