Involvement of healthcare staff in hospital hygiene during emergency hemodialysis.

Razzok El Mahdi, Machmachi Imane, Maleb Adil, Mekhfi Hassane, Bentata Yassamine
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Abstract

Background: Healthcare-associated infections are still a worrying health problem that complicates patient care and increases morbidity and mortality. The incidence of infections in hemodialysis patients is still high and they constitute the second cause of hospitalization and death in this category.

Aims: The study's objective was to evaluate nursing and medical staff's involvement in hospital hygiene.

Methods: This is an observational study that took place within the hemodialysis unit of a Moroccan university hospital from March 2021 to June 2021. A surface swabbing technique for bacteriological examination was also carried out.

Results: The study revealed some shortcomings regarding hand hygiene which was respected by the nurses in only 17.5% of sessions and in 42.2% by the doctors. Other shortcomings in asepsis measures, were also noted such as the non-change of gloves after skin preparation (1.03%) and before manual compression. The serological status of patients concerning HBV, HVC, and HIV was also not always known (31.1%). The bacteriological samples from the surfaces also showed colonization of the medical devices and the ultrasound scanner used for the ultrasound-guided introduction of the central catheters. The results of the study showed some deviations concerning the recommendations; however, they are comparable to other studies conducted internationally, especially in terms of hand hygiene.

Conclusion: Our study results highlight some shortcomings adherence to hygiene measures like inconsistent disinfection of medical devices and dialysis stations, as well as insufficient hand hygiene practices among some staff members. However, we observed an improvement in practices following the implementation of awareness-raising sessions. To maintain improved hygiene practices and prevent infections, it is crucial to provide ongoing training for staff, ensure adequate resources, and regularly monitor compliance with hygiene standards.

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医护人员参与紧急血液透析期间的医院卫生。
背景:医疗相关感染仍然是一个令人担忧的健康问题,它使患者护理复杂化,并增加了发病率和死亡率。血液透析患者的感染发生率仍然很高,是导致该类患者住院和死亡的第二大原因:这是一项观察性研究,于 2021 年 3 月至 2021 年 6 月在摩洛哥一所大学医院的血液透析室进行。研究还采用了表面拭抹技术进行细菌学检查:研究显示,手部卫生方面存在一些不足,只有 17.5%的疗程中护士和 42.2%的疗程中医生遵守了手部卫生。此外,还发现了其他无菌措施方面的不足,如备皮后(1.03%)和人工按压前未更换手套。患者的 HBV、HVC 和 HIV 血清学状况也不一定为人所知(31.1%)。从表面采集的细菌样本还显示,医疗器械和超声引导导入中心导管所用的超声扫描仪上也存在菌落。研究结果表明,在建议方面存在一些偏差;不过,这些偏差与国际上开展的其他研究不相上下,尤其是在手部卫生方面:我们的研究结果凸显了在卫生措施方面存在的一些不足,如医疗器械和透析站的消毒不一致,以及一些工作人员的手部卫生习惯不足。不过,我们注意到,在开展提高认识活动后,员工的卫生习惯有所改善。为了保持更好的卫生习惯并预防感染,为员工提供持续培训、确保充足的资源并定期监测卫生标准的遵守情况至关重要。
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