检查手套作为临床实践中防止手部污染的障碍
JAMA
|July 21, 1993
概括
乳手套在医院手术期间比乙烯基手套更好地保护手免受格拉姆阴性生物和肠球菌的污染. 即使有漏水,手套也能显著减少污染,但洗手仍然至关重要.
科学领域:
- 感染控制 感染控制
- 微生物学 微生物学
- 医疗卫生流行病学 流行病学
背景情况:
- 与医疗保健相关的感染仍然是一个重大问题.
- 手部污染是医院中病原体传播的主要途径.
- 评估个人防护设备的屏障有效性至关重要.
研究的目的:
- 为了比较乙烯基和乳手套在防止手部污染方面的有效性.
- 评估手套的完整性及其对屏障功能的影响.
- 为了确定在例行医院程序中手部污染的频率.
主要方法:
- 一项前性研究涉及137种可能造成手部污染的手术.
- 医护人员手 (手术前和手术后) 和外套表面的定量培养.
- 使用ASTM防水标准对使用过的手套进行泄漏测试.
主要成果:
- 在86%的使用过的手套上发现了格拉姆阴性生物或肠球菌.
- 手部污染发生在13%的曝光中,显著更多的是用乙烯基 (10/42) 而不是乳 (1/44) 的手套.
- 乙烯基手套的泄漏率比乳 (6/70) 高 (26/61);然而,手套在77%的情况中,即使有泄漏,也可以防止污染.
结论:
- 手套作为有效的屏障,防止手的污染,即使受到泄漏的危害.
- 乳手套表现出优越的性能,漏水较少,手部污染较少.
- 医疗保健工作者无法检测手套泄漏,因此需要患者接触后进行例行手部卫生.
相关概念视频
Hand hygiene
Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
Hand washing...
Handwashing I: Introduction and Types of Equipment
Handwashing is hand hygiene with plain or antimicrobial soap and water to physically remove dirt, organic material, and microorganisms. However, it may not kill all microorganisms. The handwashing procedure requires a hand wash basin, liquid soap, paper towels, a domestic waste bin, and disposable nail cleaner as optional equipment.
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated.
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated.
PPE Use in Healthcare Settings I: Donning
Donning PPE must be completed before contact with the patient. This process protects from infectious agents. The sequence and action included in each donning are critical, and the steps must be systematic to avoid exposure to pathogens. The institutional policy also needs to be followed while donning PPE. The pre-donning preparations are gathering equipment, inspecting the PPE equipment for tears, holes, or damage, removing jewelry, removing any garments below the elbows, and tying the hair...
PPE Use in Healthcare Settings II: Doffing
The sequence of removing or doffing PPE starts with the gloves, as they are the most contaminated. Next is removal of the face shield or goggles, as they would interfere with removing other PPE. Then remove the gown, followed by the mask or respirator. Perform hand hygiene between steps if hands become contaminated and immediately after removing all PPE. Generally, the outside front and sleeves of the isolation gown, the goggles or the mask, the respirator, and the face shield are contaminated.
Standard Precaution
Standard precautions are the minimum infection control safeguards used while caring for all patients, irrespective of their disease condition. They help prevent the spread of common infectious microorganisms to healthcare workers, patients, and visitors in all healthcare settings.
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Handwashing III: During the Procedure and Post-Procedure Steps
To wash hands properly, follow these steps:


