Chandonnet Celeste J, Boutwell Kristan M, Spigel Nadine, Carter Judith, DeGrazia Michele, Ozonoff Al, Flaherty Kathleen
Celeste J. Chandonnet, BSN, RN, CCRN, CIC, is an infection preventionist at Boston Children's Hospital in Massachusetts. Kristan M. Boutwell, RN, CPNP, is a nurse practitioner in the neonatal intensive care unit at Boston Children's Hospital in Massachusetts. Nadine Spigel, BSN, RN, CCRN, is a nurse in the neonatal intensive care unit at Mount Sinai Hospital in New York. Judith Carter, RN, CCRN, is a nurse in the neonatal intensive care unit at Boston Children's Hospital in Massachusetts. Michele DeGrazia, PhD, RN, NNP-BC, FAAN, is a nurse practitioner in the neonatal intensive care unit at Boston Children's Hospital and director of nursing research in the neonatal intensive care unit in the Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Al Ozonoff, PhD, is director of the Center for Applied Pediatric Quality Analytics at Boston Children's Hospital in Massachusetts and associate professor, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Kathleen Flaherty, BS, MT(ASCP), CIC, is an infection preventionist at Boston Children's Hospital in Massachusetts.
Dimens Crit Care Nurs. 2017 Nov/Dec;36(6):327-333. doi: 10.1097/DCC.0000000000000268.
Health care-associated infections contribute to increased morbidity and mortality, increased resource use, higher costs, and extended hospitalizations. Proper hand hygiene (HH) is essential to health care-associated infection prevention. Low compliance among parents in our neonatal intensive care unit (NICU) was identified and prompted development of an HH initiative.
The objective of this quality improvement project was to improve parent HH practices with the ultimate goal of achieving 100% compliance with parent HH.
Between December 2011 and November 2014, our NICU Infection Prevention Committee developed and implemented the parent/family HH initiative entitled "It's in Your Hands" and created learning materials based on the World Health Organization and Centers for Disease Control and Prevention recommendations. Materials included information sheets, posters, stickers, and checklists. Audits, based on the World Health Organization's Five Moments for Hand Hygiene, were performed several times per week to monitor compliance.
Before the intervention, only 71% (n = 1143) of all observed parents and family members performed proper HH. After the intervention, proper HH increased to 89% (n = 939). An average compliance of 89% was maintained throughout the intervention phase.
This initiative led to sustained improvements in HH compliance among NICU parents. It has empowered parents to speak up and request proper HH from health care providers when interacting with their child. This initiative has been adopted as a hospital-wide standard of care.
医疗保健相关感染会导致发病率和死亡率上升、资源使用增加、成本提高以及住院时间延长。正确的手部卫生（HH）对于预防医疗保健相关感染至关重要。我们在新生儿重症监护病房（NICU）发现家长的依从性较低，这促使我们开展了一项手部卫生倡议。
这个质量改进项目的目的是改善家长的手部卫生习惯，最终目标是使家长手部卫生的依从率达到100%。
在2011年12月至2014年11月期间，我们的NICU感染预防委员会制定并实施了名为“掌握在您手中”的家长/家庭手部卫生倡议，并根据世界卫生组织和疾病控制与预防中心的建议制作了学习材料。材料包括信息单、海报、贴纸和检查表。根据世界卫生组织的“五个手部卫生时刻”每周进行多次审核，以监测依从情况。
在干预前，所有观察到的家长和家庭成员中只有71%（n = 1143）进行了正确的手部卫生。干预后，正确的手部卫生比例提高到了89%（n = 939）。在整个干预阶段，平均依从率保持在89%。
这项倡议使NICU家长的手部卫生依从性得到了持续改善。它使家长有能力在与孩子互动时向医疗保健提供者提出要求并要求正确的手部卫生。这项倡议已被采纳为全院的护理标准。
