Parker M J, Goldman R D
Division of Pediatric Emergency Medicine, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Canada.
Emerg Med J. 2006 May;23(5):349-53. doi: 10.1136/emj.2005.026146.
To determine paediatric emergency department (ED) staff perceptions of the effectiveness and practice of infection control measures against a novel virulent pathogen.
All medical staff of the paediatric ED in a tertiary medical centre completed a written questionnaire near the onset of the severe acute respiratory syndrome (SARS) outbreak. Level of concern regarding SARS, and perceptions of effectiveness and use of infection control measures were assessed on a 5 point scale. Statistical analysis was performed using chi2 test and one way analysis of variance with significance at p<0.05.
Response rate was 97% (116/120). All scores were given out of 5 possible points. Using isolation rooms (mean score 4.6), wearing a mask when examining patients (4.5), and handwashing (4.5) were considered most effective. Staff physicians reported handwashing more than nurses and trainees (4.9 v 4.5 and 4.5, respectively; p<0.05) while other measures were reported equally. Respondents considering SARS a high public health threat reported higher compliance with handwashing (4.8 v 4.4), always wearing a mask (3.9 vs 3.2) and gloves (3.6 v 2.9) in the ED (p<0.05), but not eye protection (3.4 v 3.0), gown use (4.9 v 4.7), or wearing a mask when examining patients (5.0 v 4.8). Staff who considered combined infection control measures effective in protecting patients and healthcare workers did not report increased compliance.
Eye protection was perceived as only moderately effective in protecting against the spread of SARS, and reported compliance was relatively poor among ED staff. Concern of SARS as a public health threat rather than perceived effectiveness of infection control measures appears to have a greater impact on compliance.
确定儿科急诊科工作人员对针对新型强毒病原体的感染控制措施的有效性及实施情况的看法。
在一家三级医疗中心的儿科急诊科,所有医务人员在严重急性呼吸综合征(SARS)疫情爆发初期完成了一份书面问卷。采用5分制评估对SARS的关注程度以及对感染控制措施有效性和使用情况的看法。使用卡方检验和单因素方差分析进行统计分析,显著性水平为p<0.05。
回复率为97%(116/120)。所有评分均为5分制。使用隔离病房(平均得分4.6)、检查患者时戴口罩(4.5)和洗手(4.5)被认为是最有效的措施。与护士和实习医生相比,主治医师报告洗手的频率更高(分别为4.9对4.5和4.5;p<0.05),而其他措施的报告频率相同。认为SARS对公共卫生构成高度威胁的受访者报告在急诊科洗手的依从性更高(4.8对4.4)、始终戴口罩(3.9对3.2)和戴手套(3.6对2.9)(p<0.05),但在眼部防护(3.4对3.0)、穿隔离衣(4.9对4.7)或检查患者时戴口罩方面(5.0对4.8)并非如此。认为联合感染控制措施对保护患者和医护人员有效的工作人员并未报告更高的依从性。
眼部防护被认为在防止SARS传播方面效果一般,且急诊科工作人员报告的依从性相对较差。将SARS视为公共卫生威胁而非感染控制措施的感知有效性似乎对依从性有更大影响。