Beghdadli Benali, Belhadj Zora, Chabane Walid, Ghomari Omar, Kandouci Abdelkader Baderdine, Fanello Serge
Université Djilali Liabes, Faculté de médecine, Sidi Bel-Abbes, Algérie.
Sante Publique. 2008 Sep-Oct;20(5):445-53. doi: 10.3917/spub.085.0445.
Health care workers are exposed daily to blood borne injury and infection with a high risk of hepatitis B or C and human immunodeficiency virus (HIV) transmission. In the 1980s, the US Centers for Disease Control and Prevention (CDC) developed a set of protocols and guidelines known as standard precautions (SP) to prevent accidental transmission of pathogens. The SP should be followed for each intervention or delivery of care in order to protect health care workers from risks associated with contact with blood and other biological liquids. A survey was conducted in a Western Algerian university hospital to assess nurses' adherence to SP practices. A questionnaire was administered to 450 nurses in the hospital workplace setting. A field survey was also conducted in order to take into account the means and support available to the nurses in these hospital departments, namely to determine availability of hand washing and drying facilities. A total of 133 nurses, 81 women and 52 men, participated in the survey. Personal and professional data, hand-washing frequency, glove wearing practices were collected as data. A large majority (95%) of nurses reported washing their hands after removing their gloves, and 69% of them reported washing their hands between two patients. Male nurses wear gloves more often than females (respectively 77% and 53%). Sharp instruments were correctly disposed of in a puncture-resistant container more of the time. Recapping needles has been reported by two-thirds of survey respondents. Lack of liquid soap and alcohol-based washing solution were noted as major deficiencies as well as the lack of means to properly dry hands in many health care wards. Lack of SP adherence is primarily due to the lack of awareness and knowledge as well as insufficient supply of equipment and materials for good hand hygiene maintenance. This study highlights the urgent need to implement a programme to improve SP adherence among nurses and to increase the supply of hand washing and drying materials. Greater adherence to SP practices will also reduce the risk of occupational exposure to blood borne injury and infection.
医护人员每天都面临血源性损伤和感染的风险，感染乙型或丙型肝炎以及传播人类免疫缺陷病毒（HIV）的风险很高。20世纪80年代，美国疾病控制与预防中心（CDC）制定了一套协议和指南，即标准预防措施（SP），以防止病原体的意外传播。每次进行干预或提供护理时都应遵循标准预防措施，以保护医护人员免受与血液及其他生物液体接触相关的风险。在阿尔及利亚西部的一家大学医院进行了一项调查，以评估护士对标准预防措施的遵守情况。在医院工作场所对450名护士进行了问卷调查。还进行了实地调查，以考虑这些医院科室为护士提供的手段和支持，即确定洗手和烘干设施的可用性。共有133名护士参与了调查，其中81名女性和52名男性。收集了个人和专业数据、洗手频率、戴手套习惯等数据。绝大多数（95%）护士报告在摘下手套后洗手，69%的护士报告在护理两名患者之间洗手。男护士戴手套的频率高于女护士（分别为77%和53%）。锐器更多时候能正确放置在防穿刺容器中。三分之二的受访者报告有回套针头的情况。液体肥皂和酒精基洗涤液的缺乏以及许多医疗病房缺乏适当擦干手的手段被视为主要不足。缺乏对标准预防措施的遵守主要是由于缺乏意识和知识，以及用于保持良好手部卫生的设备和材料供应不足。这项研究强调迫切需要实施一项计划，以提高护士对标准预防措施的遵守情况，并增加洗手和烘干材料的供应。更好地遵守标准预防措施也将降低职业暴露于血源性损伤和感染的风险。
