School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR.
School of Nursing, Tung Wah College, Hong Kong, Hong Kong SAR.
BMC Infect Dis. 2021 Jan 14;21(1):75. doi: 10.1186/s12879-021-05767-8.
The elderly population in Hong Kong is rapidly growing, and the need for residential care homes (RCHs) is increasing. The risk of being infected with micro-organisms increases among the frail and the vulnerable elderly population as their immunity system begins to deteriorate. Furthermore, the residents in RCHs are at high risk of healthcare-associated infections (HAIs) due to the confined living environments and individual co-morbidities. In relation to this, infection control practice (ICP) is considered a crucial and effective approach in preventing HAIs. This study aimed to observe the daily ICP of healthcare workers in RCH settings.
An observational study was conducted to observe daily ICP among healthcare workers in private and subsidized RCHs. Each RCH was separated into different units based on the location (common area and bedroom area) and nature of residents for successive days. The ICP episodes were observed until 200 opportunities in each unit. The ICP episodes were recorded by an electronic tool called "eRub," which is an ICP checklist based on international guidelines.
The most frequent observed ICP episodes were hand hygiene (n = 1053), the use of gloves (n = 1053) and respiratory protection (n = 1053). The overall compliance of hand hygiene was poor, with only 15% of participants performing this during the "five moments for hand hygiene." Furthermore, the observations showed that 77.9% improperly performed the use of gloves, and 31.8% failed to wear a mask during the care provision for the elderly. However, the results showed that most healthcare workers can wear the mask in a proper way when they should. Generally, the personal care workers were the worst in terms of hand hygiene and use of gloves compared with the other types of healthcare workers.
Despite the fact that the practice of hand hygiene, the use of gloves, and respiratory protection were the important elements of ICP, overall compliance to these elements was still poor. Personal care workers had the most frequent contact with the residents, but they had the worst compliance rate. Hence, continued monitoring and training among healthcare workers is needed, particularly personal care workers, in this healthcare service setting.
香港的老年人口迅速增长，对养老院的需求也在增加。由于免疫系统开始恶化，体弱和脆弱的老年人群体感染微生物的风险增加。此外，由于居住环境有限和个人合并症，养老院的居民患与医疗保健相关的感染（HAI）的风险很高。在这方面，感染控制实践（ICP）被认为是预防 HAI 的一种重要且有效的方法。本研究旨在观察养老院环境中医护人员的日常 ICP。
本研究采用观察性研究方法，观察私营和补贴养老院医护人员的日常 ICP。根据居民的位置（公共区域和卧室区域）和性质，将每个养老院分为不同的单元，持续数天。在每个单元中观察到 200 次 ICP 事件后，会使用电子工具“eRub”记录 ICP 事件，该工具是一种基于国际指南的 ICP 检查表。
最常观察到的 ICP 事件是手部卫生（n=1053）、使用手套（n=1053）和呼吸道保护（n=1053）。手部卫生的整体依从性较差，只有 15%的参与者在“五个手部卫生时刻”进行了手部卫生。此外，观察结果表明，77.9%的人不正确地使用手套，31.8%的人在为老年人提供护理时未戴口罩。然而，结果表明，当需要佩戴口罩时，大多数医护人员都能正确佩戴口罩。总体而言，与其他类型的医护人员相比，个人护理人员在手部卫生和使用手套方面表现最差。
尽管手部卫生、使用手套和呼吸道保护是 ICP 的重要组成部分，但这些措施的整体依从性仍然较差。个人护理人员与居民的接触最频繁，但他们的依从率最低。因此，在这种医疗保健服务环境中，需要对医护人员，特别是个人护理人员进行持续监测和培训。
