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评估六个重症监护病房医护人员的手卫生依从性。

Assessing hand hygiene compliance among healthcare workers in six Intensive Care Units.

作者信息

Musu M, Lai A, Mereu N M, Galletta M, Campagna M, Tidore M, Piazza M F, Spada L, Massidda M V, Colombo S, Mura P, Coppola R C

机构信息

Anesthesia and Intensive Care Department, Pain Therapy Service, University of Cagliari, Italy.

Department of Medical Sciences and Public Health, University of Cagliari, Italy.

出版信息

J Prev Med Hyg. 2017 Sep;58(3):E231-E237.

Abstract

INTRODUCTION

Healthcare associated infections (HAIs) are a cause of high morbidity, disability and reduced quality of life, as well as mortality and rising costs for health systems. Preventing the HAI risk by planning and implementing effective preventive strategies is important to safeguard patient health.

METHODS

The study aimed to evaluate the presence of procedures and protocols for infection control, to assess the adhesion to the different aspects of hand hygiene (HH) and hand washing technique by healthcare workers in six ICUs. A perspective observational study was conducted in six ICUs. In each ICU, the adherence by health care workers to both hand hygiene practices and standard precautions was assessed, as well as the presence of procedures and written protocols.

RESULTS

The findings showed that in all the involved ICUs, 73 of 142 required protocols and procedures were available. Specifically, 59 of 79 were available for general measure of risk control, 12 of 15 for hand hygiene, and 24 of 48 for standard precautions and isolation measures. Also, the results showed highly variable levels of adherence to the best hygiene practices in all the ICUs involved in the study, with compliance rates ranging from 3% to 100%, and 73 of 142 required protocols were available at the study time.

CONCLUSIONS

Overall, the involved ICUs showed low levels of adherence to best hygiene practices. This suggests the need to implement immediate strategies for infection control in the ICUs. A multidisciplinary intervention could be effective in preventing and control the HAI risk.score was reached only by the third year students with regard to the proper HH. The level of knowledge about HAI was inadequate.A periodically check of nursing students' knowledge would be advisable in order to fill any gaps, improve training, reduce HAI and increase prevention measures compliance.

摘要

引言

医疗保健相关感染(HAIs)是导致高发病率、残疾率和生活质量下降的原因,同时也会造成死亡率上升以及卫生系统成本增加。通过规划和实施有效的预防策略来预防HAIs风险对于保障患者健康至关重要。

方法

本研究旨在评估感染控制程序和方案的存在情况,以评估六家重症监护病房(ICUs)医护人员对手卫生(HH)不同方面及洗手技术的依从性。在六家重症监护病房进行了一项前瞻性观察研究。在每个重症监护病房,评估了医护人员对手卫生实践和标准预防措施的依从性,以及程序和书面方案的存在情况。

结果

研究结果表明,在所有参与的重症监护病房中,142项所需的方案和程序中有73项可用。具体而言,79项中的59项可用于一般风险控制措施,15项中的12项可用于手卫生,48项中的24项可用于标准预防措施和隔离措施。此外,结果显示,在参与研究的所有重症监护病房中,对最佳卫生实践的依从水平差异很大,依从率从3%到100%不等,在研究时142项所需方案中有73项可用。

结论

总体而言,参与的重症监护病房对最佳卫生实践的依从水平较低。这表明需要在重症监护病房立即实施感染控制策略。多学科干预可能有效地预防和控制HAIs风险。只有三年级学生在正确的手卫生方面达到了该分数。关于HAIs的知识水平不足。建议定期检查护理专业学生的知识,以填补任何差距、改进培训、减少HAIs并提高预防措施的依从性。

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