电子监测系统间歇性部署对医护人员手卫生行为的影响。
Effect of intermittent deployment of an electronic monitoring system on hand hygiene behaviors in healthcare workers.
机构信息
iDAPT, Toronto Rehabilitation Institute, Toronto, ON, Canada; Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada.
iDAPT, Toronto Rehabilitation Institute, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON, Canada.
出版信息
Am J Infect Control. 2019 Apr;47(4):376-380. doi: 10.1016/j.ajic.2018.08.029. Epub 2018 Nov 28.
BACKGROUND
Improving hand hygiene compliance among healthcare professionals is the most effective way to reduce healthcare-acquired infections. Electronic systems developed to increase hand hygiene performance show promise but might not maintain staff participation over time. In this study, we investigated an intermittent deployment strategy to overcome potentially declining participation levels.
METHODS
An electronic monitoring system was deployed 3times at 6-month intervals on a musculoskeletal rehabilitation nursing unit in Toronto. Each deployment lasted 4 consecutive weeks. Each wall-mounted soap and hand rub dispenser was outfitted with an activation counter to assess the impact of system deployments on overall handwashing activity.
RESULTS
System deployments took place in October 2016, April 2017, and October 2017. A total of 76,130 opportunities were recorded, with an aggregate hand hygiene performance of 67.43%. A total of 515,156 dispenser activations were recorded. There was a significant increase in aggregate dispenser use with every deployment and a decrease over several weeks following each withdrawal. Participation was high at the beginning of each deployment and declined during each deployment but was restored to a high level with the start of the next deployment.
CONCLUSIONS
Intermittent deployment of an electronic monitoring intervention counteracts potential declines in participation rates sometimes seen with continuous system use. However, adoption of this strategy requires the acceptance of lower periods of performance between each deployment.
背景
提高医护人员手部卫生依从性是降低医源性感染最有效的方法。为提高手部卫生性能而开发的电子系统显示出前景，但随着时间的推移，可能无法保持员工的参与度。在这项研究中，我们调查了一种间歇性部署策略，以克服潜在的参与度下降。
方法
在多伦多的一个肌肉骨骼康复护理单元，电子监测系统每隔 6 个月部署 3 次，每次持续 4 周。每个壁挂式肥皂和洗手液分配器都配备了一个激活计数器，以评估系统部署对整体洗手活动的影响。
结果
系统部署分别于 2016 年 10 月、2017 年 4 月和 2017 年 10 月进行。共记录了 76130 次机会，手部卫生总表现率为 67.43%。共记录了 515156 次分配器激活。每次部署都会显著增加总分配器的使用，而每次撤回后几周都会减少。每次部署开始时参与度都很高，每次部署期间都会下降，但随着下一次部署的开始，又会恢复到高水平。
结论
间歇性部署电子监测干预措施可以抵消连续使用系统时有时会出现的参与率下降。然而，采用这种策略需要接受每次部署之间的绩效较低的时期。
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