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使用柯克帕特里克模型评估重症监护病房的感染控制培训:一项前瞻性队列研究。

Assessing infection control training in ICUs using the Kirkpatrick model: a prospective cohort study.

作者信息

Elsheikh Sahar, Magdy Afaf, Asem Lamiaa

机构信息

Nursing Department, Shebin Elkom Fever Hospital, Ministry of Health, Menoufia, Egypt.

Clinical Pharmacy Department, Shebin Elkom Fever Hospital, Ministry of Health, Menoufia, Egypt.

出版信息

Antimicrob Resist Infect Control. 2025 Jun 9;14(1):65. doi: 10.1186/s13756-025-01587-6.

Abstract

BACKGROUND

Hospital-acquired infections (HAIs) are a significant global health challenge, particularly in intensive care units (ICUs), where patient vulnerability is high. Effective infection prevention and control (IPC) training is critical for reducing HAIs and improving healthcare outcomes. This aims to evaluate the efficacy of an IPC training program via Kirkpatrick's four-level model.

METHODS

A prospective cohort study was conducted between June and December 2024 at Shebin El Kom Fever Hospital's ICU. The study involved 106 healthcare workers (84 nurses, 22 physicians) who participated in a two-month training program combining theoretical lectures and practical sessions. Program effectiveness was assessed via Kirkpatrick's 4 levels: reaction (satisfaction surveys), learning (knowledge tests), behavior (direct observation), and results (clinical outcomes).

RESULTS

Ninety health care workers (HCWs) whose level of satisfaction exceeded 80% across all training aspects (Level 1) were included. The knowledge assessment revealed a significant improvement in the mean test score from 76.93 to 82.29% (p = 0.0112) (Level 2). Behavioral evaluation revealed substantial improvements in infection control practices, particularly in nurses' aseptic procedures (40.00-83.54%, p < 0.001) and physicians' personal protective equipment (PPE) usage (19.05-62.50%, p = 0.0391) (Level 3). At Level 4, no significant changes were observed in HAIs, mortality rates, or hospital stay costs.

CONCLUSION

IPC training programs significantly enhance HCW knowledge and compliance with infection control practices, laying the groundwork for sustainable ICU infection control. While immediate improvements in hospital metrics were not observed, long-term monitoring is crucial to achieving full benefits. Enhanced compliance may reduce HAIs and associated costs over time.

摘要

背景

医院获得性感染(HAIs)是一项重大的全球卫生挑战,尤其是在重症监护病房(ICU),那里的患者易感性很高。有效的感染预防与控制(IPC)培训对于减少医院获得性感染和改善医疗保健结果至关重要。本研究旨在通过柯克帕特里克四级模型评估一项IPC培训计划的效果。

方法

2024年6月至12月在舍宾·埃尔·科姆发热医院的ICU进行了一项前瞻性队列研究。该研究纳入了106名医护人员(84名护士、22名医生),他们参加了一个为期两个月的培训计划,该计划结合了理论讲座和实践课程。通过柯克帕特里克的四个级别评估计划效果:反应(满意度调查)、学习(知识测试)、行为(直接观察)和结果(临床结果)。

结果

纳入了90名医护人员,他们在所有培训方面的满意度水平均超过80%(一级)。知识评估显示,平均测试分数从76.93%显著提高到82.29%(p = 0.0112)(二级)。行为评估显示感染控制措施有显著改善,特别是护士的无菌操作(从40.00%提高到83.54%,p < 0.001)和医生的个人防护装备(PPE)使用情况(从19.05%提高到62.50%,p = 0.0391)(三级)。在四级,医院获得性感染、死亡率或住院费用方面未观察到显著变化。

结论

IPC培训计划显著提高了医护人员的知识水平和对感染控制措施的依从性,为重症监护病房的可持续感染控制奠定了基础。虽然未观察到医院指标的立即改善,但长期监测对于实现全面效益至关重要。随着时间的推移,增强依从性可能会降低医院获得性感染及相关成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6183/12150569/8291b94787f3/13756_2025_1587_Fig1_HTML.jpg

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