瑞士伴侣动物诊所和实践中的手部卫生依从性：一项观察性研究。
Hand hygiene compliance in companion animal clinics and practices in Switzerland: An observational study.
机构信息
Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
出版信息
Vet Rec. 2021 Jul;189(1):e307. doi: 10.1002/vetr.307. Epub 2021 Apr 18.
BACKGROUND
Hand hygiene (HH) is one of the most important measures to prevent healthcare-associated infections. Data on HH compliance in companion animal veterinary institutions in Europe are sparse.
METHODS
This observational study assessed HH according to WHO standards in three large and two medium-sized clinics and two primary care practices in Switzerland. Associations with HH indication, professional group, clinical area and institution were determined using a generalized linear mixed effects model.
RESULTS
Based on 2056 observations, overall HH compliance [95% confidence interval] was 32% [30%-34%]. HH compliance was highest in the consultation area (41% [38%-45%]) and after contact to body fluids (45% [40%-50%]), and lowest in the pre-OR area (20% [15%-24%]) and before clean/aseptic procedures (12% [9%-15%]). Veterinarians showed a higher HH compliance (37% [34%-40%]) than veterinary nurses (25% [22%-28%]). HH compliance was lower before clean/aseptic procedures compared to all other indications (all p < 0.015 except 'before touching a patient' in medium-sized clinics/practices, p = 0.095) and higher in the consultation area compared to all other areas in large clinics (all p < 0.04).
CONCLUSION
Effective HH training should urgently be promoted for all veterinary personnel with special emphasis on the importance of HH before clean/aseptic procedures.
背景
手卫生（HH）是预防医源性感染最重要的措施之一。欧洲伴侣动物兽医机构 HH 依从性的数据很少。
方法
本观察性研究按照世界卫生组织（WHO）标准，在瑞士的三家大型和两家中型诊所及两家初级保健诊所评估 HH。使用广义线性混合效应模型确定 HH 与 HH 指征、专业组别、临床区域和机构的关联。
结果
基于 2056 次观察，总体 HH 依从率[95%置信区间]为 32%[30%-34%]。咨询区 HH 依从率最高（41%[38%-45%]），接触体液后 HH 依从率最高（45%[40%-50%]），而 OR 前区最低（20%[15%-24%]），清洁/无菌操作前最低（12%[9%-15%]）。兽医的 HH 依从率（37%[34%-40%]）高于兽医护士（25%[22%-28%]）。与所有其他指征相比，清洁/无菌操作前的 HH 依从率较低（除了中型诊所/实践中的“触摸患者前”外，所有 p<0.015，p=0.095），而在大型诊所中咨询区的 HH 依从率较高（所有 p<0.04）。
结论
应紧急为所有兽医人员推广有效的 HH 培训，特别强调清洁/无菌操作前 HH 的重要性。
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