Hilt Nataliya, Lokate Mariëtte, OldeLoohuis Alfons, Hulscher Marlies E J L, Friedrich Alex W, Voss Andreas
Radboudumc, Department of Medical Microbiology, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands.
Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Arch Public Health. 2020 Sep 12;78:79. doi: 10.1186/s13690-020-00464-5. eCollection 2020.
Hand hygiene (HH) is considered one of the most important measures to prevent healthcare-associated infections (HAI). Most studies focus on HH compliance within the hospital setting, whereas little is known for the outpatient setting. The aim of this study was to evaluate compliance with HH recommendations in general practitioners (GPs) office, based on World Health Organization (WHO) guideline.
An observational study was conducted at five Dutch GPs-practices in September 2017. We measured HH compliance through direct observation using WHO's 'five moments of hand hygiene' observation tool. All observations were done by one trained professional.
We monitored a total of 285 HH opportunities for 30 health care workers (HCWs). The overall compliance was 37%. Hand hygiene compliance was 34, 51 and 16% for general practitioners, practice assistants, and nurses, respectively. It varies between 63% after body fluid exposure and no HH performance before-, during and after home visit of a patient (defined as moment 5). The preferred method of HH was soap and water (63%) versus 37% for alcohol-based hand rub (ABHR). The median time of disinfecting hands was 8 s (range 6-11 s) for HCWs in our study.
HH compliance among HCWs in Dutch GPs was found to be low, especially with regard to home visits. The WHO recommended switch from hand wash to ABHR was not implemented by the majority of HCWs in 5 observed GPs offices.
手卫生（HH）被认为是预防医疗保健相关感染（HAI）最重要的措施之一。大多数研究聚焦于医院环境中的手卫生依从性，而对于门诊环境则知之甚少。本研究的目的是根据世界卫生组织（WHO）的指南，评估全科医生（GP）诊所中手卫生建议的依从性。
2017年9月在荷兰的五家全科医生诊所进行了一项观察性研究。我们使用WHO的“手卫生五个时刻”观察工具通过直接观察来测量手卫生依从性。所有观察均由一名经过培训的专业人员完成。
我们对30名医护人员（HCW）的总共285次手卫生时机进行了监测。总体依从率为37%。全科医生、诊所助理和护士的手卫生依从率分别为34%、51%和16%。在体液暴露后依从率为63%，而在患者家访前、家访期间和家访后（定义为时刻5）无手卫生行为，依从率有所不同。手卫生的首选方法是肥皂和水（63%），而酒精擦手液（ABHR）为37%。在我们的研究中，医护人员消毒双手的中位时间为8秒（范围6 - 11秒）。
发现荷兰全科医生诊所中医护人员的手卫生依从性较低，尤其是在家访方面。在5家观察到的全科医生诊所中，大多数医护人员未执行WHO建议的从洗手切换到使用酒精擦手液的做法。
