超越入口和出口：床边的手卫生。
Beyond entry and exit: Hand hygiene at the bedside.
机构信息
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.
出版信息
Am J Infect Control. 2019 May;47(5):487-491. doi: 10.1016/j.ajic.2018.10.026. Epub 2018 Dec 21.
BACKGROUND
We aimed to assess compliance, knowledge, and attitudes regarding the World Health Organization (WHO) 5 moments for hand hygiene (HH).
METHODS
We assessed HH compliance from July-August 2016, using a modified WHO HH observation form. A 26-question survey was used to assess health care personnel (HCP) knowledge, opinions, and barriers to HH. A subgroup of HCPs participated in a 2-round focused survey to assign priority to the moments.
RESULTS
Three hundred two HH opportunities were observed in 104 unique HCP-patient interactions. HH was performed at 106 (35%) opportunities, 37% (25 of 68) before touching a patient, 9% (6 of 70) before aseptic procedures, 5% (1 of 22) after body fluid exposure or risk, 63% (55 of 88) after touching a patient, and 35% (19 of 54) after touching patient surroundings. Two hundred eighteen HCPs completed the survey; 63 (29%) were familiar with the WHO 5 moments but only 13 (21%) were able to recall all 5 moments. In the focused surveys, 46% (6 of 13) ranked "before aseptic procedure" as the most important HH moment, and 86% (11 of 13) identified "after touching patient surroundings" as the least important.
CONCLUSIONS
We found frequent opportunities for HH with infrequent compliance. Lack of recognition of opportunities at the bedside and frequent glove use may contribute to lower compliance.
背景
我们旨在评估卫生保健人员（HCP）对世界卫生组织（WHO）5 个手卫生（HH）时刻的依从性、知识和态度。
方法
我们使用改良的 WHO HH 观察表于 2016 年 7-8 月评估 HH 依从性。采用 26 个问题的调查问卷评估 HCP 的知识、意见和 HH 障碍。一组 HCP 参与了 2 轮重点调查，为时刻分配优先级。
结果
在 104 个独特的 HCP-患者互动中观察到 302 个 HH 机会。在 106 个机会（35%）实施了 HH，37%（25/68）在接触患者之前，9%（6/70）在无菌操作之前，5%（1/22）在接触体液暴露或风险之后，63%（55/88）在接触患者之后，35%（19/54）在接触患者周围环境之后。218 名 HCP 完成了调查；63 名（29%）熟悉 WHO 5 个时刻，但只有 13 名（21%）能够回忆起所有 5 个时刻。在重点调查中，46%（6/13）将“无菌操作前”列为最重要的 HH 时刻，86%（11/13）认为“接触患者周围环境后”是最不重要的时刻。
结论
我们发现 HH 机会频繁，但依从性低。床边识别机会的能力不足和频繁戴手套可能导致依从性降低。
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