Compliance with Hand Hygiene among Health Professionals in the Medical-Surgical Emergency Department of the Donka National Hospital

Introduction: The transmission of infectious agents through the hands of nursing staff during care is the main cause of nosocomial infections. Hand hygiene has been recognized for over a century as an effective measure to prevent healthcare associated infections in healthcare settings, the objective of this study was to appreciate the practice of hand hygiene during care by health professionals in the medical-surgical emergency department of the Donka National Hospital. Methods: It was a cross-sectional, analytical study. Data collection took place from March 1 to April 30, 2021. The study covered all health professionals, namely doctors, nurses, laboratory technicians, radiography technicians, pharmacists, students, stretcher bearers, surfactants who were present at the time of the study period. Results: During the study period, out of a total of 104 registered health professionals, we surveyed 99, which is a rate of 95%. The most represented age group was [30 - 39 years] with an average of 37.17 ± 10.34 years, and extremes of 22 years to 65 years. The male sex was the most dominant or 59.60% compared to the female sex or 40.40% with a sex ratio of 1.47. The hand hygiene compliance rate was low at 21%. The practice of hand hygiene during care for 100% of health professionals was very low, at 8.08%. No factors influence the observance of the practice of hand hygiene and the socio-professional characteristics of the conditions of provision of care activities. Conclusion: Hand hygiene during care is an essential aspect that must be considered as an essential measure in the prevention of infections in this period of the COVID-19 pandemic.

Assessment of Hand Hygiene Attitude, Knowledge and Practice among Health Science Students in Aden University

Background: A proper hand washing of community health care worker (CHCW) is universally accepted as an important factor in reducing Heath Care Associated Infections (HCAIs). This cross sectional study was done to assess the knowledge, the attitude and practice on hand hygiene among health science students in Aden University. Method: 329 participants from medical, dental and nursing schools completed the questionnaire (43.8% female and 56.2% males). 1st, 2nd and internship years were excluded from the study. The questionnaire is adapted from World Health Organization (WHO) tools for hand hygiene surveys. Epi info., an epidemiological software from the Centre of Disease Control (CDC), was used for data analysis. Results: Responses of the participants in the study indicated that the majority of the students were aware of Hand hygiene (>90%) and 60% have had some sort of training. There is an obvious lack of knowledge on hand movement i.e. my five moments of hand hygiene, particularly on the main source and route of cross contamination with pathogens in hospital setting. In hand hygiene practice, 95% of participants wash their hands before and after food intake, 85% of participants use soap and water, but 8% of participants use only water and very few use alcohol base cleansing agent. 84% of participants wash their hands after handling patient. There was no significant difference between males and females in hand hygiene practice. Conclusion: The study on assessment of knowledge, attitude & practice of students of medical sciences revealed that almost all participants were aware of hand hygiene. However, at this stage of assessment, knowledge and practice are below 100% score for the correct response in particular knowledge and practice.

Analysis of Compliance and Barriers for Hand Hygiene Practices among Health Care Workers during COVID-19 Pandemic Management in Tertiary Care Hospital of India—An Important Step for Second Wave Preparedness

Introduction: Hands of health care workers play an important part in infection transmission in a healthcare setting infections. Even though it is a simple and effective procedure, it is many times ignored by the health care workers (HCWs) due to lack of knowledge and interest, time constraints, skin irritation, understaffing, etc. There are no specific drugs and vaccines available for COVID-19 pandemic management, so as control measures, hand hygiene is an essential measure. It will be helpful even for the second wave preparedness. So this study was planned for analysis of barriers and practices of hand hygiene among health care workers which determine the adherence of hand hygiene in medical practice. Methods: This was a cross-sectional study designed during COVID-19 pandemic management to analyze the barriers and knowledge, attitude and practices in health care workers for hand hygiene. Semi-structured questionnaires based study based on previous experience of seasonal flu outbreak was make to know barriers as well as to analyze the knowledge, attitude and practices of Health care workers. 215 participants were enrolled who were doctors, resident doctors, nurses, lab technicians, ward boys and food distributors. Results: The “Barriers” related questions’ analysis showed that hand hygiene facilities, with the supply of soap, hand rub, basins with adequate as well as clean water, are available at various places in the Hospital. In knowledge related questions, major gaps are found in 5 moments of hand hygiene and regarding aspects of alcohol-based hand-rub. Majority HCWs show a good attitude towards questions that hand hygiene is an important thing to do along with other works and they feel frustrated when others or they themselves omit hand hygiene. But the attitude toward hand hygiene when hands are not visibly soiled and when working with gloved hand showed a wrong attitude. There is a major gap in practices of hand hygiene. The majority feel hand hygiene is difficult due to work pressure, sometimes they forgot, they feel it difficult to adhere due to more steps during an emergency. Discussion: Hand hygiene is an essential part of COVID-19 pandemic management. Less compliance was observed due to a lack of knowledge and awareness. Such ignorance leads to an increase in Hospital-acquired infection. Conclusion: Good preparedness by Government and Institute for supplying adequate hand hygiene facilities in the work area for health care workers. But there were few gaps found in knowledge and attitude-related questionnaires and major gaps in practices were found which should be corrected by repeated training, awareness programs, demonstrations for hand hygiene and hands-on training. Conducting Periodic Webinar can be the most useful, convenient and safe method to provide training during the COVID-19 pandemic.

Health Care Personnel’s Attitude toward Hand Hygiene in Regard to the Prevention of Health-Care Associated Infections: A Cross Sectional Study at the University Hospital Pristine

Background: Hand hygiene is the leading measure for preventing the spread of antimicrobial resistance and reducing healthcare-associated infections, but health care worker compliance with optimal practices remains low in most settings. Objective: The main aim of this paper is to determine findings and start drafting policies in implementing them into practice after finding out nurses’ opinions, beliefs and attitudes toward hand hygiene (HH). Methodology and methods: A cross sectional descriptive and observational study during November 2009. Results: From the total number of 175 health care workers employed in this unit, 67 (38.3%) were observed regarding adherence to hand hygiene. Regarding the knowledge, practices and attitudes of the nurses, data were collected from 54 (50.0%) among 108 nurses in four intensive care units within the University Clinical Centre of Kosovo (UCCK). From research findings, it was concluded that hand hygiene compliance in the intensive care units was low (51.3%). Conclusion: Research results show the necessity of organizing multimodal programs with intensive care units of University Clinical Centre of Kosovo (UCCK) on increase of knowledge level on health-care associated infections (HAI).

Prevalence and Incidence of Hand Osteoarthritis and Upper Limb Complaints in Patients with Knee Osteoarthritis. Correlations among Functionality, Grip Strength, Changes in Body Mass Index and Symptoms among Patients in an Educational Osteoarthritis Program

Objective: To evaluate the prevalence of hand osteoarthritis (hOA) in a population with knee osteoarthritis (KOA) at baseline and one year following the administration of a multi-professional OA educational program correlating symptoms and changes in BMI with function questionnaires of the upper limbs and direct grip strength measurements. Design: Epidemiological study of the prevalence of hand OA in patients with knee osteoarthritis. The Stanford Health Assessment Questionnaire instruments (HAQ);Disabilities of the Arm, Shoulder and Hand* (DASH);grip strength;and finger pinch were utilized, and the upper limbs symptoms were verified at baseline and one year following the educational program. Results: The prevalence of hOA was 23.7% at baseline and 47.4% at one year (incidence of 31.8% per year). The HAQ indicated that patients who did not alter or increased their BMI experienced worsened global strength, whereas patients who reduced BMI improved global strength (p = 0.041). Patients with higher initial BMIs experienced less improvement in the HAQ (r = -0.148, p = 0.041). The DASH results improved, but the right and left tripod grip worsened in all patients, irrespective of BMI change (p < 0.05) or symptoms at baseline and reassessment (p < 0.05). Pinch strength (right and left tripod and left pulp-pulp) was higher in patients without symptoms at baseline (p = 0.048, p = 0.045 and 0.033, respectively). Conclusions: The prevalence of hand OA increased for patients with OA undergoing an educational program irrespective of improved upper function and regardless of BMI change. Patients who decreased their BMI improved their global strength.

Hand Hygiene Knowledge, Practices and Attitudes among Nurses and Physicians

Background: Hand hygiene is one of the most effective ways to control health care related infection. Nurses and physicians are the main health care workers contacting with patients, representing the vector in the chain of infection. Thus, assessing their knowledge, practice and attitudes regarding hand hygiene is very important to decrease the incidence of health care related infection and to improve quality of care. Aims: The aim is to assess the knowledge, practice and attitude of Palestinian physicians and nurses regarding hand hygiene in hospitals. Methods: The study adopted a cross-sectional, quantitative design. Nurses and doctors who worked in the major governmental and private hospitals in the West Bank (Palestine) were targeted. Data was collected using Hand Hygiene Questionnaire. Results: 200 nurses and physicians participated in this study. The results showed that the participants had a moderate knowledge regarding the hand hygiene (m = 6, SD = 1.7). They had a better attitude score than practice with a mean of 82.5 ± 8.8. There was a significant difference between male and female only in practice score (p = 0.015). Older participants had better attitudes, and private hospitals had significantly higher scores for compliance, importance of hand hygiene and practice than governmental hospitals (p < 0.05). Conclusion: The results of the current study showed that there was a further need to focus on the practices of hand hygiene by continuous education for both Palestinian nurses and physicians.

上海市74所医疗机构ICU手卫生用品消耗量及依从性相关分析

目的 了解上海市二级及以上医疗机构重症监护病房(ICU)手卫生用品消耗量与依从性,为进一步开展医务人员手卫生监测工作提供依据。方法 通过医院感染监测系统,对2017—2021年上海市二级及以上医疗机构ICU手卫生用品消耗量及依从性监测结果进行分析。结果 共纳入74所医疗机构105个ICU,手卫生用品平均消耗量为79.24(44.88~258.63)mL/(床·日),不同类型ICU手卫生用品平均消耗量比较,差异具有统计学意义(P<0.001);手卫生用品平均消耗量从2017年的65.75 mL/(床·日)增至2021年的87.55 mL/(床·日),呈逐年增加趋势(P<0.001)。医务人员手卫生依从率为82.13%,护士手卫生依从率最高(86.59%),医技最低(48.90%),不同职业医务人员手卫生依从率比较,差异具有统计学意义(P<0.001)。手卫生实施的方式中,采取流动水洗手占39.86%,速干手消毒剂擦手占42.27%,未采取手卫生措施占13.22%,戴手套未采取手卫生措施占4.65%,不同ICU医务人员手卫生实施方式比较,差异具有统计学意义(P<0.001)。手卫生用品平均每床日消耗量与医务人员手卫生依从率存在正相关关系(r=0.703,P<0.05)。结论 上海市ICU手卫生用品平均每床日消耗量与医务人员手卫生依从率均逐年增加,不同类型ICU手卫生用品平均每床日消耗量和手卫生依从率存在差异,可通过连续监测手卫生用品平均每床日消耗量评估手卫生执行情况。

Simulated Microbe Removal around Finger Rings Using Different Hand Sanitation Methods

Aim It is our opinion that the CDC and the WHO have underestimated cross-contamination under examination gloves in dental clinics while wearing jewelry, such as finger rings. These agencies only ＂recommend＂ removing jewelry, and only washing hands for 15 seconds with soap and warm water before donning gloves. This study examined several washing procedures and finger rings using simulated microbes. Methodology A gloved robber hand manikin was made and fitted with a flesh disposable vinyl glove. Four fingers were fitted with rings or no ring, dusted with simulated microbes, and washed with a scrub brush for 5, 15, and 25 seconds under 20℃ and 40℃ water alone, or with liquid hand soap. Light levels （in lux） of fluorescent powder before and after washing were measured and delta scores calculated for changes in light levels, equivalent to effectiveness of hand washing procedures. A full-factorial, 3-factor analysis of variance （ANOVA） was used to test for differences among levels of the three study factors-time, temperature, and soap use. Tukey＇s post hoc honestly significant difference （HSD） test was applied to significant factors to examine pair-wise differences between factor levels. Results It was found that the longer the hands with rings were washed with a scrub brush under flowing water, the more simulated microbes were removed. By 25 seconds, all methods were essentially the same. Simulated microbes were more difficult to remove from the palm compared to the back of the hand. The liquid hand soap used in this study was more effective with warm water than cold. When given a choice of washing with cold water up to 15 seconds, it would be preferable not to use soap to remove simulated microbes. Qualitatively, the outer surface of finger rings were more effectively cleaned than the crevice below the ring, and the ring with a stone setting appeared to accumulate and retain simulated microbes more than other rings. Conclusion The most effective treatment was washing with warm water and liquid soap. Longer times were more effective. Rings should not be worn under examination gloves due to difficulty cleaning in the crevice under the ring, and the well-known consequences of cross-contamination between the patient and the health care worker.

手卫生工作对防病保健作用的思考

手卫生是成本最低的疾病预防和感染控制措施,然而在执业操作或是生活中手卫生行为仍存在很多问题和阻碍,使得其防病保健作用受到影响。本研究通过对手卫生的重要性以及在执行中的困难进行分析,提出在硬件改善及健康科普工作中推进手部卫生的一些建议。

灵活就业人员医疗保险困境与实践探索

随着共享经济、平台经济、数字经济的发展,传统灵活就业人员以及新型灵活就业人员的医疗保险面临新问题。灵活就业人员的健康、健康受到损害获得恢复的能力是劳动力要素的重要内容,对经济社会发展具有举足轻重的作用。灵活就业人员医疗保险相关政策亟须完善,参保率低、参保渠道窄、保险待遇低等因素影响着灵活就业人员健康权的保障。解决灵活就业人员医疗保险问题需要政府、企业的共同努力。政府应制定和完善相关政策和法规,鼓励和要求企业为灵活就业人员提供医疗保险福利;企业可以主动为灵活就业人员提供医疗保险福利,增加企业的吸引力,提高灵活就业人员的幸福感和获得感。

2014—2022年手卫生干预对医院感染例次发病率的影响

目的 观察多模式手卫生干预对手卫生依从性的影响,以及手卫生依从性与医院感染例次发病率之间的关系。方法 2014—2022年,某三甲医院感染控制团队对全院医务人员实施多模式手卫生干预,回顾性分析手卫生监测数据的变化趋势、手卫生依从率与医院感染例次发病率的相关性。结果 病房手卫生用品消耗量呈稳定上升趋势;手卫生依从率从2014年64.98%提高到2022年85.01%(P<0.001),医院感染例次发病率从1.21%下降至0.83%(P<0.05),手卫生依从率与医院感染例次发病率之间存在负相关(r=-0.369,P=0.027)。各季度不同区域及不同岗位的手卫生依从率均有所提高(P<0.001)。各季度5个时刻手卫生依从率中,无菌操作前与接触患者后的手卫生依从率小幅波动;接触患者周围环境后的手卫生依从率呈上升趋势;接触患者前与接触患者体液后的手卫生依从率在2020年之后有所下降(P<0.001)。结论 多模式手卫生干预能提高医务人员的手卫生依从性,提高医务人员手卫生意识有利于降低医院感染例次发病率。

多媒体健康教育在幼儿家长三手烟暴露知信行干预中的效果

目的 探讨基于抖音的多媒体健康教育对幼儿家长三手烟暴露知信行的影响。方法 选择120例某公立幼儿园的家长作为研究对象,采用随机数字表法将其分为试验组及对照组。对照组对三手烟暴露危害及有效规避进行常规健康教育,干预组在对照组基础上进行基于抖音的多媒体健康教育;比较两组家长干预后的三手烟知信行水平。结果 干预后,试验组幼儿园家长的三手烟暴露知信行总分和各维度得分都有所提高,其家庭成员的吸烟支数有所减少,差异均有统计学意义(P<0.05)。结论 基于抖音的多媒体健康教育方式能提高幼儿园家长对三手烟暴露的知信行水平,改善幼儿家庭成员的吸烟情况,对于全面创造无烟家庭环境、促进幼儿身体健康具有借鉴意义。

高风险科室手卫生依从性电子监测与人工监测方法的卫生经济学效益

目的比较手卫生依从性电子监测(electronic system-based monitoring,ESM)与人工监测(manual paper-based monitoring,MPM)的经济学效益,为临床高风险科室手卫生监测方法提供参考。方法收集某大型三级甲等医院的呼吸与危重症医学科、创伤与显微骨科、儿科重症监护室、感染科、关节与运动医学科、呼吸与危重症医学科普通病区、神经内科、神经外科、食管纵膈与淋巴肿瘤放化疗科、头颈与儿童肿瘤放化疗科、血液内科11个高风险科室,2022年12月—2023年5月ESM和MPM两种手卫生监测方法实施期间的成本投入和效果产出,应用TreeAge Pro 2022软件构建决策树模型,测算成本效果、成本效率、霍桑效应和间接成本效益。结果ESM方法的总成本(4868.55元)低于MPM方法(7122.12元),但ESM方法的手卫生依从率(61.33%)低于MPM方法(78.79%)。MPM方法的成本效果比(9039.37元)高于ESM方法(7938.28元),增量成本效果比为17.46%。MPM方法的成本效率比(72013.35元)明显高于ESM方法(8813.45元)。MPM方法的霍桑效应(59.45%)高于ESM方法(47.90%)。MPM方法的成本效益比(2894.70元)低于ESM方法的成本效益比(4765.98元)。当支付意愿低于18500元时,ESM方法是更具成本效果的选择;当投入高于该阈值时,MPM方法是更具成本效果的选择。结论对于感染控制高风险科室,ESM方法的成本效果、成本效率、成本效益均优于MPM方法,但两者霍桑效应的差异无统计学意义。

手足口病与相似疾病鉴别模型构建研究

目的/意义建立手足口病与相似疾病鉴别模型总体架构,有效促进传染病防控并推动智慧公共卫生体系建设。方法/过程通过查阅文献资料确定需与手足口病进行鉴别的疾病及其鉴别要点,通过Meta分析对某一症状与疾病的特异性关联程度赋值,构建基于相似度算法的鉴别模型。结果/结论实现对手足口病的早期和大规模监测预警,为进一步提升手足口病的智能化识别、诊断、预警水平提供帮助。

手工疗法与大学生心理健康教育的耦合路径探索

处于时代变迁浪潮中的大学生在心理健康方面面临着巨大的挑战,大学生心理健康教育又存在着教学内容陈旧、教学形式单一、师资力量匮乏和意识观念落后等问题,已然不能满足当代大学生心理健康发展的需求。手工编织疗法可以激发手脑功能的发展,推动自我意识的觉醒,促进情绪状态的调节,因此,可以将其运用到大学生心理健康教育课堂、咨询和个案辅导中。高校在实施手工编织疗法实践过程中应该注意培养一支专业的师资队伍,构建学生兴趣社群,形成积极心理品质,并与其他课程形成教育合力。

某三级甲等医院ICU工作人员手卫生依从性及正确性调查分析

目的 研究某三级甲等医院重症监护病房(ICU)工作人员手卫生依从性及正确性,为手卫生干预提供理论基础。方法 2023年4月,专职感染监控人员对该院17个ICU的工作人员进行现场调查,填写手卫生依从性和正确性监测表。结果 使用隐蔽观察法共观察874次手卫生时机,执行手卫生时机501次,依从率57.32%,正确执行273次,正确率54.49%。不同ICU工作人员手卫生依从率及正确率差异较大。不同岗位工作人员手卫生依从率和正确率比较差异有统计学意义,保洁员的手卫生依从率(31.97%)低于护士(63.83%)、医生(58.77%)和其他人员(58.14%);保洁员的手卫生正确率(30.77%)低于护士(58.17%)。不同岗位人员及不同手卫生时刻未执行手卫生的原因差异有统计学意义:接触患者后未执行任何手卫生措施的比率(84.75%)高于接触患者前(41.27%)、清洁无菌操作前(30.00%)、接触血液体液后(45.45%);接触患者周围环境后未执行任何手卫生措施的比率(66.67%)高于接触患者前和清洁无菌操作前。不同岗位工作人员手卫生步骤不全的比率及时间不够的比率比较差异有统计学意义,其他人员的手卫生步骤不全的比率(82.35%)高于医生(52.63%);医生(82.46%)及护士(78.18%)手卫生时间不够的比率高于保洁员(51.85%)。结论 在ICU,不同职业的人群、不同时刻手卫生执行情况存在明显差异,需要综合其特点进行干预。

四手操作护理联合健康宣教在乳牙预成冠修复术中的应用

目的:探讨四手操作护理联合健康宣教在乳牙预成冠修复术中的效果。方法:将医院收治的70例接受乳牙预成冠修复术患儿随机分为对照组(35例)和观察组(35例),对照组患儿接受常规护理,观察组患儿接受四手操作护理联合健康宣教。对比两组手术时间、医生工作舒适度评分、口腔卫生行为评分、护理满意度。结果:观察组患儿手术时间短于对照组、医生工作舒适度评分高于对照组(P<0.05)。护理后,观察组患儿饭后漱口、刷牙3 min以上、早晚刷牙及定期口腔检查评分均高于对照组(P<0.05)。观察组患儿家属满意度高于对照组(P<0.05)。结论:四手操作护理联合健康宣教可缩短手术时间,提高医生工作舒适度,改善患儿口腔卫生行为,提高患儿家属对护理工作的满意度。

知信行管理模式对医护人员手卫生的影响

目的探讨知信行管理模式对医护人员手卫生的影响。方法选取2022年7月至2023年6月于我院工作的42名医护人员,其中2022年7月至2022年12月未实施知信行管理模式期间为管理前,2023年1月至2023年6月实施知信行管理模式期间为管理后。比较管理前后医护人员的手卫生健康知识、手卫生依从性、手卫生质量。结果管理后,医护人员的手卫生健康知识评分高于管理前,接触患者前、无菌操作前、接触患者后、接触液体后、接触周围环境后的手卫生依从性均高于管理前,手卫生消毒及监测合格率均高于管理前(P<0.05)。结论知信行管理模式能够提高医护人员的手卫生健康知识掌握度、手卫生依从性,进而提升手卫生质量,利于减少医院感染的发生。

四手操作配合“知信行”健康宣教在根管治疗中的应用及效果评价

目的探究根管治疗中采用四手操作配合知信行健康宣教的临床效果。方法研究开展于2022年3月至2023年3月,抽选64例根管治疗患者样本,采用抽签法分组为研究组(n=32)、对照组(n=32)。对照组患者行常规护理方案,研究组患者行四手操作配合知信行健康宣教,比较两组根管治疗时间、术后肿胀发胀率、术后VAS评分、按时复诊率及不良事件发生率。结果研究组根管治疗时间(26.44±2.97)min、术后肿胀发胀率6.25%、术后VAS评分均(1.95±0.62)分低于对照组根管治疗时间(35.61±4.28)min、术后肿胀发胀率25.00%、术后VAS评分均(3.06±0.98)分(P<0.05)。研究组患者按时复诊率93.75%高于对照组71.88%,不良事件发生率低于对照组(P<0.05)。结论根管治疗中采用四手操作配合知信行健康宣教可缩短根管治疗时间,缓解术后肿痛,并可提高患者按时复诊率,降低不良事件发生率。

基于手背视频流分析的无接触式SpO2测量方法

为提高外周血氧饱和度(SpO2)的测量效率与准确率,本研究提出了一种基于手背视频的非接触式SpO2测量方法。通过欧拉视频放大中的高斯金字塔与放大因子的组合改进,减少光线噪声的干扰,有效放大手背视频中的感兴趣区域。然后,提取放大后视频帧的红、蓝通道,并采用吸光度比值法计算SpO2值。最后,在自制数据集上进行了两种呼吸状态下的实验验证。实验结果表明,所提方法SpO2测量的平均均方根误差(RMSE)可达0.48%,与指夹式脉搏血氧仪相比,表现出较高的一致性,且发现性别对SpO2的测量误差有一定影响。该方法可便捷地移植到智能手机等简易视频设备,对SpO2的日常监测具有良好的应用前景。