Tuscan American Safety Collaboration, Piazza Pietro Leopoldo 1, Florence, Italy.
Am J Infect Control. 2011 Feb;39(1):14-8. doi: 10.1016/j.ajic.2010.06.015. Epub 2010 Oct 20.
Health care-associated infection is one of the most important patient safety problems in the world. While many methods exist to prevent health care-associated infection, most experts believe that improving hand hygiene is paramount. We previously published the results of a successful before-and-after hand hygiene interventional study performed in the pediatric emergency department of the Meyer Hospital in Florence, Italy. The goal of the current study is to assess the longer term sustainability of the previously described intervention.
Direct observation was used to assess hand hygiene compliance for both doctors and nurses in the emergency department using the same methods and observers as previously employed.
In addition to the 420 preintervention and 463 immediately postintervention observations previously reported, we observed another 456 clinician-patient interactions approximately 1 year after the intervention. Among all health care workers, there was no significant difference between hand hygiene compliance immediately postintervention (44.9%) compared with 1 year after the intervention (45.2%). Adherence among nurses, however, increased from 40.7% to 49.8% (P = .03), whereas adherence among doctors decreased from 50.5% to 36.5% (P = .008).
The overall effects of the intervention were sustained over a 1-year period, although a marked difference was observed between nurses and doctors.
医院获得性感染是全球最重要的患者安全问题之一。虽然有许多方法可以预防医院获得性感染，但大多数专家认为改善手卫生至关重要。我们之前发表了在意大利佛罗伦萨 Meyer 医院儿科急诊部进行的成功的干预前后手卫生研究结果。本研究的目的是评估之前描述的干预措施的长期可持续性。
使用与之前相同的方法和观察员，直接观察急诊部的医生和护士的手卫生依从性。
除了之前报告的 420 次干预前和 463 次干预后观察外，我们还在干预后约 1 年观察了另外 456 次医患互动。在所有医护人员中，干预后即刻（44.9%）与干预后 1 年（45.2%）之间的手卫生依从性没有显著差异。然而，护士的依从性从 40.7%增加到 49.8%（P =.03），而医生的依从性从 50.5%下降到 36.5%（P =.008）。
干预的总体效果在 1 年内持续存在，尽管护士和医生之间存在明显差异。
