van de Mortel T, Heyman L
Aust Crit Care. 1995 Jun;8(2):8-13. doi: 10.1016/s1036-7314(95)70256-9.
Nosocomial infections affect up to 30% of ICU patients. Although infection rates decline with increasing handwashing frequency, handwashing rates in ICU's are poor. This study investigated the hypotheses that the subjects' profession would not influence, and performance feedback would not increase, the incidence of handwashing post-patient contact. The study involved an initial period of covert observation to record the baseline level of handwashing, followed by a period of overt observation with regular feedback on handwashing performance by means of letters to staff and histograms of the data displayed in the ICU. Handwashing incidence was reassessed 6 months after performance feedback had ceased. Handwashing differed significantly between professions (P = 0.0001). Initially, the incidence of handwashing was highest amongst wardsmen (90%) and lowest amongst Visiting Medical Officers (VMOs) (20%). Sixty-nine percent (69%) of Registered Nurses (RNs), 57% of physiotherapists, 41% of Resident Medical Officers (RMOs) and 35% of radiographers washed their hands after touching patients. With the exception of the wardsmen, there was a trend towards an increased frequency in handwashing in all groups after performance feedback, but the differences were only statistically significant in the VMO and physiotherapist groups (P < 0.001). The improvements were maintained for 6 months after the feedback phase ended in 4 of the 6 groups.
医院感染影响多达30%的重症监护病房（ICU）患者。尽管感染率会随着洗手频率的增加而下降，但ICU的洗手率却很低。本研究调查了以下假设：受试者的职业不会影响患者接触后洗手的发生率，且绩效反馈不会增加该发生率。该研究包括一个初始的隐蔽观察期，以记录洗手的基线水平，随后是一个公开观察期，通过给工作人员写信以及在ICU展示数据直方图的方式，定期反馈洗手表现。在绩效反馈停止6个月后，重新评估洗手发生率。不同职业之间的洗手情况存在显著差异（P = 0.0001）。最初，勤杂工的洗手发生率最高（90%），而客座医务人员（VMO）的洗手发生率最低（20%）。69%的注册护士（RN）、57%的物理治疗师、41%的住院医师（RMO）和35%的放射技师在接触患者后洗手。除勤杂工外，在绩效反馈后，所有组的洗手频率都有增加的趋势，但差异仅在VMO组和物理治疗师组具有统计学意义（P < 0.001）。在6个组中的4个组，反馈阶段结束后的6个月内，洗手情况的改善得以维持。
