Raboud Janet, Saskin Refik, Wong Kurt, Moore Christine, Parucha Grace, Bennett Jocelyn, Green Karen, Low Don, Loeb Mark, Simor Andy, McGeer Allison
Department of Public Health Sciences, University of Toronto and the University Health Network, Toronto, Ontario, Canada.
Infect Control Hosp Epidemiol. 2004 Mar;25(3):198-202. doi: 10.1086/502377.
To obtain accurate data regarding the handwashing behavior and patterns of visits to patients by healthcare workers (HCWs).
All visits by HCWs to selected patient rooms were recorded for 3 days and 2 nights. Additionally, 5 nurses were observed for 1 day each and 2 nurses were observed for 1 night each. Nurses were observed for their entire shifts and all of their activities were recorded.
A general medical ward in a tertiary-care hospital.
Convenience samples of HCWs and patients.
Patients were visited every 25 minutes on average. Monitoring rooms and observing nurses resulted in similar rates of patient visits. The highest level of risk was contact with body fluids in 11% of visits and skin in 40% of visits. The overall rate of handwashing was 46%; however, the rate was higher for visits involving contact with body fluids (81%) and skin (61%). Nurses returned immediately to the same patient 45% of the time. The rate of handwashing was higher for the last of a series of visits to a patient's room (53% vs 30%, P < .0001).
Nurses adjusted their handwashing rates in accordance with the risk level of each visit. Monitoring patient rooms and observing nurses yielded similar estimates of patient visits and proportions of visits involving contact with skin or body fluids. Education programs about hand hygiene may be more effective if patterns of care and levels of risk are incorporated into recommendations.
获取关于医护人员（HCWs）洗手行为及看望患者模式的准确数据。
对医护人员到选定病房看望患者的情况进行了3天2夜的记录。此外，对5名护士每人观察1天，对2名护士每人观察1夜。对护士的整个班次进行观察并记录其所有活动。
一家三级护理医院的普通内科病房。
医护人员和患者的便利样本。
平均每25分钟看望一次患者。监测病房和观察护士得出的患者看望率相似。最高风险水平出现在11%的看望中接触体液，40%的看望中接触皮肤。总体洗手率为46%；然而，在涉及接触体液（81%）和皮肤（61%）的看望中，洗手率更高。护士45%的时间会立即回到同一患者处。在一系列看望患者病房的最后一次看望中，洗手率更高（53%对30%，P < .0001）。
护士根据每次看望的风险水平调整洗手率。监测病房和观察护士得出的患者看望估计数以及涉及接触皮肤或体液的看望比例相似。如果将护理模式和风险水平纳入建议中，手部卫生教育项目可能会更有效。
