Nouira Amel, Ounis Hend, Khediri Mouldi, Helali Radhia, Bannour Wadia, Njah Mansour
Service d'Hygiène Hospitalière, CHU Farhat Hached, Sousse.
Tunis Med. 2008 May;86(5):451-6.
Handwashing is the most effective method of preventing the spread of nosocomial infection. Despite its simplicity, handwashing is frequently omitted by health care personnel. In order to promote hand hygiene at Farhat Hached hospital (Sousse-Tunisia), the team of hygiene sets up a programme of hand hygiene programme.This work enters within the framework of the evaluation of the program's impact relatively on the healthcare worker's hand decontamination practices (physicians and nurses).
Our aim is to determine the evolution of hand washing rates, specific compliance (per unit and category of healthcare workers) and adapted compliance.
Our study is experimental with comparison of the results of 2 audits, the first carried out before the installation of the program (winter 2003) and the second after (winter 2006). The study was conducted in 4 units: two medical units (internal medicine and pneumology), a surgical unit (general surgery) and intensive care unit.
On the whole, 208 and 319 acts of care were observed respectively during the first and the second audit. The rate of total observance and that of correct observance of handwashing doubled and passed respectively from 28% to 46.4% (p = 2 x 10(-5)) and from 13.9% to 23.5% (p = 4 x 10(-5)). Failures causes observed at washing hands time (2006) are mainly related to a later recontamination of the hands. The observance of handwashing increased only for nurses, from 34% to 47.5% (p < 10(-2)).
With the aim to improve hand washing compliance, hand hygiene programme must target even more the physicians and provide alcohol hand rubs.
洗手是预防医院感染传播的最有效方法。尽管洗手操作简单，但医护人员经常会忽略。为了在法哈特·哈谢德医院（突尼斯苏塞）推广手部卫生，卫生团队制定了一项手部卫生计划。这项工作属于评估该计划对医护人员（医生和护士）手部消毒行为影响框架的一部分。
我们的目的是确定洗手率的变化、特定依从性（按医护人员单位和类别）以及适应性依从性。
我们的研究是实验性的，比较两次审核的结果，第一次在该计划实施前（2003年冬季）进行，第二次在实施后（2006年冬季）进行。研究在4个科室开展：两个内科科室（内科和肺病科）、一个外科科室（普通外科）和重症监护室。
总体而言，第一次和第二次审核期间分别观察到208次和319次护理行为。洗手的总体遵守率和正确遵守率分别翻了一番，从28%升至46.4%（p = 2×10⁻⁵），从13.9%升至23.5%（p = 4×⁻⁵）。2006年洗手时观察到的失误原因主要与手部再次污染较晚有关。洗手的遵守率仅在护士中有所提高，从３４％升至47.5%（p < 10⁻²）。
为了提高洗手依从性，手部卫生计划必须更有针对性地针对医生，并提供酒精擦手液。
