Uneke Chigozie J, Ndukwe Chinwendu D, Nwakpu Kingsley O, Nnabu Richard C, Ugwuoru Cletus D, Prasopa-Plaizier Nittita
Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria.
J Infect Dev Ctries. 2014 Jan 15;8(1):86-93. doi: 10.3855/jidc.2696.
This study aimed to assess the impact of a stethoscope disinfection sensitization campaign among doctors and nurses in a Nigerian teaching hospital.
The design was a before-and-after study. Pre-program measurements were used to provide a baseline against which the post-program results were compared. Interventions that promoted compliance with stethoscope disinfection practice that were implemented included training and education on stethoscope disinfection and introduction of 70% isopropyl alcohol disinfectant at points-of-care places. Microbiological assessment of stethoscopes used by health workers was conducted after the intervention and the outcome was compared with the pilot study results.
After the intervention, of the 89 stethoscopes screened, 18 (20.2%) were contaminated with bacterial agents. A higher prevalence of stethoscope contamination was observed among stethoscopes from the intensive care unit (66.7%), the VIP unit (50%), and the antenatal unit (37.5%). The main isolates were Staphylococcus aureus (44.4%) and Escherichia coli (50%). The antibiotic sensitivity assessment indicated that the bacterial isolates were resistant to nearly all the antibiotics tested. All the 89 health workers whose stethoscopes were screened after the intervention admitted to cleaning their stethoscopes after seeing each patient, representing a compliance rate of 100%, unlike the 15% compliance at the pilot phase. The baseline stethoscope contamination rate was 78.5% versus 20.2% post-intervention.
Training and education and introduction of alcohol-based disinfectants inexpensive but very effective methods to improve stethoscope disinfection compliance among health workers in low-income settings.
本研究旨在评估在尼日利亚一家教学医院开展的听诊器消毒宣传活动对医生和护士的影响。
采用前后对照研究设计。干预前的测量用于提供基线数据，以便与干预后的结果进行比较。实施的促进听诊器消毒实践依从性的干预措施包括听诊器消毒培训和教育，以及在护理点引入70%异丙醇消毒剂。干预后对医护人员使用的听诊器进行微生物学评估，并将结果与试点研究结果进行比较。
干预后，在筛查的89个听诊器中，有18个（20.2%）被细菌污染。重症监护病房（66.7%）、贵宾病房（50%）和产前病房（37.5%）的听诊器污染率较高。主要分离菌为金黄色葡萄球菌（44.4%）和大肠杆菌（50%）。抗生素敏感性评估表明，分离出的细菌对几乎所有测试抗生素均耐药。干预后筛查听诊器的89名医护人员均承认在为每位患者检查后会清洁听诊器，依从率达100%，而试点阶段的依从率为15%。听诊器基线污染率为78.5%，干预后为20.2%。
培训教育以及引入酒精基消毒剂是提高低收入环境中医护人员听诊器消毒依从性的低成本但非常有效的方法。
