Centro de Salud Monóvar, Gerencia de Atención Primaria de Madrid, Spain.
Infect Control Hosp Epidemiol. 2012 Jul;33(7):681-8. doi: 10.1086/666343. Epub 2012 May 18.
To evaluate the effectiveness of a multimodal intervention in primary care health professionals for improved compliance with hand hygiene practice, based on the World Health Organization's 5 Moments for Health Hygiene.
Cluster randomized trial, parallel 2-group study (intervention and control).
Primary healthcare centers in Madrid, Spain.
Eleven healthcare centers with 198 healthcare workers (general practitioners, nurses, pediatricians, auxiliary nurses, midwives, odontostomatologists, and dental hygienists). Methods. The multimodal hand hygiene improvement strategy consisted of training of healthcare workers by teaching sessions, implementation of hydroalcoholic solutions, and installation of reminder posters. The hand hygiene compliance level was evaluated by observation during regular care activities in the office visit setting, at the baseline moment, and 6 months after the intervention, all by a single external observer.
The overall baseline compliance level was 8.1% (95% confidence interval [CI], 6.2-10.1), and the healthcare workers of the intervention group increased their hand hygiene compliance level by 21.6% (95% CI, 13.83-28.48) compared with the control group.
This study has demonstrated that hand hygiene compliance in primary healthcare workers can be improved with a multimodal hand hygiene improvement strategy.
评估基于世界卫生组织“卫生保健 5 时刻”的多模式干预措施对初级保健卫生专业人员提高手卫生实践依从性的效果。
整群随机试验，平行 2 组研究（干预组和对照组）。
西班牙马德里的初级保健中心。
11 个保健中心的 198 名卫生保健工作者（全科医生、护士、儿科医生、助理护士、助产士、口腔医生和牙科保健师）。
多模式手部卫生改善策略包括通过教学课程培训卫生保健工作者、实施醇基溶液以及安装提醒海报。通过在办公室就诊环境中进行的常规护理活动、基线时刻以及干预后 6 个月由单一外部观察员进行观察来评估手部卫生依从水平。
总体基线依从率为 8.1%（95%置信区间，6.2-10.1），与对照组相比，干预组的卫生保健工作者手部卫生依从率提高了 21.6%（95%置信区间，13.83-28.48）。
本研究表明，多模式手部卫生改善策略可提高初级保健卫生工作者的手部卫生依从性。
