一个全医院计划的有效性,以改善对手部卫生的遵守. 感染控制计划 感染控制计划
D Pittet1, S Hugonnet, S Harbarth
1Department of Internal Medicine, University of Geneva Hospitals, and Institute of Social and Preventive Medicine, University of Geneva, Switzerland. didier.pittet@hcuge.ch
Lancet (London, England)
|November 10, 2000
概括
在全医院开展活动后,医院对手部卫生的遵守有了显著的改善,导致感染和甲素耐药黄金葡萄球菌 (MRSA) 传播减少. 床边以酒精为基础的手是这一成功的关键.
科学领域:
- 与医疗保健相关的感染
- 感染控制的方法是感染控制.
- 公共卫生 公共卫生
背景情况:
- 医院中不良的手部卫生遵守有助于交叉感染.
- 实施了一项全医院的计划,重点是床边以酒精为基础的手部消毒.
- 同时监测鼻腔感染,以评估该计划的影响.
研究的目的:
- 促进在医院环境中遵守手部卫生.
- 评估一项手部卫生运动对医院感染率的影响.
- 评估床边以酒精为基础的手部消毒在提高合规性方面的作用.
主要方法:
- 在三年 (1994-1997) 的时间里,在例行患者护理期间,对遵守手部卫生进行了观察性调查.
- 监测了医院感染率,抗甲素黄金葡萄球菌 (MRSA) 攻击率,以及手擦消毒剂的消耗.
- 利用统计分析来确定观察到的变化的重要性.
主要成果:
- 由于越来越多地使用手部消毒,手部卫生的遵守率从48%增加到66% (p<0.001).
- 总体而言,医院感染的患病率从16.9%降至9.9% (p=0.04).
- MRSA 传播率显著下降 (每 10,000 个患者日有 2.16 到 0.93 个发作; p<0.001),同时增加了基于酒精的手消费.
结论:
- 整个医院的运动成功地改善了持续的手部卫生遵守.
- 病房感染和MRSA传播的减少与改善的手部卫生相关.
- 推广床边消毒手是提高合规性的重要因素.
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