Acharya Ranjita, Bedanta Mishra Shakti, Ipsita Snigdha, Azim Afzal
Department of Anesthesiology, IMS and SUM Hospital, Bhubaneswar, Odisha, India.
Department of Critical Care Medicine, IMS and SUM Hospital, Bhubaneswar, Odisha, India.
Indian J Crit Care Med. 2019 Jul;23(7):316-319. doi: 10.5005/jp-journals-10071-23205.
Central line associated bloodstream infections (CLABSI) have a higher incidence in the intensive care units of developing countries.
The baseline CLABSI rate in intensive care unit (ICU) was evaluated for 6 months. An educational program for nurses on basic hand hygiene steps was conducted. Objective assessment tests were done to assess their knowledge and percentage of non-compliance with hand hygiene practice. CLABSI rate over the post-intervention 6 month period was assessed.
Thirty-four nurses were enrolled. The pre-intervention CLABSI rate was 12.5 per 1000 catheter days, pretest score 15.9 +/- 3.35 and 53.4% opportunities for hand hygiene were missed. Post workshop, there was significant (p=0.02) decrease in CLABSI rate i.e. 8.6, improvement in test score 17.76 +/- 2.1 (=0.011) and missed opportunities decreased to 33.75%. 6 months post intervention, percentage of noncompliance with hand hygiene practice were 51.75% and test score was 17 ± 2.
The effectiveness of educational program on hand hygiene compliance was reflected in the improvement of posttest score, reduced number of missed opportunities and reduction of CLABSI rates in ICU. The posttest scores and hand hygiene compliance, however, decreased 6 months post-intervention necessitating repeated feedbacks and reminders.
Educational interventions on hand hygiene can have a significant impact in CLABSI control particularly in ICUs with a high infection rate and resource constraints.
Acharya Ranjita, Mishra SB, Ipsita S, Azim A. Impact of Nursing Education on CLABSI Rates: An Experience from a Tertiary Care Hospital in Eastern India. Indian J Crit Care Med 2019;23(7):316-319.
在发展中国家的重症监护病房中，中心静脉导管相关血流感染（CLABSI）的发生率较高。
对重症监护病房（ICU）的CLABSI基线发生率进行了6个月的评估。针对护士开展了关于基本手卫生步骤的教育项目。进行了客观评估测试，以评估他们的知识以及手卫生实践的不依从率。评估了干预后6个月期间的CLABSI发生率。
招募了34名护士。干预前CLABSI发生率为每1000导管日12.5例，预测试分数为15.9±3.35，手卫生机会错失率为53.4%。工作坊结束后，CLABSI发生率显著下降（p=0.02），降至8.6例，测试分数提高到17.76±2.1（p=0.011），机会错失率降至33.75%。干预6个月后，手卫生实践的不依从率为51.75%，测试分数为17±2。
关于手卫生依从性的教育项目的有效性体现在测试后分数的提高、机会错失数量的减少以及ICU中CLABSI发生率的降低。然而，干预6个月后，测试后分数和手卫生依从性有所下降，需要反复进行反馈和提醒。
手卫生教育干预对CLABSI控制可产生重大影响，尤其是在感染率高且资源有限的ICU中。
阿查里亚·兰吉塔、米什拉·SB、伊普西塔·S、阿齐姆·A。护理教育对CLABSI发生率的影响：来自印度东部一家三级护理医院的经验。《印度重症监护医学杂志》2019年；23（7）：316 - 319。
