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台湾某教学医院实施世界卫生组织多模式手部卫生改善策略的影响

Impact of implementation of the World Health Organization multimodal hand hygiene improvement strategy in a teaching hospital in Taiwan.

作者信息

Chen Jui-Kuang, Wu Kuan-Sheng, Lee Susan Shin-Jung, Lin Huey-Shyan, Tsai Hung-Chin, Li Ching-Hsien, Chao Hsueh-Lan, Chou Hsueh-Chih, Chen Yueh-Ju, Huang Yu-Hsiu, Ke Chin-Mei, Sy Cheng Len, Tseng Yu-Ting, Chen Yao-Shen

机构信息

Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Am J Infect Control. 2016 Feb;44(2):222-7. doi: 10.1016/j.ajic.2015.10.004. Epub 2015 Dec 13.

Abstract

BACKGROUND

Hand hygiene (HH) is considered to be the most simple, rapid, and economic way to prevent health care-associated infection (HAI). However, poor HH compliance has been repeatedly reported. Our objective was to evaluate the impact of implementing the updated World Health Organization (WHO) multimodal HH guidelines on HH compliance and HAI in a tertiary hospital in Taiwan.

METHODS

We conducted a before-and-after interventional study during 2010-2011. A multimodal HH promotion campaign was initiated. Key strategies included providing alcohol-based handrub dispensers at points of care, designing educational programs tailored to the needs of different health care workers, placement of general and individual reminders in the workplace, and establishment of evaluation and feedback for HH compliance and infection rates.

RESULTS

Overall HH compliance increased from 62.3% to 73.3% after 1 year of intervention (P < .001). The rate of overall HAI decreased from 3.7% to 3.1% (P < .05), urinary tract infection rate decreased from 1.5% to 1.2% (P < .05), and respiratory tract infection rate decreased from 0.53% to 0.35% (P < .05). This campaign saved an estimated $940,000 and 3,564 admission patient days per year.

CONCLUSION

The WHO multimodal HH guidelines are feasible and effective for the promotion of HH compliance and are associated with the reduction of HAIs.

摘要

背景

手部卫生(HH)被认为是预防医疗保健相关感染(HAI)最简便、迅速且经济的方法。然而,手部卫生依从性差的情况屡有报道。我们的目的是评估在台湾一家三级医院实施更新后的世界卫生组织(WHO)多模式手部卫生指南对手部卫生依从性和医疗保健相关感染的影响。

方法

我们在2010 - 2011年期间进行了一项前后对照干预研究。启动了一项多模式手部卫生促进活动。关键策略包括在护理点提供含酒精的洗手液分配器,设计针对不同医护人员需求的教育项目,在工作场所放置通用和个性化提醒标识,以及建立手部卫生依从性和感染率的评估与反馈机制。

结果

干预1年后,总体手部卫生依从性从62.3%提高到73.3%(P <.001)。总体医疗保健相关感染率从3.7%降至3.1%(P <.05),尿路感染率从1.5%降至1.2%(P <.05),呼吸道感染率从0.53%降至0.35%(P <.05)。该活动每年节省了约94万美元和3564个住院患者日。

结论

世界卫生组织多模式手部卫生指南对于促进手部卫生依从性是可行且有效的,并且与医疗保健相关感染的减少相关。

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