Ezzat Ahmed, Safdar Muhammad Muneeb, Ahmed Irfan
Year 5 MBChB, University of Aberdeen, UK
Year 4 MBChB, University of Aberdeen, UK.
Scott Med J. 2014 Nov;59(4):214-9. doi: 10.1177/0036933014554885. Epub 2014 Oct 13.
Surgical site infections have an incidence as high as 10%. To reduce this, the World Health Organisation (WHO) recommends guidelines for surgical scrubbing.
We assessed adherence of surgical staff scrub practice before gowning to current WHO recommendations.
A prospective study conducted in operation theatres in a university hospital. Participants comprised of consultant surgeons, trainees and scrub nurses. Variables included staff grade, scrub order, length of scrub time and appropriate dress code. Data were collected anonymously and analysed.
We assessed 303 surgical scrub-episodes (95 scrub nurses, 123 trainees and 85 consultant surgeons). Mean time for first scrub of the day was 239 s, SD = 99, 95% CI 218, 259 and range = 530 (scrub nurses = 297 s, trainees = 204 s, consultant surgeons = 202 s). Mean time for subsequent scrubs was 161 s, SD = 63, 95% CI 152, 170, range = 312 (scrub nurses = 184 s, trainees = 158 s, consultant surgeons = 143 s). Statistical significance was found between staff grades based on scrub time, with WHO breaches in remaining variables.
No written local guidelines on hand scrubbing exist in the hospital and staff were unaware of WHO guidelines. In this study, mean scrub times were less than WHO guidelines with significant variation in practice across grades of staff. Clear written guidelines are needed.
手术部位感染的发生率高达10%。为降低这一发生率，世界卫生组织（WHO）推荐了手术刷手指南。
我们评估了手术人员在穿手术衣前刷手操作对当前WHO指南的依从性。
在一家大学医院的手术室进行一项前瞻性研究。参与者包括外科顾问医生、实习医生和刷手护士。变量包括人员级别、刷手顺序、刷手时间长度和合适的着装规范。数据以匿名方式收集并进行分析。
我们评估了303次手术刷手过程（95名刷手护士、123名实习医生和85名外科顾问医生）。当日首次刷手的平均时间为239秒，标准差=99，95%置信区间218，259，范围=530（刷手护士=297秒，实习医生=204秒，外科顾问医生=202秒）。后续刷手的平均时间为161秒，标准差=63，95%置信区间152，170，范围=312（刷手护士=184秒，实习医生=158秒，外科顾问医生=143秒）。基于刷手时间发现人员级别之间存在统计学差异，在其余变量方面存在违反WHO指南的情况。
该医院没有关于手部刷洗的书面本地指南，工作人员也不了解WHO指南。在本研究中，平均刷手时间低于WHO指南，且不同级别人员的操作存在显著差异。需要明确的书面指南。
