Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany.
Am J Infect Control. 2013 Jun;41(6):503-8. doi: 10.1016/j.ajic.2012.09.009. Epub 2013 Jan 20.
This study evaluates hand hygiene behavior of health care workers in a German university hospital stratified for treatment of special patient groups (eg, transplant patients).
From 2008 to 2010, comprehensive education and training of all health care workers was implemented to improve hand hygiene compliance. Consumption rates of alcohol-based hand rub and gloves were collected and evaluated.
Of the 5,647 opportunities of hand disinfection evaluated, 1,607 occurred during care for transplant patients. To our knowledge, this is the largest survey of hand hygiene compliance in special patient groups on intensive care units in a university hospital in Germany. Health care workers on surgical intensive care units showed lower hand hygiene compliance compared with health care workers on other types of intensive care units. Compliance toward hand hygiene was significantly higher on hemato-oncologic and pediatric wards. In general, hand disinfection was performed significantly more frequently after an intervention than before (P < .05, 95% confidence interval: 1.24-1.84). Overall, there was no significant difference in hand hygiene compliance when caring for transplant patients or other patients (odds ratio, 1.16; 95% confidence interval: 0.95-1.42). Nurse's and physician's hand hygiene compliance improved because of education.
Hand hygiene compliance is not increased in the care for transplant patients (despite their predisposition for nosocomial infections) compared with other patients. Additional studies will be necessary to further investigate these findings.
本研究对德国一所大学医院特殊患者群体(如移植患者)的医护人员手部卫生行为进行了分层评估。
2008 年至 2010 年,对所有医护人员进行了全面的教育和培训,以提高手部卫生依从性。收集并评估了醇基手部消毒剂和手套的消耗率。
在评估的 5647 次手部消毒机会中,有 1607 次发生在移植患者护理期间。据我们所知,这是德国一所大学医院对重症监护病房特殊患者群体手部卫生依从性进行的最大规模调查。外科重症监护病房的医护人员手部卫生依从性低于其他类型重症监护病房的医护人员。血液科和儿科病房的手部卫生依从性明显更高。一般来说,干预后手部消毒的频率明显高于干预前(P <.05,95%置信区间:1.24-1.84)。总体而言,在照顾移植患者或其他患者时,手部卫生依从性没有显著差异(优势比,1.16;95%置信区间:0.95-1.42)。由于教育,护士和医生的手部卫生依从性有所提高。
与其他患者相比,在照顾移植患者(尽管他们易患医院感染)时,手部卫生依从性并未增加。需要进一步研究以进一步调查这些发现。