Cumplimiento de las precauciones de aislamiento de contacto por microorganismos multirresistentes en un hospital de tercer nivel

A. González-Estrada , M. Fernández-Prada , C. Martínez Ortega , A. Lana Pérez , M.L. López González
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引用次数: 4

Abstract

Introduction

Preventive isolation of patients with multidrug-resistant microorganisms is considered an effective measure to prevent outbreaks in hospitals. The objective of this study is to assess compliance by healthcare workers and family of contact isolation precautions in colonised/infected patients with multidrug-resistant microorganisms.

Methods

An observational study was conducted from October 2014 to March 2015. A checklist with a structure was designed (equipment trolley), including knowledge of the situation and compliance by the patients, families, and healthcare workers. Univariate and bivariate analyses were performed. Non-parametric tests Mann-Whitney and Kruskal-Wallis were used.

Results

Out of the 467 observations made, the equipment trolley was correctly situated in 97% (453) of cases, the sphygmomanometer in 90% (421), the stethoscope 43.9% (205), and thermometer 16.5% (77). A dustbin and the alcoholic solution were observed in over 98.7% (461) of cases. The antiseptic soap for patient hygiene was observed to be correctly placed in 348 (74%) of occasions. The situation was known by 84.9% (305) of patients and 91.4% (234) of families. As regards compliance by professionals with the placement/removal of disposable gowns and gloves was about 50% for entering the room (49.5%, 56 gown and 53.09%, 60 gloves), and 40% (28) for leaving the room by professionals. Hand hygiene compliance was 26.5% (30) for entering and 35.2% (25) when leaving.

Conclusions

There is significant room for improvement in the compliance with isolation precautions. Non-compliance to isolation procedures is not due to a deficit of materials, but to individual behaviours. It is important to implement and evaluate programs based on psychosocial intervention models that can change attitudes and behaviours related to contact isolation precautions for multidrug-resistant microorganisms.

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在三级医院遵守多重耐药微生物接触隔离预防措施
对耐多药微生物患者进行预防性隔离被认为是预防医院疫情的有效措施。本研究的目的是评估在多药耐药微生物定植/感染患者中卫生保健工作者和接触者家庭隔离预防措施的依从性。方法2014年10月- 2015年3月进行观察性研究。设计了具有结构的检查表(设备小车),包括患者、家属和医护人员对情况的了解和依从性。进行单因素和双因素分析。采用非参数检验Mann-Whitney和Kruskal-Wallis。结果在467例观察中,仪器小车正确放置的占97%(453例),血压计正确放置的占90%(421例),听诊器正确放置的占43.9%(205例),体温计正确放置的占16.5%(77例)。有98.7%(461例)的病例有垃圾桶和酒精溶液。348例(74%)患者卫生消毒皂放置正确。84.9%(305人)的患者和91.4%(234人)的家庭知道这一情况。关于专业人员遵守放置/取下一次性长袍和手套的情况,进入房间的约占50%(49.5%,56件长袍,53.09%,60件手套),而离开房间的约占40%(28%)。进入时和离开时的手卫生依从性分别为26.5%(30例)和35.2%(25例)。结论对隔离措施的依从性有很大的提高空间。不遵守隔离程序不是由于缺乏材料,而是由于个人行为。重要的是实施和评估基于社会心理干预模式的规划,这些模式可以改变对耐多药微生物接触隔离预防措施的态度和行为。
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