醋酸洗必泰酒精用于新生儿皮肤消毒

目前在临床护理工作中常用的化学消毒剂有十几种,但用于皮肤消毒的往往是碘酊和酒精。新生儿皮肤细嫩,仅用酒精效果不好,碘酊对皮肤刺激较大。我院自1987年以来一直采用0.5％醋酸洗必泰酒精用于新生儿皮肤消毒,现将配制方法及临床使用结果报告如下。配制方法取醋酸洗必泰5g,酒精1000ml。将醋酸洗必泰溶于800ml酒精中.滤过,自滤器上添加酒精使成1000ml搅匀即可。效果观察我院应用0.5％醋酸洗必泰酒精用于新生儿皮肤消毒,经10000例(其中7000例肌肉注射,3000例静脉输液)注射,无一例皮肤感染及损伤。因此,我     

诺延手消毒者喱消毒效果探讨

目的：探讨诺延手消毒者喱外科手消毒效果。方法：对参与手术洗手的64医生护士分3组进行清洁前、清洁后、消毒后、手术后的细菌学监测。结果：诺延手消毒者喱消毒后细菌即时杀灭率为100％；持效作用较为理想，44位受试人员中仅3位（6．8％）手术结束后手细菌培养阳性，其中1人术中手套刺破更换手套1次，以安尔碘进行手消毒的20位被检人员术后4位（20％）手细菌培养阳性；诺延洁肤皂液刷手与不刷手组其细菌清除率分别为84％的80％，普通肥皂酊洗刷手细菌清除率为36．8％。结论：诺延手消毒者喱，一种凝胶状醇类消毒剂，杀菌力强、作用持久、且具护肤成分，其容器独特的单向出流装置，解决了使用过程中的两次污染问题，肘压式开关，取液准确，使用方便，消毒后手感干爽，是一种较为理想的外科手消毒剂。     

健之素牌手消毒剂消毒效果监测

为选择高效、快速、经济简便、对皮肤无毒副作用而有效的消毒剂。我们将75%乙醇、健之素牌手消毒剂消毒效果进行对比。1材料与方法1.1观察对象将某一病房查房的医生和集中做静脉输液操作的护士随机分为两组,观察组采用健之素牌手消毒剂,对照组采用75%乙醇棉球。1.2方法(1)健之素牌手消毒剂组:医生护士每检查完1例患者或做完1次静脉输液,即用健之素消毒剂3~5 ml均匀喷淋手指尖、手掌、手背,并双手搓擦1 min,待药液干。(2)75%乙醇组消毒法:医生、护士每检查完1例患者或做完1次静脉输液,即用75%乙醇棉球擦拭手指尖、指缝、手掌、手背,待药液干…     

连续消毒中大肠埃希菌O157:H7对洗必泰抵抗力的变化和与质粒pO157的关系

目的研究连续消毒中大肠埃希菌O157：H7对洗必泰抵抗力的变化及其与质粒pO157关系。方法用洗必泰连续消毒6株大肠埃希菌O157：H7 10代，消除连续消毒前后试验菌的质粒；对比消毒前后试验菌对该消毒剂的抵抗力、质粒图谱以及质粒酶切谱。结果连续消毒10代后，试验菌对洗必泰的抵抗力不变；试验菌的质粒图谱以及质粒pO157的ClaⅠ酶切图谱均无明显变化；消除连续消毒前后试验菌的质粒后，试验菌对洗必泰的抵抗力不变。结论连续消毒不会使试验菌对洗必泰的抵抗力增加，且试验菌对洗必泰的抵抗力与质粒pO157无直接关系。     

听诊器的微生物监测及消毒方法探讨

目的探讨听诊器的污染情况及寻找有效的消毒方法。方法对我院９４个听诊器进行微生物监测并采用１％醋酸洗必泰乙醇溶液擦拭消毒。结果有９３个听诊器被微生物污染，占被检听诊器的９８．９４％。所污染微生物依次为枯草芽胞杆菌１４７７株，占４７．３４％；微球菌属６１５株，占１９．７１％；葡萄球菌属３９３株，占１２．６０％；不动杆菌属３２３株，占１０．３５％；链球菌属３０４株，占９．７４％及真菌８株，占０．２６％。我们采用１％醋酸洗必泰乙醇溶液消毒听诊器后，微生物数量明显减少，二者呈显著差别（Ｐ＜０．０５）。结论听诊器污染严重，用１％的醋酸洗必泰乙醇溶液消毒听诊器是简便、快捷和有效的方法     

医护人员诊疗操作时手消毒方法探讨

目的 加强医护人员诊疗操作之间手的清洁消毒，切断因医护人员手污染造成医院感染的途径。方法 以3种不同手消毒方法，对3个普通病区的治疗班护士分3组进行实验观察。实验1组，双手浸泡于“84”消毒液内消毒；实验2组，用浸有“84”消毒液的小毛巾搓擦双手；实验3组，用洗必泰-醇皮肤消毒液喷涂双手。每组连续监测10例次操作。结果 实验1组消毒后手指采样合格率为92％，实验2，3组合格率均为100％。实验1，2组手部皮肤有不同程度的粗糙、干裂。结论 医护人员手消毒方法以用洗必泰-醇皮肤消毒液喷涂较好，其消毒效果好，干燥快，对手部皮肤损伤小，是较好的诊疗操作之间手消毒方法。     

洗必泰-碘对抗微生物作用的评价

我们用标准菌对洗必泰-碘络合物进行了系统的评价,结果表明其最小抑菌浓度为0.125～5μg/ml,一分钟时在312～625μg/ml浓度下可以快速有效地杀灭细菌繁殖体(>99.99％)。真菌(>99.99％),芽孢(>99.99％),对HBsAg灭活率达到99.95％以上,其毒性小,LD_(50)为3548.1mg/kg。与其它四种消毒剂:洗必泰、酒精、碘酊、PVP碘比较结果,洗必泰-碘最好。经临床346例手术时皮肤消毒,无一例手术后切口感染。实验显示洗必泰-碘络合物具有快速、广谱的杀菌作用。     

连续消毒中大肠杆菌O157:H7对两种弱效消毒剂抵抗力的变化及其与质粒关系的研究

[目的]研究连续消毒中大肠杆菌O157：H7对洗必泰和季铵盐抵抗力的变化以及抵抗力与质粒的关系。[方法]洗必泰和季铵盐连续消毒6株大肠杆菌O157：H750代，对比消毒前后试验菌对消毒剂的抵抗力，消除原始菌和连续消毒后试验菌的质粒。[结果]结果表明，连续消毒50代后，试验菌对季铵盐的抵抗力增加；对洗必泰的抵抗力不变。消除原始菌的小质粒后，细菌对两种消毒剂的抵抗力不变；消除原始菌的所有质粒后，试验菌对洗必泰的抵抗力不变，对季铵盐的抵抗力降低；消除连续消毒后试验菌的质粒后，试验菌(50代连续消毒后)季铵盐的抵抗力降低，对洗必泰的抵抗力不变。[结论]试验结果提示，连续消毒会使试验菌对季铵盐的抵抗力增加，对季铵盐抵抗力增加的原因可能与质粒pO157相关。而细菌对洗必泰的抵抗力则与试验菌的质粒无关。     

几种方法对手清洁消毒的监测

目的：为医务人员在医疗护理中寻找高效快速，简单方便，无刺激的手消毒方法。方法：对传染病区医务人员100人随机分5组进行监测（实验组：健之素牌手消毒剂，洁芙柔消毒嗜喱、0．2％过氧乙酸液毛巾擦洗手，酸化电位水液毛巾擦手；对照组：肥皂流动水洗手）。结果：按上顺序排列其除菌率为97．38％、79．19％、100％、74．6％、68．26％，健之素和过氧乙酸组相仿，与其他几组比，差异有统计意义。结论：0．2％过氧乙酸和健之素对手的消毒效果好，但健之素使用较方便简单易掌握。     

医务人员卫生洗手消毒监测

随着我国近年来医院感染和消毒法规定标准颁布实施 ,医院感染控制管理、组织机构落实 ,医务人员的手是造成医院感染最直接的传播途径 ,我们在院医务人员中采用了乙醇洗必泰甘油洗手剂 ,在接连进行检查治疗和护理不方便频繁洗手的情况下使用。1　材料与方法医生、护士和技术员采用肥皂流动自来水、乙醇洗必泰甘油 (70 %酒精 980 ml、洗必泰即氯己定 10 g、甘油 2 0 ml)每次 3m l两手摩擦洗自然搓干。按照卫生部《消毒技术规范》微生物污染监测技术手的采样及检测方法。2　结　果医务人员操作时按《医院感染管理规范》用一般洗手方法对全院医…     

The effect of handwashing with water or soap on bacterial contamination of hands

Handwashing is thought to be effective for the prevention of transmission of diarrhoea pathogens. However it is not conclusive that handwashing with soap is more effective at reducing contamination with bacteria associated with diarrhoea than using water only. In this study 20 volunteers contaminated their hands deliberately by touching door handles and railings in public spaces. They were then allocated at random to (1) handwashing with water, (2) handwashing with non-antibacterial soap and (3) no handwashing. Each volunteer underwent this procedure 24 times, yielding 480 samples overall. Bacteria of potential faecal origin (mostly Enterococcus and Enterobacter spp.) were found after no handwashing in 44% of samples. Handwashing with water alone reduced the presence of bacteria to 23% (p < 0.001). Handwashing with plain soap and water reduced the presence of bacteria to 8% (comparison of both handwashing arms: p < 0.001). The effect did not appear to depend on the bacteria species. Handwashing with non-antibacterial soap and water is more effective for the removal of bacteria of potential faecal origin from hands than handwashing with water alone and should therefore be more useful for the prevention of transmission of diarrhoeal diseases.     

Handwashing and disinfection of heavily contaminated hands--effective or ineffective?

Hands are among the principal vehicles for transfer of nosocomial pathogens in hospitals. Often, outbreaks of infection are thought to be caused by a lack of compliance with handwashing guidelines, rather than due to the inadequacy of the handwashing agents used. In this study the effectiveness of proper handwashing and the use of three different hand disinfectants: ethanol 70% (E), isopropanol 40% (I) and alcoholic chlorhexidine (70%) (AC) was compared using three volunteers whose fingertips were heavily contaminated with a succession of bacteria including: Enterococcus faecalis, Staphylococcus aureus, Escherichia coli and Enterobacter cloacae. After each contamination, thorough handwashing and application of one disinfectant on the hands were performed three times. Fingerprint-samples were taken before and 1 min after application of the disinfectants. Thorough handwashing with an ordinary liquid soap ('Sterisol') did not reduce the confluent growth of bacteria on fingertips for any of the species used (197 examinations). Only AC had a significant effect on fingers heavily contaminated with S. aureus (126 examinations; AC compared with E and I; P less than 0.0002 and P less than 0.0002 respectively), but did not completely eradicate the bacteria. After contamination with Ent. cloacae (118 examinations), none of the three agents were particularly effective, but E and AC seemed to be somewhat more effective than I (P less than 0.0002 and P less than 0.01 respectively). When successive contamination was performed using all bacterial species, AC was the most effective decontaminant. However, Ent. cloacae was still present on the fingertips after 15 repeated courses of handwashing and applications of disinfectants. Bathing of hands in AC for 20s completely eradicated all bacteria from the hands. The study demonstrates that, when heavily contaminated, an ordinary handwashing followed by disinfectants is not enough to eradicate potentially pathogenic bacteria from the hands.     

Compliance with hand hygiene and glove use in a university-affiliated hospital.

OBJECTIVE: The hands of healthcare workers often transmit pathogens causing nosocomial infections. This study examined compliance with handwashing and glove use. SETtING: A university-affiliated hospital. DESIGN: Compliance was observed covertly. Healthcare workers' demographics, hand hygiene facilities, indications for hand hygiene, compliance with handwashing and glove use in each procedure, and duration of handwashing were recorded. RESULTS: Nine nurses and 33 assistant physicians were monitored during the study. One researcher recorded 1400 potential opportunities for handwashing during 15-minute observation periods. The mean duration of handwashing was 10 +/- 2 seconds. Most healthcare workers (99.3%) used liquid soap during handwashing, but 79.8% did not dry their hands. For all indications, compliance with handwashing was 31.9% and compliance with glove use was 58.8%. Compliance with handwashing varied inversely with both the number of indications for hand hygiene and the number of patient beds in the hospital room. Compliance with handwashing was better in dirty high-risk situations. CONCLUSION: Compliance with handwashing was low, suggesting the need for new motivational strategies such as supplying feedback regarding compliance rates     

High-level handwashing compliance in a community teaching hospital: a challenge that can be met!

Handwashing is the most important and least expensive measure for preventing the transmission of hospital-acquired infection. Compliance, however, rarely exceeds 40%, even in intensive care units. The present study evaluated the effectiveness of the authors' infection control programme in relation to handwashing compliance of healthcare workers. Ten nursing students observed 300 uninformed staff members and recorded their handwashing practices throughout the working day. The observations were categorized by profession, gender, age, hospital unit and type of delivered care. In 1035 opportunities that required handwashing, the overall compliance was 76%. Healthcare workers washed hands before (68%) and after patient care (80%). Females complied more than males (69 vs. 80%, P<0.0001) and nurses more than physicians (81 vs. 69%, P<0.001). In intensive care units, overall compliance exceeded 97%, while in other wards and in the emergency departments, it approximated 61%. More handwashing was observed during the evening shift compared with the morning shift (P=0.02). Despite the high compliance, only 30% washed their hands for the required 10-20s. In conclusion, compliance with handwashing in the authors' institution is the highest reported to date, and reflects the intensive and incessant educational infection control programme.     

Handwashing practices and challenges in Bangladesh

Handwashing is universally promoted in health interventions. Studies in Bangladesh and elsewhere have shown a 14 - 40% reduction of diarrhoeal diseases with handwashing. The perceptions and methods related to washing of hands vary widely in Bangladesh. Socio-economic factors are also associated with methods practised. In general, the effectiveness of handwashing practices is poor. Faecal coliform bacteriological counts were reported to be high for both left and right hands. About 85% of women studied who lived in slums and 41% of rural women washed their hands using only water. However, most women rubbed their hands on the ground, or used soil, and rinsed them with water during post-defecation handwashing. Most women claimed that they could not afford to buy soap. Experimental trials showed that use of soap, ash or soil gave similar results when women washed their hands under the same conditions. The washing of both hands, rubbing of hands, and the amount and quality of rinsing water used were found to be important determinants in the reduction of bacterial counts on hands. Although handwashing messages have been revised by most of the main programmes after these studies, there is scope for further improvement, as well as evaluation of their impact.     

Handwashing program for the prevention of nosocomial infections in a neonatal intensive care unit.

OBJECTIVE: To evaluate the effects of a hand hygiene program on compliance with hand hygiene and the rate of nosocomial infections in a neonatal intensive care unit (NICU). DESIGN: Open trial. SETTING: A level-III NICU in a teaching hospital. PARTICIPANTS: Nurses, physicians, and other healthcare workers in the NICU. INTERVENTIONS: A multimodal campaign for hand hygiene promotion was conducted beginning in September 1998. This program consisted of formal lectures, written instructions and posted reminders regarding hand hygiene and proper handwashing techniques, covert observation, financial incentives, and regular group feedback on compliance. Surveillance of handwashing compliance and nosocomial infections before and during the program was analyzed. RESULTS: Overall compliance with hand hygiene improved from 43% at baseline to 80% during the promotion program. The rate of nosocomial infections decreased from 15.13 to 10.69 per 1,000 patient-days (P = .003) with improved handwashing compliance. In particular, respiratory tract infections decreased from 3.35 to 1.06 per 1,000 patient-days during the handwashing campaign (P = .002). Furthermore, the correlation between nosocomial infection of the respiratory tract and handwashing compliance also reached statistical significance (r = -0.385; P = .014). CONCLUSIONS: Improved compliance with handwashing was associated with a significant decrease in overall rates of nosocomial infection and respiratory infections in particular. Washing hands is a simple, economical, and effective method for preventing nosocomial infections in the NICU.     

Handwashing frequencies in an intensive care unit

As most nosocomial infections are thought to be transmitted by the hands of healthcare workers, handwashing is considered the single most important intervention to prevent nosocomial infections. However, previous studies have shown that handwashing practices are poor, especially among medical personnel.The objective of this study was to assess the rate of handwashing among intensive care unit (ICU) healthcare personnel, and then to propose realistic suggestions so that hand hygiene' could be performed at an optimal level. To achieve this, each healthcare worker in the ICU of Istanbul Medical Faculty was observed directly, and, a comprehensive microbiological investigation was carried out among personnel and of the inanimate environment.The frequency of handwashing was low; 12.9% among medical personnel. Moreover, there was a widespread contamination in the ICU and 28.1% of the healthcare workers were carriers for methicillin-resistant Staphylococcus aureus (MRSA). The factors that contributed to low compliance of handwashing protocols were: a low staff to patient ratio, excessive use of gloves and deficiencies in the infra-structure of ICU. In heavy workload conditions, alcoholic handrub solutions for quick hand decontamination can be considered as an alternative to handwashing.     

Evaluation of a patient-empowering hand hygiene programme in the UK.

Partners in Your Care, a patient education behavioral model for increasing handwashing compliance and empowering the patient with responsibility for their care was evaluated in an acute care hospital in Oxford, UK. A controlled prospective intervention study comparing medical and surgical patients was performed. Ninety-eight patients were eligible for the study. Thirty-nine patients (40%) agreed to participate in the programme Partners in Your Care by asking all healthcare workers who were going to have direct contact with them "Did you wash your hands?" Compliance with the programme was measured through soap/alcohol usage and handwashings per bed day before and after its introduction. Partners in Your Care increased handwashing on average 50%. Healthcare workers washed hands more often with surgical patients than with medical (P< 0.05). Alcohol gel was used on less than 1% of occasions. Sixty-two percent of patients in study felt at ease when asking healthcare workers "Did you wash your hands?" Seventy-eight percent received a positive response (washed hands). All patients asked nurses, but only 35% asked physicians. Partners in Your Care increased handwashing compliance in the UK. This programme empowers patients with responsibility for their care, provides infection control staff with a continuing means for providing handwashing education without additional staff and can save costs for a hospital.     

An investigation of the factors that affect surgical hand disinfection with polyvidone iodine

This study investigated the factors influencing the effectiveness of 7.5% polyvidone iodine as a surgical antiseptic. The study involved 100 operating staff (75 doctors and 25 nurses) from hospital surgical teams. Fingertips of both hands of the subjects were pressed on to agar culture before and after washing and after completion of surgery. Handwashing lasting for more than 3 min led to a significant decrease in the number of colonies compared with handwashing lasting for less than 3 min. Moreover, the number of colonies was significantly higher when surgery lasted for longer than 95 min. However, the handwashing style (with or without brushing) was not found to have a significant effect on the outcome of the disinfection procedure in terms of bacterial colonization. Subjects who had colonization of their hands after surgery were found to have significantly higher colony counts before handwashing compared with those who did not have any colonization on their hands after surgery. The results of this study revealed that in order to attain effective disinfection with polyvidone iodine, the duration of handwashing should be at least 3 min. The risk of recolonization increases when the duration of surgery exceeds 95 min.     

Why healthcare workers don't wash their hands: a behavioral explanation.

OBJECTIVE: To elucidate behavioral determinants of handwashing among nurses. DESIGN: Statistical modeling using the Theory of Planned Behavior and relevant components to handwashing behavior by nurses that were derived from focus-group discussions and literature review. SETTING: The community and 3 tertiary care hospitals. PARTICIPANTS: Children aged 9-10 years, mothers, and nurses. RESULTS: Responses from 754 nurses were analyzed using backward linear regression for handwashing intention. We reasoned that handwashing results in 2 distinct behavioral practices--inherent handwashing and elective handwashing--with our model explaining 64% and 76%, respectively, of the variance in behavioral intention. Translation of community handwashing behavior to healthcare settings is the predominant driver of all handwashing, both inherent (weighted beta =2.92) and elective (weighted beta =4.1). Intended elective in-hospital handwashing behavior is further significantly predicted by nurses' beliefs in the benefits of the activity (weighted beta =3.12), peer pressure of senior physicians (weighted beta =3.0) and administrators (weighted beta =2.2), and role modeling (weighted beta =3.0) but only to a minimal extent by reduction in effort (weighted beta =1.13). Inherent community behavior (weighted beta =2.92), attitudes (weighted beta =0.84), and peer behavior (weighted beta =1.08) were strongly predictive of inherent handwashing intent. CONCLUSIONS: A small increase in handwashing adherence may be seen after implementing the use of alcoholic hand rubs, to decrease the effort required to wash hands. However, the facilitation of compliance is not simply related to effort but is highly dependent on altering behavioral perceptions. Thus, introduction of hand rub alone without an associated behavioral modification program is unlikely to induce a sustained increase in hand hygiene compliance.