背景:人们普遍认为,手卫生是预防医疗保健相关感染的最有效方法。然而,据报道,全球医疗工作者的合规率低。2019年冠状病毒病的大流行进一步强调了全球医护人员在手卫生方面需要改善的必要性。
目的:这篇全面的系统综述提供了最新的临床试验汇编,2014年至2020年报告,评估手卫生干预措施,以便告知医疗保健领导者和从业者关于使用手卫生减少医疗保健相关感染的方法。
方法:CINAHL,科克伦,EMBase,Medline,在PubMed和WebofScience数据库中搜索了2014年3月至2020年12月之间发表的关于医护人员手部卫生依从性的临床试验。总的来说,从这些搜索中确定了332篇论文,其中57项研究符合纳入标准。
结果:纳入本综述的57项研究中有45项(79%)是在亚洲进行的,欧洲和美国。这些临床试验大部分是在急性护理机构进行的,包括医院病房和重症监护设施。护士代表了所研究的最大的医护人员群体(44项研究,77%),其次是医生(41项研究,72%)。36项研究(63%)采用了世界卫生组织的多模式框架或该框架的变体,他们中的许多人在“五个时刻”中的每个时刻都记录了手部卫生的机会。然而,记录手卫生技术并不常见。
结论:单干预和多模式手卫生策略都可以在医护人员的手卫生依从性方面实现适度到适度的改善。
BACKGROUND: There is general consensus that hand hygiene is the most effective way to prevent healthcare-associated infections. However, low rates of compliance amongst healthcare workers have been reported globally. The coronavirus disease 2019 pandemic has further emphasized the need for global improvement in hand hygiene compliance by healthcare workers.
OBJECTIVE: This comprehensive systematic
review provides an up-to-date compilation of clinical trials, reported between 2014 and 2020, assessing hand hygiene interventions in order to inform healthcare leaders and practitioners regarding approaches to reduce healthcare-associated infections using hand hygiene.
METHODS: CINAHL, Cochrane, EMbase, Medline, PubMed and Web of Science databases were searched for clinical trials published between March 2014 and December 2020 on the topic of hand hygiene compliance among healthcare workers. In total, 332 papers were identified from these searches, of which 57 studies met the inclusion criteria.
RESULTS: Forty-five of the 57 studies (79%) included in this
review were conducted in Asia, Europe and the USA. The large majority of these clinical trials were conducted in acute care facilities, including hospital wards and intensive care facilities. Nurses represented the largest group of healthcare workers studied (44 studies, 77%), followed by physicians (41 studies, 72%). Thirty-six studies (63%) adopted the World Health Organization\'s multi-modal framework or a variation of this framework, and many of them recorded hand hygiene opportunities at each of the \'Five Moments\'. However, recording of hand hygiene technique was not common.
CONCLUSIONS: Both single intervention and multi-modal hand hygiene strategies can achieve modest-to-moderate improvements in hand hygiene compliance among healthcare workers.