Charité-University Medicine Berlin, Institute for Hygiene, Berlin, Germany.
Charité-University Medicine Berlin, Institute for Hygiene, Berlin, Germany.
Clin Microbiol Infect. 2018 Jul;24(7):778.e1-778.e6. doi: 10.1016/j.cmi.2017.10.015. Epub 2017 Oct 23.
Hand hygiene is considered the most effective way to reduce the transmission of (multidrug-resistant) organisms and to prevent healthcare-associated infections. Hand rubbing with alcohol-based handrub (AHR) has become the reference standard for hand hygiene. Data on AHR consumption are easy to obtain and can serve as an approximation for hand hygiene compliance. As described earlier, AHR consumption varies among European hospitals. In the current study the role of various hospital and country indicators for AHR consumption is analysed.
As part of the European Prevention of Hospital Infections by Intervention and Training (PROHIBIT) project hospital-based data on infection prevention and control (IPC) structure and organization and hospital-wide AHR consumption were obtained from acute care hospitals. National indicators such as income, public health expenditure, national hand hygiene campaigns, IPC training and the six Hofstede dimensions were identified. Univariable and multivariable linear regression analyses using generalized linear models were performed to estimate the association between AHR consumption and indicators at both hospital and country levels.
Data from 232 hospitals from 22 European countries were analysed. Multivariate risk factor analysis showed independent associations between AHR consumption and private and university-affiliated hospitals (multiplicative effect, 95% CI: 1.76, 1.21-2.55; and 1.39, 1.17-1.64, respectively), high-income countries (3.61, 2.94-4.43), and countries offering national curricula for the training of IPC nurses (3.77, 2.32-6.13). However, no cultural dimension was independently associated with AHR consumption.
Country indicators such as high-income, national training on IPC, and hospital type and status are positively associated with AHR consumption in Europe.
手部卫生被认为是减少（多药耐药）病原体传播和预防医源性感染的最有效方法。用酒精基洗手液（AHR）进行手部揉搓已成为手部卫生的参考标准。AHR 消耗量的数据易于获取，可作为手部卫生依从性的近似值。如前所述，AHR 在欧洲各医院之间的消耗量存在差异。在本研究中，分析了各种医院和国家指标对 AHR 消耗量的影响。
作为欧洲预防医院感染干预和培训（PROHIBIT）项目的一部分，从急症护理医院获得了感染预防和控制（IPC）结构和组织以及全院范围内 AHR 消耗的基于医院的数据。确定了国家指标，如收入、公共卫生支出、国家手部卫生运动、IPC 培训以及六个霍夫斯泰德维度。使用广义线性模型进行单变量和多变量线性回归分析，以估计 AHR 消耗与医院和国家各级指标之间的关联。
对来自 22 个欧洲国家的 232 家医院的数据进行了分析。多变量风险因素分析显示，AHR 消耗与私立和大学附属医院（乘法效应，95%置信区间：1.76，1.21-2.55；和 1.39，1.17-1.64）、高收入国家（3.61，2.94-4.43）以及提供 IPC 护士国家培训课程的国家（3.77，2.32-6.13）之间存在独立关联。然而，没有任何文化维度与 AHR 消耗独立相关。
国家指标，如高收入、国家 IPC 培训以及医院类型和地位，与欧洲 AHR 消耗呈正相关。
