Imhof Robert, Chaberny Iris F, Schock Bettina
Leipzig University Hospital, Institute of Hygiene, Hospital Epidemiology and Environmental Medicine, Leipzig, Germany.
GMS Hyg Infect Control. 2021 Feb 22;16:Doc08. doi: 10.3205/dgkh000379. eCollection 2021.
The basic assumption of this study was that the use of medical non-sterile gloves represents a barrier to correct hand hygiene behaviour. The aim of this study was to examine this assumption and detect reasons for possible incorrect behaviour. Accordingly, the hypothesis is that peri-glove compliance is lower than hand-disinfection compliance. The study involved the direct observation of the use of non-sterile, single-use medical gloves in three different wards of a university hospital. Nursing staff and physicians were observed. After the observation period, the observed persons received a custom-designed questionnaire in order to test their self-assessment, knowledge as well as structural conditions relating to the use of gloves. The results were evaluated and compared with the observation data. All employees disinfected their hands in 18.6% of cases before and in 65% of cases after the use of non-sterile gloves. Gloves were changed in the event of the indication for hand disinfection/change of gloves in 27.5% of cases. When changing gloves, the employees disinfected their hands in 47.2% of cases. The respondents assessed themselves as being significantly better than the observations revealed. The respondents are aware of the rules about hand disinfection before and after the use of gloves. However, it was less commonly known that gloves are not an absolute barrier to the transmission of bacteria. Non-sterile single-use gloves seem to be a barrier to hand disinfection. Solutions must be found in order to improve peri-glove compliance, in particular with regard to hand disinfection before and during the wearing of gloves. Alongside the mere transfer of knowledge, the use of non-sterile gloves with regard to the current structural conditions in everyday clinical practice should be critically scrutinised, questioned, tested and developed for the users through precise instructions.
本研究的基本假设是，使用医用非无菌手套是正确手部卫生行为的一个障碍。本研究的目的是检验这一假设，并找出可能存在错误行为的原因。因此，假设是手套周边依从性低于手部消毒依从性。该研究对一家大学医院三个不同病房中使用非无菌一次性医用手套的情况进行了直接观察。观察对象为护理人员和医生。观察期结束后，向观察对象发放了一份定制问卷，以测试他们的自我评估、知识以及与手套使用相关的结构条件。对结果进行了评估，并与观察数据进行了比较。所有员工在使用非无菌手套前，手部消毒的比例为18.6%，使用后为65%。在有手部消毒/更换手套指征的情况下，27.5%的案例更换了手套。更换手套时，47.2%的案例中员工对手部进行了消毒。受访者对自己的评估明显优于观察结果所显示的情况。受访者了解手套使用前后手部消毒的规则。然而，人们较少知道手套并非细菌传播的绝对屏障。非无菌一次性手套似乎是手部消毒的一个障碍。必须找到解决办法，以提高手套周边依从性，特别是在戴手套前和戴手套期间的手部消毒方面。除了单纯的知识传授外，对于日常临床实践中的当前结构条件下非无菌手套的使用，应通过精确的指导对使用者进行严格审查、质疑、测试和改进。
