Herud Trine, Nilsen Roy M, Svendheim Kjersti, Harthug Stig
Centre of Infection Control, Haukeland University Hospital, Bergen, Norway.
Am J Infect Control. 2009 May;37(4):311-7. doi: 10.1016/j.ajic.2008.06.006. Epub 2008 Oct 22.
An association between use of hand hygiene products and health care-associated infection rates was investigated in a large Norwegian university hospital.
We conducted an ecologic study by combining data from purchasing and admission systems with data from 32 point prevalence surveys (27,248 patients) in 1998-2005. Data on purchase of hand disinfectants and soap, and patient-days, were collected for 20 bed wards similar to those of the prevalence surveys.
The prevalence of infections was 7.1%. We found no significant decline in overall infections (P = .19), but use of hand hygiene products significantly increased from 28.5 L per 1000 patients-days in 1998 to 43.3 L per 1000 patient-days in 2005 (P < .001). After examining a linear dose-response relation between use and infection rates, we observed a borderline significant decline in infections from 8% to 6% with increased use of hand hygiene products (P = .05). This association appeared stronger for wards that were registered with infections >9% at study start in 1998 (P < .001).
These data suggests that infection rates may be reflected by amount of hand hygiene products used. Quantification of such products over time may serve as an indicator for hand hygiene performance in hospitals.
在挪威一家大型大学医院中，对使用手部卫生用品与医疗保健相关感染率之间的关联进行了调查。
我们通过将采购和入院系统的数据与1998 - 2005年32次现患率调查（27248名患者）的数据相结合，开展了一项生态学研究。收集了与现患率调查中类似的20个病房的手部消毒剂和肥皂采购数据以及患者住院日数据。
感染率为7.1%。我们发现总体感染情况没有显著下降（P = 0.19），但手部卫生用品的使用量从1998年每1000患者住院日28.5升显著增加到2005年每1000患者住院日43.3升（P < 0.001）。在研究了使用量与感染率之间的线性剂量反应关系后，我们观察到随着手部卫生用品使用量的增加，感染率从8%降至6%，有临界显著下降（P = 0.05）。对于1998年研究开始时感染率登记>9%的病房，这种关联似乎更强（P < 0.001）。
这些数据表明，感染率可能通过手部卫生用品的使用量来反映。随着时间推移对这类产品进行量化，可作为医院手部卫生执行情况的一个指标。
