Randle Jacqueline, Arthur Antony, Vaughan Natalie, Wharrad Heather, Windle Richard
School of Nursing, Midwifery and Physiotherapy, Faculty of Medicine, University of Nottingham Queens Medical Centre, Nottingham.
School of Nursing Sciences, University of East Anglia, UK.
J Infect Prev. 2014 Jul;15(4):142-147. doi: 10.1177/1757177414531057. Epub 2014 May 12.
Hand hygiene adherence needs to be increased and sustained in order to prevent and reduce healthcare associated infections. We implemented an educational intervention and observed the adherence of healthcare workers, patients and visitors over 24 hour periods at four observation points. For healthcare workers a total of 2,294 opportunities were observed and for patients and visitors, a total of 597 opportunities were observed. Healthcare worker adherence increased following the introduction of the educational intervention, with 53.0% (282/532) adherence at baseline (observation point 1), and was sustained varying between 67.7% and 70.8% in the post-intervention points (=0.0007). The greatest increase in adherence was observed between baseline and the observation point 2. Adherence varied according to type of opportunity (<0.0001) with the lowest level of adherence observed after contact with patient surroundings, however there was no obvious trend across the observation points. There was an interaction between point of study and ward (=0.0001). For patients and visitors, adherence did differ according to the point of study (=0.0074) with adherence prior to the intervention being 49.1% and then ranging from 43.5-61.8%. We suggest that future educational interventions should be implemented as this study implies that there is potential for increased and sustained adherence to hand hygiene protocols.
为预防和减少医疗相关感染，需要提高并维持手部卫生依从性。我们实施了一项教育干预措施，并在四个观察点对医护人员、患者和访客在24小时内的依从情况进行了观察。对于医护人员，共观察到2294次机会，对于患者和访客，共观察到597次机会。引入教育干预措施后，医护人员的依从性有所提高，基线时（观察点1）的依从率为53.0%（282/532），干预后各观察点的依从率维持在67.7%至70.8%之间（P=0.0007）。在基线和观察点2之间观察到依从性的最大增幅。依从性因机会类型而异（P<0.0001），接触患者周围环境后的依从率最低，但各观察点之间没有明显趋势。研究点和病房之间存在交互作用（P=0.0001）。对于患者和访客，依从性因研究点而异（P=0.0074），干预前的依从率为49.1%，之后在43.5%至61.8%之间。我们建议应实施未来的教育干预措施，因为本研究表明提高并维持手部卫生规范的依从性具有潜力。
