评估中心静脉导管操作过程中的霍桑效应。
Assessment of the Hawthorne effect during central venous catheter manipulation.
机构信息
Hospital Sírio Libanês, Serviço de Controle de Infecção Hospitalar, São Paulo, SP, Brazil.
Hospital Sírio Libanês, Unidade de Terapia Intensiva, São Paulo, SP, Brazil.
出版信息
Rev Esc Enferm USP. 2022 Sep 2;56:e20220125. doi: 10.1590/1980-220X-REEUSP-2022-0125en. eCollection 2022.
OBJECTIVES
To describe the compliance to the practices of hand hygiene and hub disinfection before manipulation of the central venous catheter in two moments: before and after educational intervention. Adherence to hand hygiene was assessed with two methods: direct observation and video camera.
METHODS
Before and after study conducted with the nursing team in an adult intensive care unit, in São Paulo, Brazil, including 180 observations using video cameras and direct observation. Hand hygiene compliance before catheter manipulation and compliance with the correct technique and the hub disinfection for five seconds were observed.
RESULTS
When video cameras recording was observed, hand hygiene compliance increased from 46% to 66% and the use of the proper technique increased from 23% to 46% (p < 0.05). Regarding hub disinfection compliance, no difference was observed between the periods. Hand hygiene compliance in direct observation increased from 83% to 87% and in indirect observation, from 46% to 66% after the intervention.
CONCLUSION
After the educational intervention, hand hygiene compliance before CVC manipulation and the use of the correct technique improved. When observed indirectly, the adherence to these practices was lower, reinforcing the Hawthorne effect.
目的
描述在进行中心静脉导管操作之前，对两个时间点的手部卫生和中心静脉导管接头消毒实践的依从情况：教育干预之前和之后。使用两种方法评估手部卫生依从性：直接观察和摄像机。
方法
在巴西圣保罗的成人重症监护病房，对护理团队进行了一项前瞻性研究，包括使用摄像机和直接观察进行的 180 次观察。观察了导管操作前的手部卫生依从性和正确技术以及五秒中心静脉导管接头消毒的依从性。
结果
当观察摄像机记录时，手部卫生依从性从 46%增加到 66%，正确技术的使用率从 23%增加到 46%（p < 0.05）。关于中心静脉导管接头消毒的依从性，两个时期之间没有差异。直接观察时，手部卫生依从性从 83%增加到 87%，间接观察时，干预后从 46%增加到 66%。
结论
教育干预后，中心静脉导管操作前的手部卫生依从性和正确技术的使用得到了改善。间接观察时，这些实践的依从性较低，这强化了霍桑效应。
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