The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden.
Department of Anesthesia, Surgery and Intensive Care, Sahlgrenska University Hospital/Östra, Diagnosvägen 11, 416 85 Gothenburg, Sweden.
Antimicrob Resist Infect Control. 2015 Feb 6;4(1):5. doi: 10.1186/s13756-015-0042-y. eCollection 2015.
More knowledge is needed about task intensity in relation to hand hygiene in the operating room during anesthetic care in order to choose effective improvement strategies. The aim of this study was to explore the indications and occurrence of hand hygiene opportunities and the adherence to hand hygiene guidelines during routine anesthetic care in the operating room.
Structured observational data on hand hygiene during anesthetic care during 94 surgical procedures was collected using the World Health Organization's observational tool in a surgical department consisting of 16 operating rooms serving different surgical specialties such as orthopedic, gynecological, urological and general surgery.
A total of 2,393 opportunities for hand hygiene was recorded. The number of hand hygiene opportunities when measured during full-length surgeries was mean = 10.9/hour, SD 6.1 with an overall adherence of 8.1%. The corresponding numbers for the induction phase were, mean =77.5/h, SD 27.4 with an associated 3.1% adherence to hand hygiene guidelines. Lowest adherence was observed during the induction phase before an aseptic task (2.2%) and highest during full-length surgeries after body fluid exposure (15.9%).
There is compelling evidence for low adherence to hand hygiene guidelines in the operating room and thus an urgent need for effective improvement strategies. The conclusion of this study is that any such strategy should include education and practical training in terms of how to carry out hand hygiene and aseptic techniques and how to use gloves correctly. Moreover it appears to be essential to optimize the work processes in order to reduce the number of avoidable hand hygiene opportunities thereby enhancing the possibilities for adequate use of HH during anesthetic care.
为了选择有效的改进策略，需要更多地了解与麻醉护理期间手术室手卫生相关的任务强度。本研究旨在探讨手术室常规麻醉护理期间手卫生的指征和发生情况以及手卫生指南的依从性。
在一个由 16 个手术室组成的外科部门中，使用世界卫生组织的观察工具，对 94 例手术过程中的麻醉护理期间的手卫生情况进行了结构化观察数据收集，这些手术室服务于不同的外科专业，如矫形外科、妇科、泌尿科和普通外科。
共记录了 2393 次手卫生机会。当测量全长手术中的手卫生机会时，平均值为 10.9 次/小时，标准差为 6.1，总体依从率为 8.1%。诱导阶段的相应数字为，平均值=77.5/h，SD 27.4，手卫生指南的依从率为 3.1%。在无菌操作前的诱导阶段观察到的依从率最低（2.2%），在体液暴露后的全长手术中观察到的依从率最高（15.9%）。
手术室中手卫生指南的依从率很低，因此迫切需要有效的改进策略。本研究的结论是，任何此类策略都应包括有关如何进行手卫生和无菌技术以及如何正确使用手套的教育和实践培训。此外，似乎必须优化工作流程，以减少可避免的手卫生机会的数量，从而提高麻醉护理期间充分使用 HH 的可能性。
