Sili Uluhan, Ay Pinar, Bilgin Huseyin, Hidiroglu Seyhan, Korten Volkan
Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey.
Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
J Infect Dev Ctries. 2019 Aug 31;13(8):744-747. doi: 10.3855/jidc.10916.
While improvement of hand hygiene (HH) compliance is considered as the best approach to reduce healthcare-associated infections, the instructional interventions in HH among healthcare workers of intensive care unit (ICU) of our hospital was not successful enough. The following study was conducted to evaluate HH knowledge, perception, practice and effectiveness of the trainings among healthcare workers of ICU in our hospital.
A cross-sectional study was conducted in the ICU containing 8 medical and 16 surgical beds with 284 filled questionnaires about HH knowledge and 1187 observed opportunities for HH compliance.
Overall observed HH compliance rate was 40.6%; lowest compliance was 21.7% for "before clean/aseptic procedure" indication and highest compliance was 68.6% for "after touching a patient" indication. Although > 90% healthcare workers correctly identified the World Health Organization's five indications for HH, 82 - 85% failed to recognize non-indications, i.e. when it was not necessary to perform HH. Our study showed that 15.1% of healthcare workers neither received nor felt the need for HH training.
Despite regular HH trainings, healthcare workers could not differentiate when HH was not required which suggested failure to understand HH rationale. This may explain poor HH compliance rates. A systematic study is needed in order to find out the reasons behind of this noncompliance and improve HH training methods for educating healthcare workers.
虽然提高手卫生(HH)依从性被认为是减少医疗相关感染的最佳方法,但我院重症监护病房(ICU)医护人员的HH指导性干预措施并不够成功。开展以下研究以评估我院ICU医护人员的HH知识、认知、实践情况以及培训效果。
在拥有8张内科床位和16张外科床位的ICU开展一项横断面研究,共收集了284份关于HH知识的问卷,并观察了1187次HH依从性机会。
总体观察到的HH依从率为40.6%;“清洁/无菌操作前”指征的依从率最低,为21.7%,“接触患者后”指征的依从率最高,为68.6%。虽然>90%的医护人员正确识别了世界卫生组织的五项HH指征,但82 - 85%的人未能识别非指征情况,即何时无需进行HH。我们的研究表明,15.1%的医护人员既未接受过HH培训,也不觉得有必要接受培训。
尽管定期进行HH培训,但医护人员无法区分何时不需要进行HH,这表明他们没有理解HH的基本原理。这可能解释了HH依从率较低的原因。需要进行系统研究以找出这种不依从背后的原因,并改进针对医护人员的HH培训方法。