Workflows and locations matter – insights from electronic hand hygiene monitoring into the use of hand rub dispensers across diverse hospital wards

IF 1.8 Q3 INFECTIOUS DISEASES Infection Prevention in Practice Pub Date : 2024-03-27 DOI:10.1016/j.infpip.2024.100364
Christoph Senges , Christiane Herzer , Erlandas Norkus , Marco Krewing , Clara Mattner , Leonard Rose , Tobias Gebhardt , Frauke Mattner , Heide Niesalla
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Abstract

Background

While healthcare-associated infections (HAIs) affect approximately 3.2–6.5% of hospitalised patients in the US and Europe, improving hand hygiene (HH) could reduce HAI rates. Investigating HH is time-consuming and not always objective, and comprehensive, unbiased data is needed to develop effective strategies. Using electronic tools can provide new and detailed insights on the determinants of HH.

Aim

To evaluate location-dependent usage of wall-mounted dispensers (WMDs) and point-of-care dispensers (POCs) using an electronic HH recording system.

Methods

In this retrospective study, hand rub volumes were anonymously recorded for 931,446 disinfections from 17 wards in nine German hospitals using the electronic monitoring system NosoEx®. Number of disinfections and rub volumes of WMDs/POCs by ward and room type were analysed.

Findings

Generally, WMDs were most prevalent. With >3 dispensers per bed and >20 disinfections per patient day, availability and use were highest in intensive care (ICU) and intermediate care (IMC), but here rub volumes from WMDs were lowest (∼2.0 mL). Although most dispensers are located in patient rooms (∼42%), they are more frequently used in hallways. In surgical ICUs, dispensers are often used in patient rooms, where contact with open wounds is common. About 3.6 mL of hand rub is used per disinfection in treatment rooms, the highest volume of all room types.

Conclusion

Dispenser use was dependent on location, room type, ward specialisation and workflow. Optimising the location of hand rub dispensers (HRDs)s is not the only solution to improve HH, but can help reduce inconvenience, achieve more ergonomic workflows and better meet user needs.

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工作流程和地点很重要--电子手部卫生监控对不同医院病房使用擦手纸分配器的启示
背景在美国和欧洲,约有 3.2%-6.5% 的住院病人受到医疗相关感染 (HAI) 的影响,而改善手部卫生 (HH) 可以降低 HAI 发生率。调查手部卫生不仅耗时,而且并不总是客观的,因此需要全面、无偏见的数据来制定有效的策略。方法在这项回顾性研究中,使用电子监控系统 NosoEx® 匿名记录了 9 家德国医院 17 个病房 931446 次消毒的擦手次数。研究结果总体而言,大规模毁灭性武器最为普遍。重症监护室(ICU)和中级监护室(IMC)每张病床有 3 台消毒机,每天为 20 名患者进行消毒,其可用性和使用率最高,但 WMD 的擦拭量最低(2.0 mL)。虽然大多数配药机位于病房内(42%),但在走廊上的使用频率更高。在外科重症监护室中,分配器通常用于与开放性伤口接触频繁的病房。治疗室每次消毒使用的擦手纸约为 3.6 毫升,是所有病房类型中使用量最大的。优化擦手纸分配器 (HRDs) 的位置并不是改善 HH 的唯一解决方案,但有助于减少不便、实现更符合人体工程学的工作流程并更好地满足用户需求。
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来源期刊
Infection Prevention in Practice
Infection Prevention in Practice Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
0.00%
发文量
58
审稿时长
61 days
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