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三步与六步手部卫生技术的临床效果：一项随机对照交叉研究。

Clinical Effectiveness of a 3-Step Versus a 6-Step Hand Hygiene Technique: A Randomized Controlled Cross-over Study.

作者信息

Chen Nuo, Li Yan, He Wenbin, Chen Xiaoyan, Cheng Fan, Cheng Xiaolin, Zhou Weilong, Tan Yibin, Wu Wenwen, Wu Lingling, Qiao Fu, Feng Bilong, Wang Ying

机构信息

School of Public Health, Hubei University of Medicine, Shiyan, Hubei, China.

Department of Healthcare-associated Infection Prevention and Control, Zhongnan Hospital of Wuhan University, Hubei, China.

出版信息

Open Forum Infect Dis. 2024 Sep 16;11(10):ofae534. doi: 10.1093/ofid/ofae534. eCollection 2024 Oct.

DOI:10.1093/ofid/ofae534
PMID:39411223
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11475017/
Abstract

BACKGROUND

The aim of this study is to assess the clinical effectiveness of the 3-step hand hygiene (HH) technique (3-HT) compared with the 6-step HH technique (6-HT; World Health Organization 6-step technique) using an alcohol-based hand rub.

METHODS

A randomized controlled crossover trial was conducted from November to December 2023 in 10 wards of a tertiary A-level hospital according to CONSORT guidelines. The 240 healthcare workers (HCWs) were randomly divided into the 3-HT intervention group or the 6-HT control group. The trial was conducted in 2 stages, and the effectiveness of each indicator in the 2 groups was compared after a washout period of 2 weeks.

RESULTS

Compared with the 6-HT, the 3-HT has demonstrated significant superiority in all indicators of HH compliance as well as the accuracy rate of HH practices. The total HH median times for the 3-HT and 6-HT were 16.00 (interquartile range, 15.00-20.00) and 32.50 (30.00-40.00) seconds, respectively ( < .05). The reduction factors for bacterial colony-forming unit counts did not differ and the colony-forming unit counts were not significantly different. , , and were detected before and after the use of hand rubs. HCWs preferred the 3-HT over the 6-HT. There were no significant difference in healthcare-associated infections rate between the 2 techniques.

CONCLUSIONS

The 3-HT was significantly superior to the 6-HT in terms of the HH eligibility rate, compliance, and HH time. The safety and feasibility of the 3-HT were verified by assessing microorganism count.

摘要

背景

本研究旨在评估三步手卫生（HH）技术（3-HT）与六步HH技术（6-HT；世界卫生组织六步技术）相比，使用含酒精洗手液的临床效果。

方法

根据CONSORT指南，于2023年11月至12月在一家三级甲等医院的10个病房进行了一项随机对照交叉试验。240名医护人员（HCW）被随机分为3-HT干预组或6-HT对照组。试验分两个阶段进行，在2周的洗脱期后比较两组各指标的有效性。

结果

与6-HT相比，3-HT在HH依从性的所有指标以及HH操作准确率方面均显示出显著优势。3-HT和6-HT的总HH中位时间分别为16.00（四分位间距，15.00 - 20.00）秒和32.50（30.00 - 40.00）秒（<0.05）。使用洗手液前后细菌菌落形成单位计数的降低因子无差异，菌落形成单位计数也无显著差异。在使用洗手液前后检测了[具体指标未给出]。医护人员更喜欢3-HT而非6-HT。两种技术在医疗相关感染率方面无显著差异。

结论

3-HT在HH合格率、依从性和HH时间方面显著优于6-HT。通过评估微生物计数验证了3-HT的安全性和可行性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/b9b36fdbc2e3/ofae534f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/2d4e7257fede/ofae534f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/58053cd5dce1/ofae534f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/e7aa1fe32ad8/ofae534f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/a73676f62327/ofae534f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/154f46cd3e4a/ofae534f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/495ac6dbadb9/ofae534f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/b9b36fdbc2e3/ofae534f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/2d4e7257fede/ofae534f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/58053cd5dce1/ofae534f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/e7aa1fe32ad8/ofae534f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/a73676f62327/ofae534f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/154f46cd3e4a/ofae534f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/495ac6dbadb9/ofae534f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6420/11475017/b9b36fdbc2e3/ofae534f7.jpg

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