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香港地区医院手部卫生操作与手套使用评估

An evaluation of hospital hand hygiene practice and glove use in Hong Kong.

机构信息

Nethersole School of Nursing, Chinese University of Hong Kong, Shatin, Hong Kong.

出版信息

J Clin Nurs. 2011 May;20(9-10):1319-28. doi: 10.1111/j.1365-2702.2010.03586.x.

Abstract

AIM

To identify omissions in hand hygiene practice and glove use among hospital workers in Hong Kong.

BACKGROUND

Hospital-acquired infection is the commonest complication affecting hospitalised patients. Even though research evidence suggests that hand hygiene and proper glove use are the most important ways to prevent the spread of disease and infection, compliance with both are reported to be unacceptably low.

DESIGN

An observational study of hospital workers in one acute and two convalescence and rehabilitation hospitals in Hong Kong was conducted. The participating clinical areas included the medical and surgical wards, accident and emergency department and intensive care unit.

METHODS

Hand hygiene practice and glove use amongst 206 hospital health and support workers, stratified according to years of working experience, were observed.

RESULTS

The number of observed episodes for hand hygiene was 1037 and for glove use 304. Compliance with hand hygiene was 74.7% and with glove use 72.4%. In approximately two-third of episodes, participants washed their hands after each patient contact; though, 78.5% failed to rub their hands together vigorously for at least 15 seconds. The major break in compliance with glove use was failure to change gloves between procedures on the same patient. In 28.6% of observed glove use episodes, participants did not wear gloves during procedures that exposed them to blood, body fluids, excretion, non-intact skin or mucous membranes. Significant differences in performance scores on antiseptic hand rub were found between the two types of hospital and on glove use between the three groups of work experience: ≤ 5, 6-10, >10 years.

RELEVANCE TO CLINICAL PRACTICE

Education and reinforcement of proper hand hygiene practice and glove use among hospital health and support workers is needed.

摘要

目的

识别香港医院工作人员在手部卫生操作和手套使用方面的遗漏。

背景

医院获得性感染是影响住院患者最常见的并发症。尽管研究证据表明,手部卫生和正确使用手套是预防疾病和感染传播的最重要方法,但报告称,这两者的依从性都低得令人无法接受。

设计

在香港的一家急症医院和两家康复医院进行了一项对医院工作人员的观察性研究。参与的临床区域包括内科和外科病房、急症室和重症监护室。

方法

对 206 名医院卫生和支持人员的手部卫生操作和手套使用情况进行了观察,根据工作年限进行了分层。

结果

观察到的手部卫生操作次数为 1037 次,手套使用次数为 304 次。手部卫生的依从率为 74.7%,手套使用的依从率为 72.4%。在大约三分之二的情况下,参与者在每次接触病人后都洗手;尽管 78.5%的人没有用力揉搓双手至少 15 秒。违反手套使用规定的主要行为是在为同一病人进行的不同操作之间不更换手套。在观察到的手套使用情况中,有 28.6%的情况下,参与者在接触血液、体液、排泄物、非完整皮肤或粘膜的操作中没有戴手套。在两种类型的医院中,使用消毒剂洗手的表现评分存在显著差异,在三种工作经验组之间,手套使用的差异也显著:≤5 年、6-10 年、>10 年。

相关性

需要对医院卫生和支持人员进行正确的手部卫生操作和手套使用教育和强化。

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