背景:基于酒精的手擦(ABHR)是手部卫生(HH)的黄金标准,并且是感染预防和控制(IPC)策略的基石。然而,几个因素影响卫生工作者对ABHR的有效使用。这项研究评估了卫生工作者对本地生产的ABHR产品和HH行为的耐受性和可接受性。
方法:根据WHO的标准化方案进行了一项基于医院的纵向干预研究,以评估ABHR的耐受性和可接受性(方法1)。塞拉利昂4家医院的60名卫生工作者在30天的时间内接受了训练有素的观察员的三次单独访问(第1天、第3-5天和第30天)的观察。感兴趣的结果包括使用主观和客观测量评估的皮肤耐受性和产品可接受性。
结果:客观和主观评价显示出较强的皮肤耐受性和产品的高可接受性。在所有三次访问中,经过培训的观察者评估的皮肤耐受性评分<2,≥97%的参与者,超过WHO基准评分(BMS=<2in≥75%)。参与者对整体皮肤完整性的自我评估为97%(第2次访问)和98%(第3次访问),得分>4(BMS=>4,≥75%)。主要可接受性标准在第3次就诊时增加到95%(颜色)和88%(气味)(BMS=>4,≥50%)。尽管可接受性很高,在第2次和第3次访问期间,产品的干燥效果分别为52%和58%(BMS=>4in≥75%)。有积极的HH行为(n=53,88%),其中一半以上(n=38,63%)几乎在每个HH时刻都表现出HH。平均ABHR明显较高(76.1ml,标准差±35),特别是在护士(平均=80.1毫升)和医生(平均=74.0毫升)。
结论:世界卫生组织制定的,本地生产的ABHR耐受性良好,并被卫生工作者接受.这些发现支持持续利用基于证据的,在资源有限的环境中进行具有成本效益的手卫生干预。高手擦消耗和频繁的HH实践是明显的HH行为。建议进一步研究以优化皮肤干燥的产品配方,并研究ABHR消耗与手部卫生依从性之间的关联。
BACKGROUND: Alcohol-based handrub (ABHR) is the gold standard for hand hygiene (HH) and is a cornerstone of infection prevention and control (IPC) strategies. However, several factors influence the efficient use of ABHR by health workers. This study evaluated the tolerability and acceptability of a locally produced ABHR product and HH behaviour among health workers.
METHODS: A longitudinal hospital-based intervention study was conducted in accordance with the WHO\'s standardized protocol for evaluating ABHR tolerability and acceptability (Method 1). Sixty health workers across 4 hospitals in Sierra Leone were observed over a 30-day period at three separate visits (days 1, 3-5, and 30) by trained observers. The outcomes of interest included skin tolerability and product acceptabilityevaluated using subjective and objective measures.
RESULTS: Objective and subjective evaluations demonstrated strong skin tolerability and high acceptability with the product. At all three visits, the skin tolerability score assessed by trained observers was < 2 in ≥ 97% of participants, exceeding the WHO benchmark score (BMS = < 2 in ≥ 75%). Participants\' self-evaluations of overall skin integrity were 97% (visit 2) and 98% (visit 3) for scores > 4 (BMS = > 4 in ≥ 75%). The primary acceptability criteria increased up to 95% (colour) and 88% (smell) at visit 3 (BMS = > 4 in ≥ 50%). Despite high acceptability, the product\'s drying effect remained low at 52% and 58% during visits 2 and 3, respectively (BMS = > 4 in ≥ 75%). There were positive HH behaviours (n = 53, 88%), with more than half (n = 38, 63%) of them exhibiting HH at almost every HH moment. The mean ABHR was notably high (76.1 ml, SD ± 35), especially among nurses (mean = 80.1 ml) and doctors (mean = 74.0 ml).
CONCLUSIONS: The WHO-formulated, locally produced ABHR was well tolerated and accepted by health workers. These findings support the continuous utilization of evidence-based, cost-effective hand hygiene interventions in resource-limited settings. High handrub consumption and frequent HH practices were noticeable HH behaviours. Further research is recommended to optimize product formulations for skin dryness and investigate the association between ABHR consumption and hand hygiene compliance.