Turnberg Wayne, Daniell William, Seixas Noah, Simpson Terri, Van Buren Jude, Lipkin Edward, Duchin Jeffery
University of Washington, Washington State Department of Health, Seattle, WA 98105-2925, USA.
Am J Infect Control. 2008 May;36(4):268-75. doi: 10.1016/j.ajic.2007.08.004.
The severe acute respiratory syndrome (SARS) epidemic and concern about pandemic influenza prompted the Centers for Disease Control and Prevention (CDC) to develop guidelines to prevent the transmission of all respiratory infections in health care settings during first contact with a potentially infected person. The extent to which health care workers and institutions use these CDC recommended practices is uncertain.
The study examined health care worker adherence to CDC recommended respiratory infection control practices in primary care clinics and emergency departments of 5 medical centers in King County, Washington, using a self-administered questionnaire. All clinical, allied, and administrative health care workers in study settings were invited to participate: 653 (53%) responded, and 630 were included.
The survey revealed important shortcomings in overall personal and institutional use of CDC recommended practices, including deficiencies in posted alerts, patient masking and separation, hand hygiene, personal protective equipment, staff training, and written procedures. Use of recommended measures was generally higher among nursing staff than medical practitioners.
This study found significant gaps in adherence to CDC recommendations for the control of respiratory infections in ambulatory care clinical settings. Practical strategies are needed to identify and reduce barriers to implementation of recommended practices for control of respiratory infections.
严重急性呼吸综合征（SARS）疫情以及对大流行性流感的担忧促使疾病控制与预防中心（CDC）制定指南，以防止在首次接触潜在感染者时医疗机构内所有呼吸道感染的传播。医护人员和机构对这些CDC推荐措施的使用程度尚不确定。
该研究通过一份自填式问卷，调查了华盛顿州金县5家医疗中心的基层医疗诊所和急诊科医护人员对CDC推荐的呼吸道感染控制措施的遵守情况。研究场所的所有临床、辅助和行政医护人员均受邀参与：653人（53%）做出回应，其中630人被纳入研究。
调查显示，在个人和机构对CDC推荐措施的总体使用方面存在重大缺陷，包括张贴警示标识、患者佩戴口罩和隔离、手部卫生、个人防护设备、员工培训以及书面程序等方面的不足。护理人员对推荐措施的使用通常高于医务人员。
本研究发现，在门诊护理临床环境中，遵守CDC呼吸道感染控制建议方面存在显著差距。需要采取切实可行的策略来识别并减少实施呼吸道感染控制推荐措施的障碍。
