Fariñas-Alvarez C, Portal-María T, Flor-Morales V, Aja-Herrero A, Fabo-Navarro M, Lanza-Marín S, Lobeira-Rubio R, Polo-Hernández N, Sixto-Montero M, Moreta-Sánchez R, Ballesteros-Sanz M Á, Yañez-San Segundo L, Bartalome-Pacheco M J, Armiñanzas-Castillo C
Grupo de Mejora de la Higiene de Manos, Hospital Universitario Marqués de Valdecilla, Santander, España.
Grupo de Mejora de la Higiene de Manos, Hospital Universitario Marqués de Valdecilla, Santander, España.
Rev Calid Asist. 2017 Jan-Feb;32(1):50-56. doi: 10.1016/j.cali.2016.06.011. Epub 2016 Sep 7.
Within the framework of the PaSQ (Patient Safety and Quality care) Project, this hospital decided to implement a multifaceted hospital-wide Hand Hygiene (HH) intervention based on a multimodal WHO approach over one year, focusing on achieving a sustained change in HH cultural change in this hospital.
Setting: University Hospital Marqués de Valdecilla, Santander (Spain), a tertiary hospital with 900 beds. Intervention period: 2014. An action plan was developed that included the implementation of activities in each component of the 5-step multimodal intervention. An observation/feedback methodology was used that included the provision of performance and results feedback to the staff. A 3/3 strategy (non-blinded direct observation audits performed during 3 randomised days every 3 weeks with pro-active corrective actions at the end of each observation period). HH compliance, alcohol-based hand-rub (ABHR) consumption, and rate of MRSA infection, were monitored during the intervention.
Hospital ABHR consumption increased during the study period: from 17.5 to 19.7mL/patient-days. In the intervention units, this consumption was 24.8mL pre-intervention, 42.5mL during the intervention, and 30.4mL two months post-intervention. There were 137 evaluation periods in 30 different days, in which a total of 737 health-care workers were observed and 1,870 HH opportunities. HH compliance was 54.5%, ranging between 44.8% and 69.9%. The incidence of MRSA infection decreased during the intervention in the selected units, from 13.2 infections per 10,000 patient-days pre-intervention to 5.7 three months post-intervention.
Our HH strategy, supported by a 3/3 strategy increased alcohol-based hand-rub consumption and compliance. A reduction in MRSA infections was observed.
在“患者安全与优质护理”（PaSQ）项目框架内，该医院决定在一年时间里基于世界卫生组织的多模式方法实施一项全院范围的多方面手卫生（HH）干预措施，重点是在本院实现手卫生文化的持续转变。
地点：西班牙桑坦德市瓦尔迪西利亚侯爵大学医院，一家拥有900张床位的三级医院。干预期：2014年。制定了一项行动计划，其中包括在五步多模式干预的每个组成部分开展活动。采用了观察/反馈方法，包括向工作人员提供绩效和结果反馈。采用3/3策略（每3周在3个随机日进行非盲法直接观察审核，并在每个观察期结束时采取积极的纠正措施）。在干预期间监测手卫生依从性、含酒精洗手液（ABHR）消耗量和耐甲氧西林金黄色葡萄球菌（MRSA）感染率。
在研究期间，医院ABHR消耗量增加：从17.5毫升/患者日增至19.7毫升/患者日。在干预科室，干预前ABHR消耗量为24.8毫升，干预期间为42.5毫升，干预后两个月为30.4毫升。在30个不同日期进行了137个评估期，共观察了737名医护人员和1870次手卫生机会。手卫生依从率为54.5%，范围在44.8%至69.9%之间。在选定科室的干预期间，MRSA感染发生率从干预前的每10000患者日13.2例感染降至干预后三个月的5.7例。
我们的手卫生策略在3/3策略的支持下增加了含酒精洗手液的消耗量和依从性。观察到MRSA感染有所减少。
