在全科医生访视中促进养老院居民参与感染预防：一项定性研究。
Enablement of nursing home residents in infection prevention during general practitioner visits: A qualitative study.
机构信息
Institute for Patient Safety, University Hospital Bonn, Bonn, Germany.
Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, Bonn, Germany.
出版信息
PLoS One. 2022 Apr 7;17(4):e0266502. doi: 10.1371/journal.pone.0266502. eCollection 2022.
INTRODUCTION
Hand hygiene measures are essential to protect nursing home residents against nosocomial infections. Evidence on the prevention of nosocomial infections for nursing home residents by general practitioners during their medical visits in nursing homes or how they enable nursing home residents to perform hand hygiene measures is lacking. This study aimed to explore hand hygiene behaviors of general practitioners in nursing homes, their attitudes toward infection prevention measures, and the enablement of nursing home residents in performing hand hygiene measures.
MATERIALS AND METHODS
Semi-structured interviews were conducted with general practitioners and nursing home residents in Germany. Interviews were audio-recorded and transcribed. Data were analyzed using thematic content analysis.
RESULTS
Overall, 12 general practitioners and 12 nursing home residents participated in the study. The general practitioners expressed the fact that the possibilities for practicing hand hygiene differ in individual nursing homes. For nursing home residents, the availability of hand rub solutions was limited. Instructions for residents on hand disinfection from general practitioners was not described. Due to the lack of enablement, the residents' knowledge on how to correctly perform hand hygiene was low, although some of the nursing home residents have experience with multidrug-resistant organisms. The nursing home residents varied in their needs for active participation and enablement during the general practitioners visit.
CONCLUSION
Nursing home residents require continuous enablement by their general practitioners to maintain adequate hand hygiene. Therefore, general practitioners should consider the different needs of nursing home residents to ensure adequate individual hand hygiene and safety for the residents. Existing guidelines for infection prevention and control do not adequately cover the nursing home care setting for the enablement of residents to enquire about hand hygiene.
简介
手部卫生措施对于保护养老院居民免受医院感染至关重要。关于全科医生在养老院就诊期间或如何使养老院居民能够进行手部卫生措施来预防养老院居民医院感染的证据尚缺乏。本研究旨在探讨养老院全科医生的手部卫生行为、他们对感染预防措施的态度，以及使养老院居民能够进行手部卫生措施的情况。
材料与方法
在德国，对全科医生和养老院居民进行了半结构式访谈。访谈进行了录音并转录。使用主题内容分析对数据进行分析。
结果
共有 12 名全科医生和 12 名养老院居民参与了研究。全科医生表示，在个别养老院实施手部卫生的可能性存在差异。对于养老院居民，手部揉搓液的供应有限。全科医生没有向居民提供手部消毒的说明。由于缺乏使能，居民对手部卫生正确操作的知识水平较低，尽管一些养老院居民有接触多重耐药菌的经验。养老院居民在全科医生就诊期间对积极参与和使能的需求各不相同。
结论
养老院居民需要其全科医生持续提供使能，以保持足够的手部卫生。因此，全科医生应考虑养老院居民的不同需求，以确保每个居民都能进行足够的个人手部卫生，并确保居民的安全。现有的感染预防和控制指南不能充分涵盖养老院护理环境，以确保居民能够询问手部卫生措施。
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