대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
권호 표지

손씻기 향상프로그램과 MRSA 보균자 색출프로그램이 MRSA감염 발생률에 미치는 영향

The Effect of Handwashing Improving Program and MRSA Carrier Screening Program on the MRSA Infection Rates in an Intensive Care Unit

  • 김영혜 (부산대학교 의과대학 간호학과) ;
  • 전성숙 (부산대학교 의과대학 간호학과) ;
  • 정인숙 (부산대학교 의과대학 간호학과) ;
  • 장철훈 (부산대학교 의과대학 임상병리과 교실) ;
  • 김정화 (부산대학교 병원 간호부) ;
  • 허정애 (부산대학교 병원 간호부)
  • 발행 : 2003.10.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: To assess the effect of handwashing improving program and MRSA carrier detection program on MRSA(methicillin resistant Staphylococcus aureus) infection rate in a intensive care unit. Method: The intervention was Nosocomial Infection(NI) control program consisted of hand washing improving program and identification and treatment of MRSA carrier. Data on the NI and MRSA infections were collected by an infection control nurse based on the definition of CDC. MRSA infection rates were calculated by the number of MRSA infection per 100 admissions or 1,000 patients-days. The difference of MRSA infection rates between pre and post intervention was tested by Chi-square at =.05. Result: MRSA infection rates 3.0% or 3.2 per 1,000 patient-days at the pre, 4.6% or 3.7 per 1,000 patient-days at the post, and the differences were not statistically significant (p=.411, p=.769 respectively). Conclusion: The handwashing improving program and MRSA carrier detection program was not effective in reducing the Nosocomial Infection(NI) or MRSA infection rates. It is recommended further studies with a longer intervention and follow-up period.

키워드

참고문헌

  1. Berg, D. E., Hershow, R. C., Claudio, A. R., & Weinstein R. A. (1995). Control of nosocmial infections in an ICU in Guatemala city. Clin Infect Dis, 21, 588-593
  2. Boyce, J. (1999). It is time for action: Improving hand hygiene in hospitals. Ann Intern Med. 130(2), 153-155
  3. Casewell, M., & Phillips I. (1977). Hands as route of transmission for Klebsiella species. BMJ, 2, 1315-1317 https://doi.org/10.1136/bmj.2.6098.1315
  4. Coignard, B., Grandbastein, B., Berrouane, Y., Krembel, C., Queverue, M., Salomez, J. L., & Martin, G. (1998). Handwashing quality impact of a special program. Infect Control Hosp Epidemol, 19, 510-513 https://doi.org/10.1086/647860
  5. Conly, J. M., Hill, S., Ross, J., Lertaman, J., & Louie, J.J. (1989). Hand washing practices in an ICU: the effects of an educatinal program and its relationship to infection rates. Am J Infect Control, 17, 330-339 https://doi.org/10.1016/0196-6553(89)90002-3
  6. Doebbeling, B. N., Stanley, G. L., Sheet, C.T., Pfaller, M. A., Houston, A. K., & Annis, L., Li, N., & Wenzel, R. P. (1992). Comparative efficacy of alternative handwashing agents in reducing nosocomical infections in intensive care unit. N Engl J Med 327, 88-93
  7. Dubbert, P. M., Dolce, J., Richter, W., Miller, M., & Chapman, S. W. (1990). Increasing ICU staff hand washing: effects of education and group feedback, Infect Control Hosp Epidemiol, 11, 191-193
  8. Garner, J. S., Jarvis, W. R., Emori, T. G., Horan, T. C., & Hughes, J. M. (1996). CDC definitions for nosocomical infections. In R. N. Olmsted (Eds.) APIC Infection Control and Applied Epidemiology: Principles and Practice (pp.A-1-A-20). St Louis: Mosby
  9. Garner, J. S., Jarvis, W. R., Emori, T. G., Horan, T. C., Huges, J. M. (1988). CDC definitions for nosocomial infection, Am J Infect Control, 16, 128-40
  10. Jin, H. Y., Gwak, Y. S., Lee, W. G. (1999). Effctive control of MRSA nosocomial infection in intensive care unit. Korean J Nosocomial Infect Control, 4(1), 7-16
  11. Jeong, J. S. (2002). The effect of hand washing improving programs on the adherence of hand washing and nosocomial infections in a surgical intensive care unit. Unpublished Doctoral Dissertation, Seoul National University of Korea, Seoul
  12. Kim, J. M., Park, E. S., Jeong, J. S., Kim, K. M., Kim, J. M., Oh, H. S., Yoon, S. W., Lee, S. I, Kim, M, N., Jeong, J. S., Choi, J. S., Woo, J. H., Ryu, J. S., Pai, C. H. (1997). 1996 National nosocomial infection surveillance in Korea. Korean J Nosocomial Infect Control, 2(2), 157-176
  13. Larson, E. L., Early E., Cloonan, P., Sugrue, S., & Parides, M. (2000). An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. J Behav Med, 26, 14-22
  14. Lee, S. E. (1993). A study on epidemiological characteristics of nosocomial infection and developing an effective control model in Korea. Unpublished Doctoral Dissertation, Seoul National University of Korea, Seoul
  15. Pittet, D., Hugonnet, S., Harbath, S., Mourouga, P., Sauvan, V., Touveneau, S., & Pernerger, T. V. (2000). Effctiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet, 356, 1307-1312
  16. Pittet, D. (2001). Improving adherence to hand hygiene practice: a multidisciplinary a approach. Emerging Infectious Diseases, 7(2), 234-240
  17. Simmons, B., Bryant, J., Neiman, K., Spencer, L., & Arheart, K. (1990). The role of hand washing in prevention of endemic lCU infections. Infect Control Hosp Epidemiol, 11, 589-594 https://doi.org/10.1086/646100
  18. Slota, M., Green, M., Farley, A., Janosky, J., & Carcillo, J. (2001). The role of gown and glove isolation and strict handwashing in the reduction of nosocomial infection in children with solid organ transplantation. Crit Care Med, 29, 405-412 https://doi.org/10.1097/00003246-200102000-00034
  19. Zafar, A. B., Butler, R. C., Reese, D. J., Gaydos, L. A., & Mennonna, P. A. (1995). Use of 0.3% triclosan(Bacti-Stat) to eradicate an outbreak of methicilli-resistant Staphylococcus aureus in a neonate nursery. Am J Infect Control, 23, 200-208