Chen Jing, Yang Lin, Mak Yim-Wah, O'Donoghue Margaret, Shi Chen, Tsang Hilda, Lu Shuya, Zou Jing, Qin Jing, Xie Yao Jie, Lai Timothy, Li Chen, Cao Jiannong, Pittet Didier
School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China.
JAMA Netw Open. 2024 Jun 3;7(6):e2413835. doi: 10.1001/jamanetworkopen.2024.13835.
Few studies have directly and objectively measured the individual and combined effects of multifaceted hand hygiene education programs.
To evaluate the individual and combined immediate effects of an instructional video and hand scan images on handwashing quality, decontamination, and knowledge improvement.
DESIGN, SETTING, AND PARTICIPANTS: This cluster randomized clinical trial was conducted in June to July 2023 among first-year nursing students at a university in Hong Kong. The study used an intention-to-treat analysis.
Hand hygiene education sessions featuring an instructional video, hand scan images, or both.
The primary outcome was the change in residue from fluorescent lotion remaining on participants' hands after handwashing before and after the intervention. The secondary outcomes included handwashing quality and knowledge of hand hygiene.
A total of 270 of 280 students (mean [SD] age, 19 [1] years; 182 [67.4%] female) participated in the trial (96.4% participation rate). Participants were randomized to a control group (66 participants), hand scan image group (68 participants), instructional video group (67 participants), and hand scan image with instructional video group (69 participants). All intervention groups had greater reductions in residue after the intervention compared with the control group, although none reached statistical significance (hand scan image group: 3.9 [95% CI, 2.0-5.8] percentage points; instructional video group: 4.8 [95% CI, 2.9-6.7] percentage points; hand scan image with instructional video: 3.5 [95% CI, 1.6-5.4] percentage points; control group: 3.2 [95% CI, 1.3-5.2] percentage points). The instructional video group showed a significant improvement in their handwashing performance, with a higher percentage of participants correctly performing all 7 steps compared with the control group (22.4% [95% CI, 13.1% to 31.6%] vs 1.5% [-7.9% to 10.9%]; P < .001). Hand scan images revealed that wrists, fingertips, and finger webs were the most commonly ignored areas in handwashing.
In this cluster randomized clinical trial of an education program for hand hygiene, a handwashing instructional video and hand scan images did not enhance the level of decontamination. The intervention group had improved handwashing techniques compared with the control group, a secondary outcome.
ClinicalTrials.gov Identifier: NCT05872581.
很少有研究直接且客观地衡量多方面手部卫生教育计划的个体及综合效果。
评估教学视频和手部扫描图像对手部清洁质量、去污效果及知识提升的个体及综合即时效果。
设计、背景与参与者：这项整群随机临床试验于2023年6月至7月在香港一所大学的一年级护理专业学生中进行。该研究采用意向性分析。
开展以教学视频、手部扫描图像或两者皆有的手部卫生教育课程。
主要结局是干预前后洗手后残留在参与者手上的荧光洗剂残留量的变化。次要结局包括洗手质量和手部卫生知识。
280名学生中的270名（平均[标准差]年龄，19[1]岁；182名[67.4%]为女性）参与了试验（参与率96.4%）。参与者被随机分为对照组（66名参与者）、手部扫描图像组（68名参与者）、教学视频组（67名参与者）和手部扫描图像加教学视频组（69名参与者）。与对照组相比，所有干预组在干预后残留量的减少幅度更大，尽管均未达到统计学显著性（手部扫描图像组：3.9[95%置信区间，2.0 - 5.8]个百分点；教学视频组：4.8[95%置信区间，2.9 - 6.7]个百分点；手部扫描图像加教学视频组：3.5[95%置信区间，1.6 - 5.4]个百分点；对照组：3.2[95%置信区间，1.3 - 5.2]个百分点）。教学视频组的洗手表现有显著改善，与对照组相比，正确完成所有7个步骤的参与者百分比更高（22.4%[95%置信区间，13.1%至31.6%]对1.5%[-7.9%至10.9%]；P < 0.001）。手部扫描图像显示，手腕、指尖和指蹼是洗手时最常被忽视的部位。
在这项针对手部卫生教育计划的整群随机临床试验中，洗手教学视频和手部扫描图像并未提高去污水平。与对照组相比，干预组的洗手技术有所改善，这是一个次要结局。
ClinicalTrials.gov标识符：NCT05872581。
