Microbiology and Immunology Department, Faculty of Medicine, Benha University, Benha, Egypt.
Public Health Department, Health Sciences College at Al Leith, Umm Al-Qura University, Saudi Arabia.
East Mediterr Health J. 2020 Feb 24;26(2):198-205. doi: 10.26719/2020.26.2.198.
Adequate hand hygiene is considered the most effective measure to reduce transmission of nosocomial pathogens.
To determine the effectiveness of infection control intervention to improve compliance with hand hygiene in the Emergency Department, Al-Leith General Hospital, Saudi Arabia, and evaluate bacterial load on hands as a possible indicator of improvement.
The study consisted of 3 phases: Phase I, measurement of basal hand hygiene compliance level; Phase II, multimodal hand hygiene educational programme was initiated; and Phase III, hand hygiene compliance level was measured again. Data were collected by direct observation of healthcare workers in the emergency department between October 2016 and March 2017, using the standardized World Health Organization method for direct observation, "Five Moments for Hand Hygiene". The intervention comprised health education sessions using direct personal contact. Hands of healthcare workers were sampled during Phases I and III by sterile bag method, and bacterial load was determined.
A total of 1374 opportunities for hand hygiene were observed during the triphase study. Implementation of the interventional hand hygiene educational programme significantly improved compliance with hand hygiene guidelines from 30.7% to 45.5% (P < 0.01). Log10 bacterial load per hand dropped from 4.97 (standard deviation = 0.32) to 4.57 (0.47) (P < 0.05).
Hand hygiene educational programmes were effective in improving compliance in the emergency department, and bacterial load on hands of healthcare workers could be used as an indicator of improvement in hand hygiene compliance.
充分的手部卫生被认为是减少医院病原体传播的最有效措施。
确定感染控制干预措施在提高沙特阿拉伯 Al-Leith 综合医院急诊科手部卫生依从性方面的有效性，并评估手部细菌负荷作为改善的可能指标。
该研究包括 3 个阶段：第 I 阶段，测量基础手部卫生依从性水平；第 II 阶段，启动多模式手部卫生教育计划；第 III 阶段，再次测量手部卫生依从性水平。2016 年 10 月至 2017 年 3 月期间，通过直接观察急诊科医护人员使用世界卫生组织（WHO）直接观察的标准化方法“五个时刻进行手部卫生”收集数据。干预措施包括使用直接个人接触进行健康教育课程。在第 I 阶段和第 III 阶段，通过无菌袋法采集医护人员的手部样本，并确定细菌负荷。
在三阶段研究中观察到了 1374 次手部卫生机会。实施干预性手部卫生教育计划后，手部卫生指南的依从性从 30.7%显著提高至 45.5%（P<0.01）。每只手的细菌负荷对数从 4.97（标准差=0.32）降至 4.57（0.47）（P<0.05）。
手部卫生教育计划在急诊科提高了依从性，医护人员手部的细菌负荷可作为手部卫生依从性改善的指标。
