浅谈控制医院感染与手卫生

目的: 手卫生被认为是防止医源性感染最重要的手段,有足够的证据证明很多医医院感染的爆发是和医护人员的手污染有关.经手接触传播是院内医患之间交叉感染的 最重要的途径.因此,提高洗手的依从性,做好手卫生工作,是防治医院感染的重要手段.     

手卫生监测系统在ICU医院感染目标监测中的应用效果

目的 探讨手卫生监测系统在ICU医院感染目标监测中的应用效果.方法 选取2019年7月—12月在ICU采用手卫生监测系统对某院ICU医护人员手卫生进行动态监测,比较2019年上半年和下半年,ICU医护人员手卫生依从性、三种导管感染发生率.结果 手卫生监测系统在临床应用以后,ICU医护人员的手卫生依从性显著提高,从60％提高到92％.导管相关血流感染率由4.43‰下降至1.02‰、导尿管相关泌尿系感染率由5.12‰下降至1.57‰,呼吸机相关性肺炎的感染率由20.53‰下降至13.04‰,差异有统计学意义(P<0.05).结论 手卫生监测系统应用于ICU,可提高医护人员手卫生的依从性,有效降低医院感染率.     

手卫生成本与效益分析

目的分析手卫生成本与效益。方法对医院2005年1月至2008年12月医院感染发生率、手卫生所消耗费用以及各种医院感染疾病治疗产生的平均费用建立数据库,进行分析统计。结果普及手卫生后,医院手卫生物资消耗费81 666元,但医院例次感染率下降20.36%,医院感染治疗费用较前节约229 633元,加强手卫生所增加的费用显著低于医院感染的治疗费用。结论推广手卫生具有很大的成本效益。     

某三级甲等综合性医院护士手卫生现状调查研究

目的探讨某三级甲等综合性医院护士的手卫生现状及其影响因素。方法随机选取该院166名临床护士作为调查对象,采用现场观测和问卷调查法收集了解被调查护士的手卫生状况,并分析其影响因素。结果该院护士手卫生执行不规范,手卫生依从率为(26.89±12.33)%,不同科室的护士手卫生依从率差异有统计学意义(P0.05)。工作太忙,清洁剂、消毒剂刺激皮肤,没有针对洗手或擦手的奖惩措施是影响护士手卫生依从性的最主要的三项条目。结论护理人员手部卫生状况亟待提高,医院管理者应加强管理,加大宣传教育,采取多种措施提高护理人员手卫生水平。     

医护人员手卫生依从性调查

目的了解本医院医护人员手卫生依从性状况,以便加强手卫生管理。方法采用随机抽样和填写调查表方法,对本医院2007～2008年在岗医护人员手卫生依从性的情况进行了调查。结果2007年共监测医护人员497人次,手卫生执行率为22.07%;2008年共监测2251人次,手卫生执行率为77.92%。该医院2007年医院感染发生率为4.56%,2008年医院感染发生率为2.78%。结论该医院医务人员手卫生依从性比较低,但2008年度明显高于2007年度,手卫生依从率与医院感染率呈负相关关系。     

改善医护人员手卫生现状 预防医院感染

随着医学技术的高速发展和医学模式的改变,医院感染是影响疾病治愈率和病人生存率的重要因素,甚至成为病人死亡的直接原因。手卫生作为医院感染控制中最简单而又十分重要的环节正在全世界范围内引起广泛重视,但一些医护人员对手卫生的重视程度存在错误观念再加之设施不完善,大大影响了医护人员手卫生的依从性。     

改善医护人员手卫生现状预防医院感染

随着医学技术的高速发展和医学模式的改变,医院感染是影响疾病治愈率和病人生存率的重要因素,甚至成为病人死亡的直接原因.手卫生作为医院感染控制中最简单而又十分重要的环节正在全世界范围内引起广泛重视[1,2],但一些医护人员对手卫生的重视程度存在错误观念再加之设施不完善,大大影响了医护人员手卫生的依从性.     

强化手卫生 预防和控制医院感染

阐述医院感染与手卫生现状、手卫生的概念,提出强化手卫生、预防和控制医院感染的措施。     

强化手卫生预防和控制医院感染

阐述医院感染与手卫生现状、手卫生的概念,提出强化手卫生、预防和控制医院感染的措施.     

手部卫生的研究进展

介绍了医务人员手部卫生的重要意义以及手部卫生的历史发展。重点从手部卫生依从性、洗手指证、洗手程序、手部卫生设备等方面阐述国内外手部卫生的研究现状和进展,并对我国手部卫生的前景进行了描述。     

我国护理人员手卫生研究进展

护理人员手卫生的质量与医院感染的发生密切相关。本文阐述了影响护士手卫生的主要因素,主要有护理人力资源不足、认知程度不高、洗手设施不完善、监管力度不够等方面。通过对护理人员加强培训提高认知、完善洗手设施、强化监督管理等措施,以提高护理人员手卫生的依从性,降低医院感染,保障病人医疗安全。     

Outcomes of an infection prevention project focusing on hand hygiene and isolation practices

Nosocomial infections are a major health problem for hospitalized patients and their families. Since the 1800s, hand hygiene has been recognized as the single best method to prevent the spread of pathogens and nosocomial infections. Despite this fact, many healthcare workers do not adhere to hand hygiene policies. The Centers for Disease Control and Prevention issued a guideline for hand hygiene practices in 2002. Multifaceted approaches to improve hand hygiene have been shown to increase compliance among healthcare workers and subsequently reduce infections. A performance improvement project was initiated to implement this guideline and other strategies to prevent nosocomial infection. This article summarizes the performance improvement processes and the preliminary outcomes on adherence to infection prevention policies related to hand hygiene and isolation practices. Clinically and statistically significant increases were noted for hand hygiene prior to patient care and in wearing masks when indicated. Nurses and patient care technicians had the greatest increases in compliance. Increases in hand hygiene after patient contact and wearing of gown and gloves were also noted, but results were not statistically significant. Nosocomial infection rates from antibiotic-resistant organisms decreased in the first surveillance, but rates increased during the 1-year surveillance. Consumption of alcohol-based foam disinfectant doubled from baseline. Findings are consistent with other published studies. The project will continue with further reinforcement and education over the second year.     

应用PDCA模式对改善儿科护理人员洗手依从性及医院感染发生率的影响

目的 探讨应用PDCA模式对改善儿科护理人员洗手依从性以及医院感染发生率的影响。 方法 2014年8月-2015年7月将PDCA循环模式应用于儿科护理人员手卫生管理,比较实施前后儿科护理人员洗手依从性和医院感染发生率。 结果 实施PDCA模式后,儿科护理人员的手卫生知识考试及格率,接触患儿前后、脱手套后、无菌操作前后的洗手率明显高于实施前;接触患儿体液前后的洗手率比较,差异无统计学意义;护理人员洗手依从性逐渐提高,医院感染发生率逐渐下降。 结论 应用PDCA模式可提高儿科护理人员的洗手依从性,降低医院感染的发生率。     

Skin care: an essential component of hand hygiene and infection control

Skin care is an important component of hand hygiene and also infection prevention education programmes relating to hand hygiene (Bissett, 2007a,b). Hand hygiene is the term commonly used to describe hand washing using plain soap or antiseptic soaps and hand rubbing using waterless antiseptic products or alcohol-based products. The importance of effective hand hygiene is well documented (Larson, 1997; Boyce et al, 2002; Horton and Parker, 2002) and can be achieved by following the six-step technique used for hand washing as illustrated by the Royal College of Nursing (2000). During hand washing, hand soaps not only remove soils, but also the natural oils that protect the skin. This can vary depending on the frequency of hand washing, the temperature of the water and the ability of the soap to be rinsed from the surface of the hands (Starobin, 2007). This article aims to examine the evidence available to enable healthcare staff to make an informed decision on the importance of following a skin care regime to reduce the risk of bacterial loading on the hands caused by damaged skin. This would consequently lead to an improvement in hand hygiene efficacy.     

护理人员手卫生知识和对手卫生设施需求调查

目的 了解护理人员手卫生知识掌握情况和对手卫生设施的需求,为提高护理人员手卫生依从性提供依据.方法 采用自行设计的问卷对135名临床护士进行调查,内容包括手卫生知识测评、手卫生执行状况自评和对洗手设施的需求.结果 95.6%的护理人员能够掌握六步洗手法,31.9%对洗手的时间不明确,对先洗手、后进行手卫生消毒的指征掌握情况最差;22.2%的护士每天手卫生行为超过50次;导致护理人员手卫生依从性低的最主要原因有担心洗手液伤害皮肤、工作忙碌,顾不上洗手、洗手设施不够充足;对洗手设施的需求主要为干手纸巾和非接触式水龙头.结论 医院应采取宣传、培训、考核、监督等联合干预策略强化手卫生知识和意识,提供必要的手卫生设施,切实提高手卫生行为的依从性.     

Patient safety and healthcare-associated infection

Healthcare-associated infection (HCAI) has become a major patient safety issue in National Health Service (NHS) hospitals. The UK has an HCAI prevalence rate of 8.2% which equates to an annual incidence of approximately 300000 patients (Hospital Infection Society, 2007). HCAI is a safety issue because it is associated with increased morbidity and mortality as well as increased healthcare costs (National Audit Office (NAO), 2009). In 2000, the NAO identified cultural change as a requirement if the NHS is to get a grip of infection prevention and control. This article has taken a 'conceptual culture of safety model' that has been previously described in the literature and applied it to the organization of infection control. It is clear that while there are many areas of good practice, in relation to infection prevention and control, there is still much to do if the NHS is to invoke the type of paradigm shift that will result in a mature sustainable safety culture.     

Prevention and control of healthcare-associated infection

Current policy and initiatives to reduce healthcare-associated infections (HCAIs) are outlined and discussed. Approaches to the effective control and prevention of HCAIs include surveillance, evidence-based infection control practice and responsible antibiotic prescribing.     

The new dirt on hand hygiene

Brown et al.'s (2003) study supported that the use of alcohol-based hand rubs would improve hand hygiene compliance and decrease the incidence of cross-infection. The results of this study can be used to support a group research utilization project that would educate nurses about the use of alcohol-based hand rubs as an effective technique for hand hygiene. Feasibility issues could include cost of the antiseptic and dispensers, placement of dispensers in relation to patient care, and education sessions with the nurses on how and when to use the antiseptic. Future research could be done to examine various nations' compliance with hand hygiene through use of a alcohol-based hand rubs, while also using a more discrete means of observation.     

Effects of student participation in hand hygiene monitoring on knowledge and perception of infection control practices

Studies report that students in health care professions do not retain knowledge of infection control and demonstrate poor hand hygiene compliance. This study describes the effect of a multifaceted approach (education, skills training, and monitoring) on nursing students' knowledge of infection control principles, opinions, hand hygiene practices, and value of nursing research in evidence-based practice. Students participated in hand hygiene monitoring of health care workers with 900 observations. Students demonstrated strong knowledge of hand hygiene principles: 63% reported that hand hygiene monitoring positively influenced their own compliance. Although posters have been identified as effective prompts, students did not perceive poster reminders as effective in prompting handwashing. Students reported that hand hygiene activities helped them value the role of the nurse in research and evidence-based practice. This study may help educators clarify misconceptions that result in student noncompliance in hand hygiene practices.