Wong Shuk-Ching, Ip Stephen Chun-Yat, Kwok Monica Oi-Tung, Siu Crystal Yuen-Ki, Chen Jonathan Hon-Kwan, So Simon Yung-Chun, Chiu Kelvin Hei-Yeung, Yuen Kwok-Keung, Cheng Vincent Chi-Chung
Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Pokfulam, Hong Kong Special Administrative Region, China.
Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.
Antimicrob Resist Infect Control. 2024 Dec 21;13(1):154. doi: 10.1186/s13756-024-01510-5.
Hand hygiene is a critical component of infection prevention in healthcare settings. Innovative strategies are required to enhance hand hygiene practices among patients and healthcare workers (HCWs).
This study was conducted at the Chemotherapy Day Center of Queen Mary Hospital, Hong Kong. It comprised three phases: phase 1 involved observational audits of hand hygiene practices among patients and HCWs by infection control nurse (ICN); phase 2 included the installation of 53 pressure sensors on alcohol-based hand rub (AHR) bottles at designated sites to monitor usage; phase 3 introduced the robot named Temi Medic to promote hand hygiene through video broadcasts at strategic locations in the center. The mean counts of pressure sensor-equipped AHR per 100 attendances per day (hereafter referred to as the mean count) across phases 2 and 3 were analyzed.
A total of 2580 patient attended the center from April to September 2023. The ICN observed a significant increase in hand hygiene practices among patients at the entrance and reception area, rising from phase 1 (0.2%, 1/583) and phase 2 (0.5%, 3/656) to phase 3 (5.0%, 33/654) (p < 0.001). Meanwhile, the overall hand hygiene compliance among HCWs was 74.1% (1341/1810) throughout the study period. From phase 2 to phase 3, the mean counts of 7 AHR bottles designated for patient use (P1-P7) significantly increased (35 ± 17 vs. 64 ± 24, p < 0.001), as did the 33 AHR bottles shared by both patients and HCWs (207 ± 104 vs. 267 ± 113, p = 0.027). In contrast, there was no significant change in the mean count among the 13 AHR bottles designated for HCWs (H1-H13). The mean count of H1-H13 was significantly higher than that of P1-P7 throughout phases 2 and 3 (214 ± 93 vs. 49 ± 25, p < 0.001), indicating a 4.4-fold difference.
While HCWs maintained stable hand hygiene compliance, the introduction of the robot significantly improved hand hygiene practices among patients in the chemotherapy day center. This underscores the importance of integrating technology into routine practices to promote infection prevention and control in healthcare settings.
手部卫生是医疗机构感染预防的关键组成部分。需要创新策略来加强患者和医护人员的手部卫生习惯。
本研究在香港玛丽医院化疗日间中心进行。它包括三个阶段：第一阶段由感染控制护士（ICN）对手部卫生习惯进行观察性审核，涉及患者和医护人员；第二阶段在指定地点的酒精擦手液（AHR）瓶上安装53个压力传感器以监测使用情况；第三阶段引入名为Temi Medic的机器人，通过在中心的战略位置进行视频广播来促进手部卫生。分析了第二阶段和第三阶段每天每100人次配备压力传感器的AHR的平均使用量（以下简称平均使用量）。
2023年4月至9月共有2580名患者到该中心就诊。ICN观察到，在入口和接待区，患者的手部卫生习惯有显著改善，从第一阶段（0.2%，1/583）和第二阶段（0.5%，3/656）上升到第三阶段（5.0%，33/654）（p<0.001）。同时，在整个研究期间，医护人员的总体手部卫生依从率为74.1%（1341/1810）。从第二阶段到第三阶段，指定供患者使用的7个AHR瓶（P1 - P7）的平均使用量显著增加（35±17对64±24，p<0.001），患者和医护人员共用的33个AHR瓶的平均使用量也显著增加（207±104对267±113，p = 0.027）。相比之下，指定供医护人员使用的13个AHR瓶（H1 - H13）的平均使用量没有显著变化。在第二阶段和第三阶段，H1 - H13的平均使用量显著高于P1 - P7（214±93对49±25，p<0.001），相差4.4倍。
虽然医护人员保持了稳定的手部卫生依从率，但机器人的引入显著改善了化疗日间中心患者的手部卫生习惯。这凸显了将技术融入日常实践以促进医疗机构感染预防和控制的重要性。
