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影响医护人员在门诊医疗环境中采取呼吸道感染控制措施的个人医护人员(HCW)及工作场所特征。

Personal healthcare worker (HCW) and work-site characteristics that affect HCWs' use of respiratory-infection control measures in ambulatory healthcare settings.

作者信息

Turnberg Wayne, Daniell William, Simpson Terri, Van Buren Jude, Seixas Noah, Lipkin Edward, Duchin Jeffery

机构信息

Washington State Department of Health, the School of Public Health and Community Medicine, University of Washington, and Public Health-Seattle and King County, Seattle, Washington 98105-2925, USA.

出版信息

Infect Control Hosp Epidemiol. 2009 Jan;30(1):47-52. doi: 10.1086/592707.

Abstract

OBJECTIVES

To identify healthcare worker (HCW) and work-site characteristics associated with HCWs' reported use of recommended respiratory-infection control practices in primary and emergency care settings.

DESIGN

A cross-sectional study using a self-administered questionnaire for HCWs during the summer and fall of 2005.

SETTING

Primary and emergency care clinics at 5 medical centers in King County, Seattle, Washington.

RESULTS

Nurse professionals who reported receiving training (odds ratio [OR], 2.5 [confidence interval {CI}, 1.1-5.9]; P=.029), instructional feedback from supervisors (OR, 3.0 [CI, 1.5-5.9]; P=.002), and management support for implementing safe work practices had a higher odds of also reporting adherence to recommended respiratory precautions, compared with nurses who did not. Training was the only important determinant for adherence to respiratory precaution measures among medical practitioners (OR, 5.5 [CI, 1.2-25.8]; P=.031). The reported rate of adherence to hand hygiene practices was higher among nurse professionals who were male (OR, 2.2 [CI, 1.0-4.9]; P=.045), had infants, small children, or older adults living at home (OR, 2.2 [CI, 1.2-3.9]; P=.007), reported cleanliness and orderliness of the establishment where they worked (OR, 2.0 [CI, 1.1-3.5]; P=.019), had received respiratory-infection control training (OR, 3.2 [CI, 1.8-6.0]; P<.001), and reported fears about catching a dangerous respiratory infection at work (OR, 2.3 [CI, 1.2-4.5]; P=.011).

CONCLUSION

A number of HCW and work-site characteristics associated with HCWs' use of recommended respiratory-infection control measures have been identified. These potentially influential characteristics should be considered as targets or guides for further investigation, which should include the evaluation of intervention strategies.

摘要

目的

确定在基层医疗和急诊环境中,与医护人员报告使用推荐的呼吸道感染控制措施相关的医护人员及工作场所特征。

设计

2005年夏秋季节,采用自填式问卷对医护人员进行横断面研究。

地点

华盛顿州西雅图市金县5家医疗中心的基层医疗和急诊诊所。

结果

报告接受过培训(比值比[OR],2.5[置信区间{CI},1.1 - 5.9];P = 0.029)、得到上级主管的指导性反馈(OR,3.0[CI,1.5 - 5.9];P = 0.002)以及管理部门对实施安全工作规范给予支持的护士专业人员,与未接受这些的护士相比,报告坚持推荐的呼吸道预防措施的几率更高。培训是医生坚持呼吸道预防措施的唯一重要决定因素(OR,5.5[CI,1.2 - 25.8];P = 0.031)。在男性护士专业人员中,报告的手部卫生规范坚持率更高(OR,2.2[CI,1.0 - 4.9];P = 0.045),家中有婴儿、幼儿或老年人的护士专业人员(OR,2.2[CI,1.2 - 3.9];P = 0.007),报告其工作场所干净整洁有序的护士专业人员(OR,2.0[CI,1.1 - 3.5];P = 0.019),接受过呼吸道感染控制培训的护士专业人员(OR,3.2[CI,1.8 - 6.0];P < 0.001),以及报告担心在工作中感染危险呼吸道感染的护士专业人员(OR,2.3[CI,1.2 - 4.5];P = 0.011)。

结论

已确定了一些与医护人员使用推荐的呼吸道感染控制措施相关的医护人员及工作场所特征。这些潜在的影响因素应被视为进一步调查的目标或指南,其中应包括对干预策略的评估。

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