通过系统性手部卫生审核评估三级医院医护人员的手部卫生习惯

Amit Khelgi, Sathya Anandam
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摘要

:手部卫生(HH)在感染控制中起着举足轻重的作用。然而,在全球范围内,手部卫生的依从性仍然很低。在大多数医疗机构中,医院获得性感染(HAI)的发生率正在上升。据推测,如果医护人员(HCWs)严格遵守手部卫生规范,可减少约 30% 的 HAI。本研究旨在通过手部卫生审计,评估我们这家三级医疗保健医院的医护人员遵守适当手部卫生规范的程度。这项横断面观察研究在一家三级护理教学医院进行,历时六个月。经过培训的感染控制护士采用单一观察者直接观察法收集手卫生依从性数据。包括医生、护士、CRMIs 和技术人员在内的医护人员在所有关键区域、门诊和住院部的所有部门接受了符合性观察。研究中使用了根据世界卫生组织卫生保健审核工具包设计的卫生保健审核表。审核在所有区域随机进行,每天不少于 20 分钟。 手部卫生合规性审核:共有 583 名医护人员接受了手部卫生合规性审核。总体手卫生达标率为 67.88%,其中医生为 74.31%,护士为 70.42%。妇产科/产科病房的合规率为 78.7%,肿瘤科病房为 78.5%。世卫组织特定时刻手卫生依从性显示,时刻 1 的依从性最低,为 55%,其次是时刻 5,为 58.9%。手卫生依从性最好的是时刻 3,为 79.2%:在我们的研究中,总体手卫生依从性相对较好。要达到良好的手卫生依从性,需要采取具体措施,如改善设施、培训和监测。
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Evaluation of hand hygiene practices of health care workers in tertiary care hospital by systematic hand hygiene audits
: Hand hygiene (HH) holds a pivotal role in infection control. However, compliance with hand hygiene has remained low worldwide. Hospital Acquired Infection (HAI) incidence is rising in most healthcare facilities. It is postulated that around 30% of HAI can be reduced by following strict hand hygiene protocols by healthcare workers (HCWs). This study was done to evaluate the level of compliance of healthcare personnel in our tertiary care hospital with respect to appropriate hand hygiene practices by employing HH audits. A cross-sectional observational study was conducted in a tertiary care teaching hospital over six months. A single‑ observer direct observation technique was used to collect the HH compliance data conducted by trained Infection control nurses. HCWs, including doctors, nurses, CRMIs and technicians, were observed for compliance in all the critical areas, outpatient and inpatient sections across all departments. The HH audit form designed based on the WHO's HH audit tool kit was used in the study. The audits were conducted randomly in all the areas for at least 20 minutes per day. : A total of 583 HCWs were observed for the Hand Hygiene Compliance audit. The overall HH compliance rate was 67.88%, with doctors at 74.31%, followed by nurses at 70.42%. Compliance was observed in OBG/Labour ward at 78.7% and the oncology ward at 78.5%. WHO moments-specific hand hygiene adherence showed the least compliance rate of 55% for moment 1, followed by moment 5 with 58.9%. Best compliance was observed for moment 3, with 79.2%.: The overall hand hygiene compliance was comparatively better in our study. Specific measures such as improved facilities, training and monitoring are needed to attain good H`H compliance.
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