Klymenko Iryna, Kampf Günter
Organization and Economy Department, P.L. Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine.
Bode Science Center, Bode Chemie GmbH, Hamburg, Germany ; Institute of Hygiene and Environmental Medicine, University Medicine, Greifswald, Germany.
GMS Hyg Infect Control. 2015 Jan 14;10:Doc01. doi: 10.3205/dgkh000244. eCollection 2015.
Every year, millions of people around the world suffer from different infectious diseases, considerable part of which are hospital-acquired infections. WHO considers hand hygiene as a priority measure aimed to reduce the level of infection. We evaluated various aspects related to the situational behavior and prioritization regarding hand hygiene measures among the healthcare workers of Ukraine.
Identification of system mistakes in hand hygiene was carried out first of all by direct and indirect observation of the activities of medical and pharmaceutical personnel in their everyday practice as well as during their participation in trainings on routine hand hygiene. Questionnaires also were used to estimate the level of hand hygiene compliance of participants of the study. During this period 112 training courses, 315 master-classes and presentations on proper hand hygiene were realized. The target audience included health care workers of medical centers, clinics, maternity hospitals, health care organizations and staff of pharmacies and pharmaceutical manufacturing enterprises in all regions of Ukraine. 638 respondents took part in anonymous survey on hand hygiene practice.
The most common mistakes were to regard hand washing and hand disinfection equally, to wash hands before doing a hand disinfection, to neglect the five moments for hand hygiene and to ignore hand hygiene before and after wearing protective gloves. Practitioners, medical attendants, pharmacy and pharmaceutical industry workers highlighted the need for practical and understandable instructions of various hand hygiene procedures, including the clarification of the possible technical mistakes. This became a ground for us to create individual master classes on hand hygiene for each cluster of healthcare workers.
Changing hand hygiene behavior and attitude is possible by beginning to observe clinical practice and by involving healthcare workers in teaching and training.
全球每年有数百万人遭受各种传染病折磨，其中相当一部分是医院获得性感染。世界卫生组织将手卫生视为降低感染水平的首要措施。我们评估了乌克兰医护人员在手部卫生措施方面的情境行为和优先级的各个相关方面。
首先通过直接和间接观察医护人员日常工作以及参与常规手卫生培训时的活动，来识别手卫生方面的系统错误。还使用问卷调查来评估研究参与者的手卫生依从水平。在此期间，举办了112期培训课程、315次关于正确手卫生的大师班和讲座。目标受众包括乌克兰所有地区医疗中心、诊所、妇产医院、医疗机构的医护人员以及药房和制药企业的员工。638名受访者参与了关于手卫生实践的匿名调查。
最常见的错误是将洗手和手消毒等同看待、在进行手消毒前洗手、忽视手卫生的五个时刻以及忽视戴防护手套前后的手卫生。从业者、医护助理、药房和制药行业的工作人员强调需要针对各种手卫生程序提供实用且易懂的指导，包括澄清可能的技术错误。这成为我们为每类医护人员创建手卫生个人大师班的依据。
通过开始观察临床实践并让医护人员参与教学和培训，有可能改变手卫生行为和态度。
