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电子手卫生监测综述:医院管理在数据收集、医护人员监督及患者认知方面的考量

A Review of Electronic Hand Hygiene Monitoring: Considerations for Hospital Management in Data Collection, Healthcare Worker Supervision, and Patient Perception.

作者信息

McGuckin Maryanne, Govednik John

出版信息

J Healthc Manag. 2015 Sep-Oct;60(5):348-61.

Abstract

Healthcare-associated infections (HAIs) in U.S. acute care hospitals lead to a burden of $96-$147 billion annually on the U.S. health system and affect 1 in 20 hospital patients (Marchetti & Rossiter, 2013). Hospital managers are charged with reducing and eliminating HAIs to cut costs and improve patient outcomes. Healthcare worker (HCW) hand hygiene (HH) practice is the most effective means of preventing the spread of HAIs, but compliance is at or below 50% (McGuckin, Waterman, & Govednik, 2009). For managers to increase the frequency of HCW HH occurrences and improve the quality of HH performance, companies have introduced electronic technologies to assist managers in training, supervising, and gathering data in the patient care setting. Although these technologies offer valuable feedback regarding compliance, little is known in terms of capabilities in the clinical setting. Less is known about HCW or patient attitudes if the system allows feedback to be shared. Early-adopting managers have begun to examine their experiences with HH technologies and publish their findings. We review peer-reviewed research on infection prevention that focused on the capabilities of these electronic systems, as well as the related research on HCW and patient interactions with electronic HH systems. Research suggests that these systems are capable of collecting data, but the results are mixed regarding their impact on HH compliance, reducing HAIs, or both and their costs. Research also indicates that HCWs and patients may not regard the technology as positively as industry or healthcare managers may have intended. When considering the adoption of electronic HH monitoring systems, hospital administrators should proceed with caution.

摘要

美国急症护理医院中的医疗保健相关感染(HAIs)每年给美国医疗系统带来960亿至1470亿美元的负担,每20名住院患者中就有1人受到影响(马尔凯蒂和罗斯特,2013年)。医院管理人员负责减少和消除医疗保健相关感染,以降低成本并改善患者治疗效果。医护人员(HCW)的手部卫生(HH)措施是预防医疗保健相关感染传播的最有效手段,但依从率仅为50%或更低(麦古金、沃特曼和戈夫德尼克,2009年)。为了提高医护人员手部卫生措施的执行频率并改善执行质量,一些公司引入了电子技术,以协助管理人员在患者护理环境中进行培训、监督和收集数据。尽管这些技术提供了有关依从性的宝贵反馈,但在临床环境中的功能方面却知之甚少。如果系统允许分享反馈,医护人员或患者的态度则了解得更少。早期采用这些技术的管理人员已开始审视他们使用手部卫生技术的经验并发表他们的研究结果。我们回顾了经同行评审的关于感染预防的研究,这些研究聚焦于这些电子系统的功能,以及医护人员和患者与电子手部卫生系统互动的相关研究。研究表明,这些系统能够收集数据,但在它们对手部卫生依从性、减少医疗保健相关感染或两者的影响以及成本方面,结果好坏参半。研究还表明,医护人员和患者对该技术的看法可能不像行业或医院管理人员预期的那样积极。在考虑采用电子手部卫生监测系统时,医院管理人员应谨慎行事。

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