量化 COVID ICU 中“手套卫生”依从性的昼夜变化：一项探索性研究。
Quantification of diurnal variation in "glove hygiene" compliance in COVID ICUs: An exploratory study.
机构信息
Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
出版信息
Am J Infect Control. 2023 Apr;51(4):372-375. doi: 10.1016/j.ajic.2022.07.018. Epub 2022 Jul 29.
BACKGROUND
Hand hygiene compliance (HHC) monitoring is almost always done in daytime. Documentation of HHC in health care workers (HCWs) is limited during odd hours and nighttime. The objective of the study was to determine diurnal variation in HHC in different categories of health care workers in tertiary care hospital in North India.
METHODS
A prospective, observational study was conducted in 3 COVID-19 intensive care units (ICUs) with closed-circuit television (CCTV) cameras. Dedicated infection control nurses monitored HHC among various HCWs (doctors, nursing staff, technicians, hospital and sanitary attendants) during day and nighttime, in 20-minute durations. The difference in HHC by-professional category and for each WHO moment was assessed using χ² test and P value.
RESULTS
A total of 705 opportunities were observed over a period of 7 days, with overall compliance of 53%. Day and nighttime compliance was recorded to be 60.7% and 42.1%, respectively (P < .001). HCC was highest amongst resident doctors with little diurnal variation. However, nurses and housekeeping staff exhibited significant diurnal variation. The compliance at "after" moments was much higher than "before" moments in all professional categories.
CONCLUSION
There was a significant decrease in compliance during nighttime, amongst all HCWs, with maximum variation exhibited by nursing staff. The present study underlines the importance of monitoring HHC at odd hours, to elicit a more accurate picture round the clock. Health care facilities monitoring compliance only during the daytime may substantially overestimate HHC.
背景
手卫生依从性（HHC）监测几乎总是在白天进行。医护人员（HCWs）在非正常工作时间和夜间的 HHC 记录有限。本研究的目的是确定印度北部一家三级保健医院不同类别的 HCWs 中 HHC 的昼夜变化。
方法
一项前瞻性、观察性研究在 3 个配备闭路电视（CCTV）摄像机的 COVID-19 重症监护病房（ICU）进行。专职感染控制护士在白天和夜间，每 20 分钟对不同 HCWs（医生、护理人员、技术人员、医院和卫生服务员）的 HHC 进行监测。使用 χ²检验和 P 值评估按专业类别和每个世卫组织时刻的 HHC 差异。
结果
在 7 天的时间里共观察到 705 个机会，总体依从率为 53%。白天和夜间的依从率分别为 60.7%和 42.1%（P<0.001）。住院医生的 HHC 最高，昼夜变化不大。然而，护士和家政服务员的昼夜变化明显。在所有专业类别中，“之后”时刻的依从率均明显高于“之前”时刻。
结论
所有 HCWs 在夜间的依从率显著下降，其中护理人员的变化最大。本研究强调了在非正常工作时间监测 HHC 的重要性，以更准确地了解全天的情况。仅在白天监测依从性的卫生保健设施可能会大大高估 HHC。
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