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新型冠状病毒肺炎疫情前后日本医院使用醇基手部消毒剂的手部卫生实践趋势:利用国家监测数据的观察性研究。

Trends in the hand hygiene practices using alcohol-based hand rubs in Japanese hospitals before and after the novel coronavirus pandemic: an observational study using national surveillance data.

机构信息

Department of Pharmacy, Okayama University Hospital, Okayama, Japan.

Department of Infectious Diseases, Okayama University Hospital, Okayama, Japan.

出版信息

J Hosp Infect. 2024 Oct;152:150-155. doi: 10.1016/j.jhin.2024.08.007. Epub 2024 Aug 28.

Abstract

BACKGROUND

Healthcare-associated infections (HAIs) are a global concern in healthcare facilities, and hand hygiene (HH) using alcohol-based hand rubs (ABHR) is fundamentally crucial for their prevention. While previous studies report improvements in HH compliance amid the COVID-19 pandemic, the real situation in Japanese medical settings remains unclear.

METHODS

This observational study sought data from the Japanese national surveillance, focusing on ABHR use in hospitals before and after the COVID-19 pandemic. Data were retrieved from facilities certified to receive the Additional Healthcare Reimbursements for Infection Prevention and Control I. The study spanned five years (2019-2023), segmented quarterly, and employed Joinpoint regression analysis to assess the annual percentage change (APC).

RESULTS

Overall, ABHR use per patient per day significantly increased both in critical care units and general wards amid the pandemic. However, the APC in the critical care units demonstrated a downward trend from Q4 of 2021 to Q1 of 2023, and ABHR use in general wards remained below the amount of WHO recommendations.

CONCLUSION

This trend analysis highlighted recent patterns of ABHR use in Japanese hospitals by comparing pre- and post-COVID-19 periods. Although increases in ABHR use were observed over time, sustained efforts to promote HH compliance are necessary, particularly in general wards.

摘要

背景

医疗保健相关感染(HAIs)是医疗保健机构面临的全球性问题,使用酒精基手部消毒剂(ABHR)进行手部卫生(HH)对于预防感染至关重要。尽管之前的研究报告表明,在 COVID-19 大流行期间,HH 依从性有所提高,但日本医疗环境的实际情况仍不清楚。

方法

本观察性研究从日本全国监测中获取数据,重点关注 COVID-19 大流行前后医院中 ABHR 的使用情况。数据来自已获得感染预防和控制额外医疗报销认证的设施。该研究跨越五年(2019-2023 年),每季度分段,并采用 Joinpoint 回归分析评估年度百分比变化(APC)。

结果

总体而言,大流行期间,重症监护病房和普通病房的每位患者每天使用 ABHR 的数量均显著增加。然而,重症监护病房的 APC 从 2021 年第四季度到 2023 年第一季度呈下降趋势,普通病房的 ABHR 使用量仍低于世界卫生组织的建议量。

结论

通过比较 COVID-19 前后时期,本趋势分析强调了日本医院最近 ABHR 使用模式。尽管 ABHR 的使用量随时间增加,但仍需持续努力促进 HH 依从性,特别是在普通病房。

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