Clinical Microbiology, Division of Medical Services, Jönköping, Sweden.
Am J Infect Control. 2013 May;41(5):e45-8. doi: 10.1016/j.ajic.2012.09.008. Epub 2013 Jan 20.
Good compliance with hygiene guidelines is essential to prevent bacterial transmission and health care-associated infections. However, the compliance is usually <50%.
A multimodal and multidisciplinary hygiene intervention was launched once the baseline compliance was determined through direct observations in 4 departments of obstetrics and gynecology. Detailed evaluations of the compliance rates were performed at point of stability (at 80%) and follow-up (3 years after hygiene intervention). Validation of direct observations was performed using blinded double appraisal and multiappraisal.
At baseline, the compliance with barrier precautions and the dress code at the 4 departments were 39% to 47% and 79% to 98%, respectively. Point of stability was reached approximately 1 year after the hygiene intervention was launched. The compliance with barrier precautions was significantly higher at follow-up compared with baseline in 3 departments. In the validation by double appraisal, 471 of 483 components were judged identical between observers. In the multiappraisal, 95% to 100% of the observers correctly judged the 7 components.
It is possible to improve compliance with hygiene guidelines, but, to ensure a long-lasting effect, a continuous focus on barrier precautions is required. Observation is a valid method to monitor compliance.
良好的卫生规范依从性对于防止细菌传播和医源性感染至关重要。然而，通常只有不到 50%的人能够遵守。
在妇产科的 4 个部门通过直接观察确定基线依从率后，启动了多模式和多学科的卫生干预措施。在稳定点（达到 80%）和随访（卫生干预 3 年后）时，对依从率进行详细评估。使用盲法双评估和多评估来验证直接观察的结果。
在基线时，4 个部门的屏障预防措施和着装规范的依从率分别为 39%至 47%和 79%至 98%。卫生干预措施启动大约 1 年后达到稳定点。在 3 个部门中，随访时的屏障预防措施依从率显著高于基线时。在双评估的验证中，观察者之间判断一致的组件有 471 个。在多评估中，7 个组件的 95%至 100%的观察者判断正确。
提高卫生规范的依从性是可能的，但为了确保长期效果，需要持续关注屏障预防措施。观察是监测依从性的有效方法。
