爱尔兰护理和医学专业学生手部卫生与使用醇基手部消毒剂的比较研究。
A comparative study of hand hygiene and alcohol-based hand rub use among Irish nursing and medical students.
机构信息
Department of Nursing and Midwifery, University of Limerick, Ireland.
Department of Clinical Microbiology, University Hospital Limerick, Ireland.
出版信息
Nurse Educ Today. 2018 Apr;63:112-118. doi: 10.1016/j.nedt.2018.01.022. Epub 2018 Jan 31.
BACKGROUND
In Ireland, the setting for this study, the national prevalence rate of health care-associated infection (HCAI) in acute-care facilities is 5.2%. Hand hygiene and in particular hand rubbing using alcohol-based hand rub (ABHR) is highly efficacious in preventing HCAI transmission. Yet, compliance among healthcare professionals is sub-optimal. Less is known about the practices of nursing and medical students and no study comparing practices among these groups in Ireland was found. Hence, the aim of this study was to provide insight into the current hand hygiene and hand rubbing practices of nursing and medical students in Ireland and, by doing so, contribute to the broader understanding of this topic.
METHODS
This observational study employed a cross-sectional, self-reported design. An electronically administered questionnaire was sent to all nursing and medical students from one university. Data were analysed using appropriate software.
RESULTS
The response rate was 37% (323/872). Higher compliance with the World Health Organisation 'my five moments for hand hygiene' model was reported among nursing students (NS) than medical students (MS), with scope for improvement in both disciplines identified. Hand hygiene compliance was highest after body fluid exposure (99.5% NS, 91% MS) and lowest after touching a patient's surroundings (61.5% NS, 57.5% MS). Attitudes towards hand rubbing were largely positive in both disciplines. 16% of NS were not aware of the clinical contraindications to ABHR use, compared to 45% of MS. 9% of NS did not know when to use soap and water and when to use ABHR, compared to 36% of MS. In contrast, more medical students (46%) than nursing students (22%) were routinely using alcohol-based hand rub for decontamination of hands as recommended.
CONCLUSIONS
Results suggest scope to review current hand hygiene curricula focusing on the knowledge gaps, the practice deficits and the barriers to ABHR usage identified.
背景
在本研究所在的爱尔兰，急性保健机构内的卫生保健相关感染（HAI）的全国流行率为 5.2%。手部卫生，特别是使用酒精基手部搓揉液（ABHR）的手部搓揉，在预防 HAI 传播方面非常有效。然而，医护人员的依从性并不理想。关于护理和医学生的实践情况了解较少，也没有发现比较爱尔兰这些群体实践情况的研究。因此，本研究的目的是深入了解爱尔兰护理和医学生目前的手部卫生和手部搓揉实践情况，并以此为基础，更全面地了解这一主题。
方法
本观察性研究采用了横断面、自我报告的设计。从一所大学向所有护理和医学生发送了电子调查问卷。使用适当的软件对数据进行分析。
结果
应答率为 37%（323/872）。护理学生（NS）比医学生（MS）报告的遵守世界卫生组织“五个手卫生时刻”模型的比例更高，但两个学科都有改进的空间。在接触体液后（99.5%的 NS，91%的 MS），手部卫生依从性最高，而在接触患者周围环境后（61.5%的 NS，57.5%的 MS），手部卫生依从性最低。两个学科的学生对手部搓揉的态度基本都是积极的。16%的 NS 不知道 ABHR 使用的临床禁忌症，而 MS 为 45%。9%的 NS 不知道何时该使用肥皂和水，何时该使用 ABHR，而 MS 为 36%。相比之下，更多的医学生（46%）比护理学生（22%）按照建议常规使用 ABHR 对手部进行去污。
结论
研究结果表明，有必要审查当前的手部卫生课程，重点关注确定的知识差距、实践缺陷和 ABHR 使用障碍。
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