Division of Infection Control and Hospital Epidemiology, Marburg University Hospital, Marburg, Germany.
Division of Infection Control and Hospital Epidemiology, Marburg University Hospital, Marburg, Germany.
J Hosp Infect. 2023 Nov;141:71-79. doi: 10.1016/j.jhin.2023.08.017. Epub 2023 Sep 1.
Availability of alcohol-based hand rub (ABHR) dispensers at positions adapted to the work flow of healthcare workers (HCWs) is decisive in order to carry out indication-based hand rubbing. Although requirements and guidelines regarding the positioning of ABHR dispensers are in place, scientific evidence is often lacking.
In order to analyse the impact of the location and number of ABHR dispensers on hand hygiene performance, additional dispensers were systematically placed in patient rooms in a surgical 38-bed ward at Marburg University Hospital, Germany to complement the existing dispenser locations. ABHR use was monitored continuously before and after complementation using the NosoEx hand hygiene monitoring system. The ward had 53 dispensers before the intervention and 82 dispensers after the intervention.
The addition of dispensers increased ABHR consumption across the entire ward. Before the intervention, mean consumption was 20.6 mL/patient-day, whereas mean consumption after the intervention was 25.3 mL/patient-day. Depending on the combination of dispenser locations, consumption increased through targeted supplementation in patient rooms. The presence of two or three dispensers per patient room resulted in significantly greater ABHR consumption compared with one dispenser per patient room. The preferred location combinations were entrance-front bed-back bed and entrance-foot end.
ABHR consumption can be increased significantly by optimizing the position and number of dispensers. The outstanding factors are visibility and integrability of dispenser use into the work flow; in particular, a dispenser should be positioned in the entrance area. Recommendations should be optimized with regard to the required number and location of dispensers in patient rooms.
为了进行基于指征的手卫生，医护人员（HCWs）工作流程中配备的酒精基手部搓揉液（ABHR）分配器的可用性至关重要。尽管已经有关于 ABHR 分配器定位的要求和指南，但往往缺乏科学证据。
为了分析分配器的位置和数量对手卫生执行情况的影响，德国马尔堡大学医院的一个 38 床外科病房在原有分配器位置的基础上，系统地在病房内增设了额外的分配器。使用 NosoEx 手部卫生监测系统在补充前后持续监测 ABHR 的使用情况。干预前该病房有 53 个分配器，干预后有 82 个分配器。
在整个病房内，分配器的增加提高了 ABHR 的消耗量。干预前，平均消耗量为 20.6 毫升/患者/天，而干预后平均消耗量为 25.3 毫升/患者/天。通过在病房内有针对性地补充分配器，可实现消耗量的增加。每个病房配备两个或三个分配器比配备一个分配器的消耗量明显增加。首选的分配器位置组合是进门-床头-床尾和进门-床脚。
通过优化分配器的位置和数量，可以显著增加 ABHR 的消耗量。重要因素是分配器使用的可见度和与工作流程的兼容性；特别是，分配器应位于入口区域。应根据病房内分配器的数量和位置优化相关建议。
