干预措施的效果和过程评估,以改善长期护理设施中改善手部卫生的遵守
Anja Haenen1, Anita Huis2, Steven Teerenstra3
1Scientific Center for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands; National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control/Epidemiology and Surveillance Unit, Bilthoven, the Netherlands.
一个多方面的战略显著改善了长期护理设施 (LTCFs) 的手部卫生遵守. 对干预组件的更大暴露导致了更好的结果,突出了需要加强领导力支持的需要.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 预防和控制感染.
- 长期护理机构的管理人员管理长期护理机构.
背景情况:
- 遵守手部卫生对于预防长期护理设施 (LTCF) 感染至关重要.
- 之前的干预措施在改善遵守手部卫生协议方面取得了不同程度的成功.
研究的目的:
- 评估一个量身定制的,多方面的改进战略对LTCFs手部卫生合规性的有效性.
- 进行过程评估,探索战略引发的变化机制.
主要方法:
- 一个阶梯集群随机对照试验,涉及14个LTCF (23个病房) 在荷兰.
- 实施战略,包括教育,培训,提醒,反观察和团队会议.
- 在5个测量期内使用世卫组织的"手部卫生五个时刻"观察手部卫生的遵守情况.
主要成果:
- 该战略导致整体手部卫生遵守率显著增加了13%,绝对增加了13%.
- 在大多数"五个时刻"类别中观察到统计学上显著的改善,在无菌手术前 (23%) 和接触住户后 (18%) 获得的最大收益.
- 对干预组件的更高暴露与遵守手部卫生的更大改善有关.
结论:
- 多方面的改进战略有效地提高了LTCF的手部卫生遵守.
- 增加团队成员对干预组件的接触,扩大了战略的影响.
- 建议包括为管理人员提供增强的支持,以加强领导力,保持手部卫生的遵守.
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