Pediatric Infection and Vaccine

  • 제22권3호
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  • Pages.186-193
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  • 2015
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  • 2384-1079(pISSN)
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  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
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소아병원 종사자의 손 위생 수행

Hand Hygiene Compliance of Healthcare Workers in a Children's Hospital

  • Oh, Hyang Soon (Nursing Department, School of Public Heath and Welfare, Woosong University)
  • 투고 : 2015.07.19
  • 심사 : 2015.09.09
  • 발행 : 2015.12.25
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초록

목적: 소아병원 의료기관 종사자들의 손 위생 수행률을 계량화하고 분석함으로써 소아병원 종사자의 손 위생 수행실태에 대한 기본 자료를 구축하고자 수행되었다. 방법: 3차 의료기관이며 대학병원인 313병상 소아병원의 533명 직원을 대상으로 WHO 손 위생 모니터링 도구로 2010년도 11월 1일부터 12월 31일까지 직접관찰법으로 자료를 수집하였다. 결과: 총 관찰건수 2,999으로, 손 위생 수행률은 95.3%였고, 직종별로 간호사(97.7%), 의사(89.2%), 이송직(72.1%) (P<0.001), 부서별로 중환자실(92.5%), 외래(95.4%), 응급실(97.2%), 수술실(97.2%) 이었으며(P<0.001), 의사직급별로 전임의(97.5%), 교수(93.9%), 전공의(89.7%), 인턴(80.9%)이었다(P<0.001). 손 마찰(81.1%)을 많이 사용하였고, 손 씻기는 '환자 체액 노출 후'(37.7%), '환자 환경 접촉 후' (28.5%)에 많이 사용하였다. 손 위생 방법은 부서별로 차이가 없었으나(P=0.083), WHO 5 Moments 별로 차이가 있었다(P<0.001). 직종별 WHO 5 Moments 분포는 차이가 있었다(P<0.001). 손 위생 이행 odds ratio는 의사직 0.353 (95% CI, 0.241-0.519), 중환자실 0.291 (95% CI, 0.174-0.487), 외래 0.484 (95% CI, 0.281-0.834)이었다. 결론: 손 위생 수행은 직종별, 부서별로 차이가 있었다. 직종별, 부서별로 효과적인 손 위생 교육 및 훈련 프로그램 개발이 필요하다.

Purpose: The aim of study was to estimate the hand hygiene (HH) compliance of healthcare workers (HCWs) in a children's hospital. Methods: This study was conducted in a hospital which is a tertiary and educational children's hospital with 313 beds and 533 HCWs. Data were collected by direct observation methods from November 1, 2010 to December 31, 2010. Results: A total of 2,999 opportunities for HH were observed, and the overall HH rate was 95.3%. HH rate of the registered nurse, physicians and transferer was 97.7%, 89.2%, and 72.1%, respectively (P<0.001). Among physicians, HH rate of the fellows, professors, residents and interns was 97.5%, 93.9%, 89.7%, and 80.9%, respectively (P<0.001). HH rate in the emergency room, operation room, outpatient department (OPD), and the intensive care unit (ICU) was 97.2%, 97.2%, 95.4%, and 92.5%, respectively (P<0.001). Hand rubbing was the most frequently used (81.1%), and hand washing was frequently used in the case of 'after body fluids exposure risk' (37.7%) and 'after touching patient surroundings' (28.5%). HH methods were not statistically different from each departments (P =0.083), however, they were significantly different according to the World Health Organization (WHO) 5 Moments (P<0.001). Distributions in WHO 5 Moments by the job titles were significantly different (P<0.001). The odds ratio of physicians, ICU and OPD was 0.353 (95% CI, 0.241-0.519), 0.291 (95% CI, 0.174-0.487), and 0.484 (95% CI, 0.281-0.834), respectively. Conclusions: Compliance of HH was different by the job titles and departments. Effective custom-tailored HH programs for each job title and department need to be developed.

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참고문헌

  1. Middle East respiratory syndrome coronavirus (MERSCoV). Available from http://www.who.int/emergencies/mers-cov/en/[accessed on 15 July 2015].
  2. Bolyard EA, Tablan OC, Williams WW, Pearson ML, Shapiro CN, Deitchmann SD. Guideline for infection control in healthcare personnel, 1998. Hospital infection control practices advisory committee. Infect Control Hosp Epidemiol 1998;19:407-63. https://doi.org/10.2307/30142429
  3. Hong KB, Oh HS, Song JS, Lim JH, Kang DK, Son IS, et al. Investigation and control of an outbreak of imipenemresistant Acinetobacter baumannii infection in a pediatric intensive care unit. Pediatr Infect Dis J 2012;31:685-90. https://doi.org/10.1097/INF.0b013e318256f3e6
  4. Ciofi degli Atti ML, Cuttini M, Rava L, Ceradini J, Paolini V, Ciliento G, et al. Trend of healthcare-associated infections in children: annual prevalence surveys in a research hospital in Italy, 2007-2010. J Hosp Infect 2012;80:6-12. https://doi.org/10.1016/j.jhin.2011.11.004
  5. WHO. WHO Guidelines on Hand Hygiene in Health Care: First global patient safety challenge clean care is safer care. Geneva: World Health Organization; 2009. Available from http://www.who.int/gpsc/5may/en/[accessed on 1 May 2015].
  6. Buser GL, Fisher BT, Shea JA, Coffin SE. Parent willingness to remind health care workers to perform hand hygiene. Am J Infect Control 2013;41:492-6. https://doi.org/10.1016/j.ajic.2012.08.006
  7. Randle J, Firth J, Vaughan N. An observational study of hand hygiene compliance in paediatric wards. J Clin Nurs 2013;22:2586-92. https://doi.org/10.1111/j.1365-2702.2012.04103.x
  8. Ciofi degli Atti ML, Tozzi AE, Ciliento G, Pomponi M, Rinaldi S, Raponi M. Healthcare workers' and parents' perceptions of measures for improving adherence to hand-hygiene. BMC Public Health 2011;11:466. https://doi.org/10.1186/1471-2458-11-466
  9. Esteban E, Ferrer R, Urrea M, Suarez D, Rozas L, Balaguer M, et al. The impact of a quality improvement intervention to reduce nosocomial infections in a PICU. Pediatr Crit Care Med 2013;14:525-32. https://doi.org/10.1097/PCC.0b013e31828a87cc
  10. Harris BD, Hanson C, Christy C, Adams T, Banks A, Willis TS, et al. Strict hand hygiene and other practices shortened stays and cut costs and mortality in a pediatric intensive care unit. Health Aff 2011;30:1751-61. https://doi.org/10.1377/hlthaff.2010.1282
  11. Oh HS, Park ES, Jeong SY, Cheon HG, Kim SR, Chang YS, et al. Activation of infection prevention and control program in hospital via healthcare accreditation system. Final report. Korea Association of Infection Control Nurses 2011.
  12. Sax H, Allegranzi B, Chraiti MN, Boyce J, Larson E, Pittet D. The World Health Organization hand hygiene observation method. Am J Infect Control 2009;37:827-34. https://doi.org/10.1016/j.ajic.2009.07.003
  13. Pittet D, Simon A, Hugonnet S, Pessoa-Silva CL, Sauvan V, Perneger TV. Hand hygiene among physicians: performance, beliefs, and perceptions. Ann Intern Med 2014;141:1-8.
  14. Rosenthal VD, Pawar M, Leblebicioglu H, Navoa-Ng JA, Villamil-Gomez W, Armas-Ruiz A, et al. Impact of the international nosocomial infection control consortium (INICC) multidimensional hand hygiene approach over 13 years in 51 cities of 19 limited-resource countries from Latin America, Asia, the Middle East, and Europe. Infect Control Hosp Epidemiol 2013;34:415-23. https://doi.org/10.1086/669860
  15. Graf K, Ott E, Wolny M, Tramp N, Vonberg RP, Haverich A, et al. Hand hygiene compliance in transplant and other special patient groups: an observational study. Am J Infect Control 2013;41:503-8. https://doi.org/10.1016/j.ajic.2012.09.009
  16. Korniewicz DM, El-Masri M. Exploring the factors associated with hand hygiene compliance of nurses during routine clinical practice. Appl Nurs Res 2010;23:86-90. https://doi.org/10.1016/j.apnr.2008.06.002
  17. Dierssen-Sotos T, de la Cal-Lopez M, Navarro-Cordoba M, Rebollo-Rodrigo H, Antolin-Juarez FM, Llorca J. Factors related with the performance of a proper hand hygiene. Med Clin 2010;135:592-5. https://doi.org/10.1016/j.medcli.2010.02.040
  18. Alsubaie S, Maither Ab, Alalmaei W, Al-Shammari AD, Tashkandi M, Somily AM, et al. Determinants of hand hygiene noncompliance in intensive care units. Am J Infect Control 2013;41:131-5. https://doi.org/10.1016/j.ajic.2012.02.035

피인용 문헌

  1. Knowledge, Perceptions, and Self-reported Performance of Hand Hygiene Among Registered Nurses at Community-based Hospitals in the Republic of Korea: A Cross-sectional Multi-center Study vol.51, pp.3, 2018, https://doi.org/10.3961/jpmph.17.188
  2. Hand Hygiene Compliance among Visitors at a Long-term Care Hospital in Korea: A Covert Observation Study vol.30, pp.1, 2015, https://doi.org/10.12799/jkachn.2019.30.1.99