Jeanes A, Dick J, Coen P, Drey N, Gould D J
Infection Control Department, University College London Hospitals, London, UK.
University College Hospital, London, UK.
J Infect Prev. 2018 May;19(3):116-122. doi: 10.1177/1757177418755306. Epub 2018 Feb 16.
Hand hygiene compliance scores in the anaesthetic department of an acute NHS hospital were persistently low.
To determine the feasibility and validity of regular accurate measurement of HHC in anaesthetics and understand the context of care delivery, barriers and opportunities to improve compliance.
The hand hygiene compliance of one anaesthetist was observed and noted by a senior infection control practitioner (ICP). This was compared to the World Health Organization five moments of hand hygiene and the organisation hand hygiene tool.
In one sequence of 55 min, there were approximately 58 hand hygiene opportunities. The hand hygiene compliance rate was 16%. The frequency and speed of actions in certain periods of care delivery made compliance measurement difficult and potentially unreliable. During several activities, taking time to apply alcohol gel or wash hands would have put the patients at significant risk.
We concluded that hand hygiene compliance monitoring by direct observation was invalid and unreliable in this specialty. It is important that hand hygiene compliance is optimal in anaesthetics particularly before patient contact. Interventions which reduce environmental and patient contamination, such as cleaning the patient and environment, could ensure anaesthetists encounter fewer micro-organisms in this specialty.
一家急性国民保健服务医院麻醉科的手卫生依从性得分一直很低。
确定在麻醉中定期准确测量手卫生依从性（HHC）的可行性和有效性，并了解护理提供的背景、提高依从性的障碍和机会。
由一名资深感染控制从业者（ICP）观察并记录一名麻醉师的手卫生依从情况。将其与世界卫生组织的手卫生五个时刻以及该机构的手卫生工具进行比较。
在一段55分钟的过程中，大约有58次手卫生机会。手卫生依从率为16%。在护理提供的某些阶段，操作的频率和速度使得依从性测量变得困难且可能不可靠。在几次活动中，花时间涂抹酒精凝胶或洗手会使患者面临重大风险。
我们得出结论，在这个专业中，通过直接观察进行手卫生依从性监测是无效且不可靠的。在麻醉中，尤其是在接触患者之前，手卫生依从性达到最佳状态很重要。减少环境和患者污染的干预措施，如清洁患者和环境，可以确保麻醉师在这个专业中接触到更少的微生物。
