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[多重干预方案对重症监护病房手部卫生依从性的影响]

[Influence of a multiple intervention program for hand hygiene compliance in an ICU].

作者信息

García-Vázquez E, Murcia-Payá J, Allegue J M, Canteras M, Gómez J

机构信息

Servicios de Medicina Interna-Infecciosas, Hospital Universitario Virgen de Arrixaca, Murcia, España.

出版信息

Med Intensiva. 2012 Mar;36(2):69-76. doi: 10.1016/j.medin.2011.07.003. Epub 2011 Sep 9.

DOI:10.1016/j.medin.2011.07.003
PMID:21906849
Abstract

OBJECTIVE

To assess compliance with hand hygiene (HH) in ICU workers before (P1) and after (P2) implementation of a HH promotion program and distribution of an alcoholic solution for HH, and to analyze factors independently associated to HH before and after patients care.

DESIGN

Fifty hours of observational evaluation were carried out during each period of the study (P1 and P2); the number of opportunities for HH (before and after patients care) was registered. Educational program (6 months): poster campaign, educational meetings with staff about HH, and the provision of alcohol hand rubs.

SETTING

ICU in a secondary level hospital.

PARTICIPANTS

Healthcare workers in the ICU.

INTERVENTIONS

A quasi-experimental design was used to evaluate compliance with HH before and after implementation of the educational program.

VARIABLES

Dependent variable: HH compliance before-after patients care; independent variables that might be associated to compliance (including the educational program).

RESULTS

In P1 there were 338 opportunities for HH both before and after patients care, versus 355 in P2 (before and after patients care). The hand-washing rate was significantly higher in P2 than in P1 (prior to patient care: 45.3% and 34.9%, respectively, and after patient care: 63% and 51.7%, respectively). In the multivariate analysis, the educational program, together with other variables, was significantly associated to HH before and after patients care.

CONCLUSION

There was a significant increase in compliance with hand hygiene among the ICU personnel during the educational phase, both before and after patients care.

摘要

目的

评估在实施手部卫生(HH)促进计划并分发用于手部卫生的酒精溶液之前(P1)和之后(P2),重症监护病房(ICU)工作人员对手部卫生的依从性,并分析在患者护理前后与手部卫生独立相关的因素。

设计

在研究的每个阶段(P1和P2)进行50小时的观察性评估;记录手部卫生的机会数量(患者护理前后)。教育计划(6个月):张贴宣传海报、与工作人员就手部卫生问题召开教育会议,并提供酒精擦手液。

地点

二级医院的重症监护病房。

参与者

重症监护病房的医护人员。

干预措施

采用准实验设计评估教育计划实施前后手部卫生的依从性。

变量

因变量:患者护理前后的手部卫生依从性;可能与依从性相关的自变量(包括教育计划)。

结果

在P1阶段,患者护理前后手部卫生的机会均为338次,而在P2阶段(患者护理前后)为355次。P2阶段的洗手率显著高于P1阶段(患者护理前:分别为45.3%和34.9%,患者护理后:分别为63%和51.7%)。在多变量分析中,教育计划以及其他变量与患者护理前后的手部卫生显著相关。

结论

在教育阶段,重症监护病房人员在患者护理前后对手部卫生的依从性均显著提高。

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