Infection Control Unit, Hospital Sírio Libanês, São Paulo, Brazil.
Endoscopy. 2013 Jun;45(6):421-5. doi: 10.1055/s-0032-1326284. Epub 2013 Jun 3.
Although hand hygiene is the most important measure in preventing infection transmission in healthcare settings, adherence to recommendations among healthcare workers is low. We implemented and assessed the impact of a World Health Organization-recommended educational intervention to improve hand hygiene adherence at the endoscopy unit of a Brazilian tertiary hospital.
Hand hygiene adherence and techniques used by healthcare workers of the endoscopy unit in the course of their duties were observed unobtrusively by four nurses from the infection control unit. Data were collected at every opportunity for hand hygiene. Evaluations were carried out before and 1 and 10 months after an educational intervention. The intervention consisted of task-orientated training sessions, with live demonstrations of the multitude of opportunities for hand hygiene and the appropriate techniques. In addition to assessing hand hygiene practices, we also evaluated staff knowledge through standardized questionnaires administered before and after the education intervention. Adherence was defined as hand hygiene/disinfection at an opportunity for hand hygiene.
Adherence improved from 21.4 % before the intervention to 63.3 % 1 month and 73.5 % 10 months after the educational intervention. Correct answers to the questionnaire were 82.1 % on pre-intervention test and 85.7 % on post-intervention test.
Hand hygiene rates were low before the education intervention and improved significantly after it. Against expectations, adherence to hand hygiene practices had increased further at 10 months after the intervention, reinforcing the intervention's positive impact.
尽管手卫生是预防医疗机构感染传播最重要的措施,但医护人员对建议的依从性较低。我们实施并评估了世界卫生组织推荐的一项教育干预措施,以提高巴西一家三级医院内镜科的手卫生依从性。
感染控制部门的四名护士对内镜科医护人员在工作过程中的手卫生依从性和技术进行了非干扰性观察。在每次有机会进行手卫生时收集数据。在教育干预之前和之后的 1 个月和 10 个月进行评估。干预措施包括任务导向培训课程,对多种手卫生机会和适当技术进行现场演示。除了评估手卫生实践外,我们还通过在教育干预前后进行的标准化问卷评估了员工知识。依从性定义为在进行手卫生/消毒的机会进行手卫生。
干预前的依从率为 21.4%,干预后 1 个月和 10 个月分别提高至 63.3%和 73.5%。干预前测试的正确答案率为 82.1%,干预后测试的正确答案率为 85.7%。
在教育干预之前,手卫生率较低,干预后显著提高。出乎意料的是,干预后 10 个月,手卫生实践的依从性进一步提高,强化了干预的积极影响。