Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata Japan.
Department of Nursing, Niigata Saiseikai Daini Hospital, Niigata, Japan.
J Hosp Med. 2020 May;15(5):262-267. doi: 10.12788/jhm.3446. Epub 2020 Apr 27.
Hand hygiene is key to preventing healthcare-associated infection and the spread of respiratory viruses like the novel coronavirus that causes COVID-19. Unfortunately, hand hygiene adherence of healthcare workers (HCWs) in Japan is suboptimal according to previous studies.
Our objectives were to evaluate hand hygiene adherence among physicians and nurses before touching hospitalized patients and to evaluate changes in hand hygiene adherence after a multimodal intervention was implemented.
DESIGN, SETTING, AND PARTICIPANTS: We conducted a pre- and postintervention study with HCWs at four tertiary hospitals in Niigata, Japan. Hand hygiene observations were conducted from June to August 2018 (preintervention) and February to March 2019 (postintervention).
The multimodal hand hygiene intervention recommended by the World Health Organization was tailored to each hospital and implemented from September 2018 to February 2019.
We observed hand hygiene adherence before touching patients in each hospital and compared rates before and after intervention. Intervention components were also evaluated.
There were 2,018 patient observations preintervention and 1,630 postintervention. Overall, hand hygiene adherence improved from 453 of 2,018 preintervention observations (22.4%) to 548 of 1,630 postintervention observations (33.6%; P < .001). Rates improved more among nurses (13.9 percentage points) than among doctors (5.7 percentage points). Improvement varied among the hospitals: Hospital B (18.4 percentage points) was highest, followed by Hospitals D (11.4 percentage points), C (11.3 percentage points), and Hospital A (6.5 percentage points).
A multimodal intervention improved hand hygiene adherence rates in physicians and nurses in Niigata, Japan; however, further improvement is necessary. Given the current suboptimal hand hygiene adherence rates in Japanese hospitals, the spread of COVID-19 within the hospital setting is a concern.
手部卫生是预防医疗保健相关感染和新型冠状病毒（导致 COVID-19 的呼吸道病毒）传播的关键。然而，根据之前的研究，日本医护人员（HCWs）的手部卫生依从性并不理想。
我们的目的是评估在接触住院患者之前医生和护士的手部卫生依从性，并评估在实施多模式干预后手部卫生依从性的变化。
设计、地点和参与者：我们在日本新泻的四家三级医院进行了一项干预前后研究，研究对象为 HCWs。手部卫生观察于 2018 年 6 月至 8 月（干预前）和 2019 年 2 月至 3 月（干预后）进行。
根据世界卫生组织的建议，对每家医院进行了针对性的多模式手部卫生干预，并于 2018 年 9 月至 2019 年 2 月实施。
我们观察了每家医院在接触患者前的手部卫生依从性，并比较了干预前后的比率。还评估了干预措施的组成部分。
干预前共观察了 2018 例患者，干预后共观察了 1630 例。总体而言，手部卫生依从性从干预前的 2018 次观察中的 453 次（22.4%）提高到干预后的 1630 次观察中的 548 次（33.6%；P<.001）。护士的依从率提高了 13.9 个百分点，而医生的提高了 5.7 个百分点。医院之间的改善情况有所不同：医院 B（18.4 个百分点）最高，其次是医院 D（11.4 个百分点）、医院 C（11.3 个百分点）和医院 A（6.5 个百分点）。
多模式干预提高了日本新泻地区医生和护士的手部卫生依从率；然而，还需要进一步改进。鉴于日本医院目前手部卫生依从率不理想，COVID-19 在医院内传播令人担忧。
