Anargh V, Singh Harpreet, Kulkarni Aniket, Kotwal Atul, Mahen Ajoy
Intern, 166 Military Hospital, C/o 56 APO, India.
Resident, Dept of Community Medicine, AFMC, Pune 411040, India.
Med J Armed Forces India. 2013 Jan;69(1):54-6. doi: 10.1016/j.mjafi.2012.08.011. Epub 2012 Nov 30.
Improper hand hygiene by healthcare workers (HCWs) is responsible for about 40% of nosocomial infections resulting in prolonged illnesses, hospital stays, long-term disability and unexpected high costs on patients and their families, and also lead to a massive additional financial burden on the health-care system.
To assess knowledge and practices regarding hand hygiene among HCWs of a tertiary health care facility.
A cross sectional, questionnaire and observation based study was carried out in a tertiary care health care facility in Pune. Based on sample size calculations, 100 HCWs working in medical and surgical wards were studied.
The proportion knowledgeable about hand hygiene practices was 85% and 73% HCWs were of the belief that unclean hands are an important route of cross transmission. WHO guidelines regarding procedure were being followed by 90% for hand washing with soap and water and 64% for alcohol based rubs. Majority preferred hand washing with soap and water over hand rubbing with alcohol based solutions. 21% of HCWs were missing hand hygiene opportunities 1 in 5 times. Heavy workload (38%), non availability (52%) and inaccessibility (9%) of hand hygiene facilities were the common reasons for non-compliance. Availability of 'one time use paper towels' was low (12%).
Inadequate compliance despite knowledge and false sense of security by alcohol based rubs was seen. A multi disciplinary, multifaceted approach is required to tackle issues of non-compliance.
医护人员手部卫生不当导致约40%的医院感染,造成患者病情延长、住院时间延长、长期残疾以及患者及其家庭意外的高额费用,还给医疗系统带来巨大的额外经济负担。
评估一家三级医疗机构中医护人员关于手部卫生的知识和行为。
在浦那的一家三级医疗机构开展了一项基于问卷调查和观察的横断面研究。根据样本量计算,对在医疗和外科病房工作的100名医护人员进行了研究。
了解手部卫生做法的比例为85%,73%的医护人员认为不干净的手是交叉传播的重要途径。90%的人遵循世界卫生组织关于用肥皂和水洗手的程序指南,64%的人遵循关于使用酒精类擦手液的指南。大多数人更喜欢用肥皂和水洗手,而不是用酒精类溶液擦手。21%的医护人员每5次中有1次会错过手部卫生时机。手部卫生设施繁重的工作量(38%)、无法获取(52%)和难以获取(9%)是不遵守规定的常见原因。“一次性纸巾”的可用性较低(12%)。
尽管有知识,但仍存在手部卫生依从性不足以及对酒精类擦手液存在安全感错觉的情况。需要采取多学科、多方面的方法来解决不遵守规定的问题。