Kurtz Sharon Lea
Walden University, Minneapolis, MN.
Am J Infect Control. 2017 Aug 1;45(8):839-843. doi: 10.1016/j.ajic.2017.04.004. Epub 2017 May 16.
The purpose of this article was to provide information identified during hand hygiene (HH) surveillance periods at 5 intensive care units (ICUs) (4 hospitals) in Texas.
Using room entry and room exit, overt observation periods were 8 consecutive hours for 3-5 days on 64 ICU nurses.
A total of 3,620 HH opportunities were recorded during 18 days of observation (144 hours). The average hand hygiene compliance (HHC) rate was 64%, with 19% of the nurses participating in HH in the 60%-69% range. Male nurses had a rate of 67%, whereas female nurses had a rate of 62%. Having a HHC rate of <29%, 6% of the nurses were identified as low gelers, whereas 14% were identified as high gelers (HHC rate 80%-89%), and 13% were classified as super gelers (HHC rate 90%-100%). Four barriers to HHC were identified: carrying something in their hands, talking on mobile phones, donning gloves or personal protective equipment, and pushing or pulling the workstation on wheels; all were statistically significant. Accounting for 18% noncompliance, barriers identified present teaching opportunities to increase compliance.
Average HHC rates recorded during 10- to 20-minute periods with random sampling may not show the complete picture of HHC. Barriers to HHC were identified that can be used as teaching interventions.
本文旨在提供在得克萨斯州4家医院的5个重症监护病房（ICU）进行手卫生（HH）监测期间所发现的信息。
通过记录进入和离开病房的情况，对64名ICU护士进行了为期3至5天、连续8小时的公开观察。
在18天的观察期（144小时）内共记录了3620次手卫生机会。手卫生依从性（HHC）平均率为64%，19%的护士HHC率在60%至69%之间。男护士的HHC率为67%，而女护士为62%。6%的护士HHC率<29%，被确定为低凝胶使用者，14%被确定为高凝胶使用者（HHC率80%至89%），13%被归类为超级凝胶使用者（HHC率90%至100%）。确定了影响HHC的四个障碍因素：手中拿着东西、打电话、戴手套或个人防护装备，以及推或拉带轮工作站；所有这些因素在统计学上均具有显著意义。这些已确定的障碍因素占不依从情况的18%，为提高依从性提供了教学机会。
在随机抽样的10至20分钟时间段内记录的HHC平均率可能无法全面反映HHC情况。已确定了可作为教学干预措施的HHC障碍因素。
