Larson E, McGinley K J, Grove G L, Leyden J J, Talbot G H
Am J Infect Control. 1986 Apr;14(2):51-9. doi: 10.1016/0196-6553(86)90055-6.
The handwashing practices of 22 personnel on an oncology unit in an urban medical center were studied for 2 months. During 891 person-hours of observation, 986 handwashes were observed. Subjects washed a mean of 1.1 times an hour for a mean of 13.2 seconds. Reported and observed handwashing behavior was only moderately correlated (p = 0.05 for frequency, 0.30 for duration of handwashing). Physicians washed significantly less often (p less than 0.001), but more thoroughly (p less than 0.001), than did nurses. Nurses washed more often after minimal or no patient contact than did physicians (p less than 0.001). Individuals were very consistent in their handwashing technique. A total of 558 isolates were recovered from 158 hand cultures. The mean log count was 4.88, with no significant difference between physicians and nurses. Coagulase-negative staphylococci isolated from hands of physicians and nurses were significantly more resistant to antimicrobial agents than those of personnel with minimal patient contact (p less than 0.01). Subjects had more skin damage in winter than in summer, as indicated by increased shedding of skin squames (p less than 0.05). We conclude that handwashing practices vary significantly by profession and that reporting of handwashing practices by personnel is inaccurate.
对一家城市医疗中心肿瘤科的22名工作人员的洗手习惯进行了为期2个月的研究。在891人时的观察期间，观察到986次洗手。受试者平均每小时洗手1.1次，平均每次洗手13.2秒。报告的洗手行为与观察到的洗手行为仅呈中度相关（洗手频率的p值为0.05，洗手持续时间的p值为0.30）。医生洗手的频率明显低于护士（p<0.001），但洗手更彻底（p<0.001）。与医生相比，护士在与患者接触极少或没有接触后洗手更频繁（p<0.001）。个体的洗手技术非常一致。从158份手部培养物中总共分离出558株菌株。平均对数计数为4.88，医生和护士之间无显著差异。从医生和护士手上分离出的凝固酶阴性葡萄球菌比与患者接触极少的人员手上分离出的凝固酶阴性葡萄球菌对抗菌剂的耐药性更强（p<0.01）。如皮肤鳞屑脱落增加所示，受试者在冬季比夏季有更多的皮肤损伤（p<0.05）。我们得出结论，洗手习惯因职业而异，并且工作人员报告的洗手习惯不准确。
