以酒精为基础的手套手的消毒:一个随机对照试验
Kerri A Thom1, Clare Rock2, Gwen L Robinson1
1Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
Infection control and hospital epidemiology
|November 23, 2023
概括
与通常的护理相比,将酒精为基础的手 (ABHR) 应用到戴着手套的手上减少了细菌,尽管不如金标准那么有效. 这种高效的方法为医疗保健人员 (HCP) 的手部卫生提供了可行的替代方案.
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.
- 微生物学 微生物学
背景情况:
- 标准的手部卫生 (HH) 协议要求在患者护理时刻之间脱掉手套并重新使用手套.
- 一个新的策略涉及将酒精为基础的手 (ABHR) 直接应用到戴着手套的手上,以提高效率.
研究的目的:
- 与黄金标准和通常的护理相比,评估ABHR在戴着手套的手上应用的有效性和效率.
- 根据不同的手部卫生协议,评估戴着手套的手上的细菌污染.
主要方法:
- 在4家医院的成人和儿科重症监护病房进行了一项混合方法,多中心,三臂随机试验.
- 医疗保健人员 (HCP) 被随机分为三个组:戴着手套的ABHR,黄金标准的HH或通常的护理.
- 戴着手套的手用直接印记取样,以量化细菌污染.
主要成果:
- 在82.8%的ABHR干预观察中,在戴着手套的手上发现了细菌,而黄金标准的这一比例为67.4% (P < .01).
- 该ABHR干预需要平均14秒,远低于黄金标准的28.7秒 (P < .01).
- 与通常的护理 (98.5%的污染) 相比,戴着手套的手上的ABHR显示污染减少了 (76.6%,P <.01). 在ABHR手臂的2.9%的手套中发现了微孔.
结论:
- 与通常的护理相比,将ABHR应用于戴着手套的手上显著减少了污染,尽管它不如黄金标准有效.
- 鉴于节省时间和微生物的好处,而不是通常的护理,以及黄金标准的不切实际性,这种方法值得考虑.
- 建议卫生组织考虑建议医疗保健工作者在单个患者接触期间在戴手套的手上使用ABHR.
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