Phan Hang Thi, Zingg Walter, Tran Hang Thi Thuy, Dinh Anh Pham Phuong, Pittet Didier
Infection control programme, Hung Vuong hospital, Ho Chi Minh City, Vietnam.
Infection control programme and WHO collaborating centre on patient safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland.
Antimicrob Resist Infect Control. 2020 Apr 10;9(1):51. doi: 10.1186/s13756-020-00712-x.
Hung Vuong Hospital (HVH) is a 900-bed maternity hospital in Ho-Chi-Minh-City, Vietnam. Due to low compliance, a quasi-experimental, observational study was conducted with the aim to improve hand hygiene.
A multimodal promotion strategy was established in 2010 and further developed towards ongoing, repetitive and inventive campaigns including patient participation. Hand hygiene compliance was monitored by direct observation and healthcare-associated infections (HAIs) by applying standard definitions.
Between 2010 and 2018, a total of 43,711 hand hygiene opportunities were observed. Compliance improved from 21.5% (95%CI: 20.2-22.8%) in 2010 to 75.1% (73.9-76.2%) in 2018 (incidence rate ratio, IRR , 1.10; 95%CI, 1.10-1.11). This was achieved through increasing recourse to alcohol-based hand rubbing. A total of 554,720 women were admitted to HVH during the study period for 353,919 deliveries (198,679 vaginal; 155,240 by C-section) and 257,127 surgical procedures. The HAI-incidence decreased significantly from 1.10 episodes per 1000 patient-days in 2010 to 0.45 per 1000 patient-days in 2018 (IRR 0.85; 95%CI, 0.79-0.90). Significant improvement was observed also for surgical site infections after gynaecological surgery (IRR 0.95; 95%CI, 0.92-0.99) and endometritis after abortion (IRR 0.80; 95%CI, 0.68-0.93).
A multimodal strategy aiming at behaviour change significantly improved and sustained hand hygiene, which contributed to the reduction of healthcare-associated infections.
洪王医院（HVH）是越南胡志明市一家拥有900张床位的妇产医院。由于依从性较低，开展了一项准实验性观察研究，旨在改善手部卫生。
2010年制定了多模式推广策略，并朝着持续、重复和创新的活动（包括患者参与）进一步发展。通过直接观察监测手部卫生依从性，并采用标准定义监测医疗相关感染（HAIs）。
2010年至2018年期间，共观察到43,711次手部卫生机会。依从性从2010年的21.5%（95%CI：20.2-22.8%）提高到2018年的75.1%（73.9-76.2%）（发病率比，IRR，1.10；95%CI，1.10-1.11）。这是通过增加使用酒精擦手实现的。在研究期间，共有554,720名妇女入住HVH，进行了353,919次分娩（198,679次阴道分娩；155,240次剖宫产）和257,127次外科手术。医疗相关感染发病率从2010年的每1000患者日1.10次显著下降到2018年的每1000患者日0.45次（IRR 0.85；95%CI，0.79-0.90）。妇科手术后手术部位感染（IRR 0.95；95%CI，0.92-0.99）和流产后子宫内膜炎（IRR 0.80；95%CI，0.68-0.93）也有显著改善。
旨在改变行为的多模式策略显著改善并维持了手部卫生，有助于减少医疗相关感染。
