van de Mortel Thea, Murgo Margherita
School of Nursing and Health Care Practices, Southern Cross University, Lismore, Australia.
Am J Infect Control. 2006 Apr;34(3):95-9. doi: 10.1016/j.ajic.2005.07.006.
Many studies have examined hand hygiene (HH) frequency and adherence in response to various interventions. This study used 2 methods to determine HH frequency and adherence to see how well the outcomes correlated.
HH frequency was measured over 4, 1-month periods (phases 1-4), using 2 methods: an audit of HH solution used during each phase adjusted for patient-days and covert observation of HH adherence. The number of x-ray technician contacts with patients (a known quantity) across the study period was retrospectively compared with the number of observations made of x-ray technicians' HH behavior to see what proportion of contacts were observed.
HH solution use doubled in phase 2 and was 65% and 55% higher than the baseline level in phases 3 and 4, respectively. Observed HH adherence fell from 51% to 37% in phase 2 and then rose to 58% in phases 3 and 4. Three percent of x-ray technicians' patient contacts were observed across the 4 phases.
Observation of HH may not adequately sample patient contacts to provide an accurate measure of HH adherence. Further studies are needed to confirm this finding.
许多研究已针对各种干预措施对洗手频率和依从性进行了调查。本研究采用两种方法来确定洗手频率和依从性，以观察结果的相关性如何。
在4个为期1个月的时间段（第1 - 4阶段）内测量洗手频率，采用两种方法：根据患者天数对每个阶段使用的洗手液进行审计，并对洗手依从性进行隐蔽观察。回顾性比较研究期间X射线技师与患者接触的次数（已知数量）与对X射线技师洗手行为的观察次数，以了解观察到的接触比例。
洗手液的使用量在第2阶段增加了一倍，在第3阶段和第4阶段分别比基线水平高65%和55%。观察到的洗手依从性在第2阶段从51%降至37%，然后在第3阶段和第4阶段升至58%。在4个阶段中，观察到3%的X射线技师与患者的接触。
对洗手的观察可能无法充分抽样患者接触情况，以提供洗手依从性的准确测量。需要进一步研究来证实这一发现。
