Chavali Siddharth, Menon Varun, Shukla Urvi
Department of Anesthesia and Critical Care, MKCG Medical College, Berhampur, Odisha, India.
Department of Critical Care, Aditya Birla Memorial Hospital, Pune, Maharashtra, India.
Indian J Crit Care Med. 2014 Oct;18(10):689-93. doi: 10.4103/0972-5229.142179.
We are using multimodal technique to improve hand hygiene (HH) compliance among all health care staff for the past 1-year. This cross-sectional observational study was conducted in the surgical ICU to assess adherence to HH among nurses and allied healthcare workers, at the end of the training year.
This was a cross-sectional observational study using direct observation technique. A single observer collected all HH data. During this analysis, 1500 HH opportunities were observed. HH compliance was tested for all 5 moments as per WHO guidelines.
Overall compliance as per WHO Guidelines was 78%. Nurses had an adherence rate of 63%; allied staff adherence was 86.5%. Compliance was 93% after patient contact versus 63% before patient contact. Nurses'compliance before aseptic procedures was lowest at 39%. 92% staff was aware of the facts viz. Diseases prevented by hand washing, ideal duration of HH, reduction of health care associated infections, etc.
After 1-year of aggressive multimodal intervention in improving HH compliance, we have an overall compliance of 78%. It implies that sustained performance and compliance to HH can be ensured by ongoing training. Direct observation remains a widely used, easily reproducible method for monitoring compliance.
在过去一年中,我们一直在使用多模式技术来提高所有医护人员的手卫生(HH)依从性。这项横断面观察性研究在外科重症监护病房进行,以评估培训年度结束时护士和辅助医护人员对手卫生的依从情况。
这是一项采用直接观察技术的横断面观察性研究。由一名观察者收集所有手卫生数据。在此分析过程中,观察了1500次手卫生时机。按照世界卫生组织指南对所有5个时刻的手卫生依从性进行了检测。
按照世界卫生组织指南,总体依从率为78%。护士的依从率为63%;辅助人员的依从率为86.5%。接触患者后依从率为93%,而接触患者前为63%。护士在无菌操作前的依从率最低,为39%。92%的工作人员了解以下事实,即洗手预防的疾病、理想的手卫生持续时间、减少医疗保健相关感染等。
在进行了为期一年的积极多模式干预以提高手卫生依从性之后,我们的总体依从率为78%。这意味着通过持续培训可以确保手卫生的持续执行和依从性。直接观察仍然是一种广泛使用、易于重复的监测依从性的方法。