Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.
Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Antimicrob Resist Infect Control. 2019 Dec 30;8(1):206. doi: 10.1186/s13756-019-0666-4.
Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a "Train-the-Trainers" (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries.
We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training.
Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively.
The TTT in hand hygiene model proved to be effective in enhancing participant's knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.
在感染预防和控制（IPC）专业人员中，手部卫生培训的协调一致程度不足。我们描述了一种标准化的培训方法，采用“培训培训师”（TTT）的概念对 IPC 专业人员进行培训，并评估其在六个国家对手部卫生知识的影响。
我们根据世界卫生组织（WHO）多模式手部卫生改善策略，开发了一个为期三天的基于模拟的 TTT 课程。为了评估其影响，我们进行了课程前后的知识问卷调查。使用 Wilcoxon 符号秩检验比较培训前后的结果。
2016 年 6 月至 2018 年 1 月，我们在六个国家（伊朗、马来西亚、墨西哥、南非、西班牙和泰国）进行了七次 TTT 课程：共有 305 名 IPC 专业人员完成了该计划。参与者包括护士（n=196；64.2%）、医生（n=53；17.3%）和其他卫生专业人员（n=56；18.3%）。共有来自 20 多个国家的参与者接受了培训。在所有国家，TTT 培训前后的知识均有显著（p<0.05）提高。普埃布拉（墨西哥）的提高幅度最大（22.3%；p<0.001），其次是马来西亚（21.2%；p<0.001）、哈利斯科（墨西哥；20.2%；p<0.001）、泰国（18.8%；p<0.001）、南非（18.3%；p<0.001）、伊朗（17.5%；p<0.001）和西班牙（9.7%；p=0.047）。西班牙的总体测试得分最高，而泰国的前测和后测得分最低。报告的积极方面包括：独特的学习环境、分享经验、在安全环境下进行实践操作以及 IPC 专业人员之间的交流。通过在墨西哥（哈利斯科和普埃布拉）和西班牙最初的三个 TTT 课程地点进行的后续评估来评估可持续性：在第一个 TTT 课程后 5 个月、1 年和 2 年分别进行的最后一次随访阶段，改善得以维持。
手部卫生 TTT 模式被证明在提高参与者的知识、分享经验和交流网络方面是有效的。IPC 专业人员可以在全球范围内使用这种参考培训方法，将知识进一步传播给其他卫生保健工作者。
