Author/Editor		Grilc, Tjaša; Miklavčič, Vesna; Slemenjak, Janja; Muzlovič, Igor; Jereb, Matjaž; Trampuž, Andrej
Title		Analiza upoštevanja higiene rok na intenzivnem oddelku
Translated title		Analysis of compliance of hand hygiene in an intensive care unit
Type		članek
Source		Obz Zdrav Nege
Vol. and No.		Letnik 36, št. 3
Publication year		2002
Volume		str. 153-9
Language		slo
Abstract		Hand hygiene of health care workers (HCW) is the most important, the easiest and the cheapest measure for prevention of nosocomial infections. Hand disinfection is more effective, faster and less harmful for the skin then all other techniques for hand hygiene. In the intensive care unit (ICU) at the Department of Infectious Diseases, University Hospital Ljubljana, in the last years alcoholic hand disinfection became a standard procedure when the hands are not visibly soiled. In the study we evaluated the compliance of hand hygiene, especially we were interested in factors positively or negatively influencing hand hygiene. We observed HCW in during routine care and rounds in the ICU during 2 months. The compliance for hand hygiene was related to transmission of methicillin resistant Staphylococcus aureus (MRSA) between parients in the ICU. Opportunities for hand hygiene were defined according to the guidelines of the Center for Disease Control and Prevention (CDC) (1). 531 opportunities for hand hygiene were documented. In 75% opportunities HCW performed a hand hygiene procedure: hand disinfection was used in 97% with a mean duration of 7 seconds; whereas hand washing was used in 3% and required a mean of 11 seconds. Compliance was higher after removing gloves (85 %), after direct patient contact (89%) and after contact with patient body fluids (100%) than between care of clean and dirty body areas (21%) and before manipulating vascular and urinary catheters (25%) (p < 0.05). After implementing additional infection control measures, compliance significantly increased from 72% to 82% (p < 0.05). (Abstract truncated at 2000 characters).
Summary		Higiena rok zdravstvenega osebja je najpomembnejši, najenostavnejši in najcenejši ukrep za preprečevanje bolnišničnih okužb. Razkuževanje rok je učinkovitejše, hitrejše in manj škodljivo za kožo kot vse druge tehnike higiene. Na intenzivnem oddelku Klinike za infekcijske bolezni in vročinska stanja Kliničnega centra v Ljubljani smo razkuževanju rok v zadnjih letih posvečali veliko pozornosti in danes predstavlja standardni način higiene rok, kadar te niso vidno onesnažene. Z raziskavo smo želeli oceniti upoštevanje higiene rok. Predvsem so nas zanimali dejavniki, ki pozitivno ali negativno vplivajo na higieno rok. Na intenzivnem oddelku smo dva meseca opazovali zdravstveno osebje med rednimi opravili in na vizitah. Stopnjo upoštevanja higiene rok smo primerjali s številom prenosov na meticilin odporne bakterije Staphylococcus aureus (MRSA) med bolniki na oddelku. Indikacije za higieno rok smo definirali po smernicah ameriškega Centra za nadzor in preprečevanje bolezni (CDC) (1). Zabeležili smo 531 priložnosti za higieno rok. V 75% teh priložnosti je zdravstveno osebje izvedlo eno od oblik higiene rok: v 97% si je roke razkužilo s povprečnim trajanjem postopka 7 sekund, v 3% si je roke umilo s povprečnim trajanjem 11 sekund. Upoštevanje doktrine higiene rok je bilo boljše po odstranitvi rokavic (85%), po neposrednem stiku z bolnikom (89%) in po stiku z bolnikovimi telesnimi tekočinami (100%), kot med nego čistega in nečistega dela telesa (21%) ter pred ravnanjem na žilnih in urinskih katetrih (25%). Dodatni higienski ukrepi, ki smo jih uvedli zaradi povečanja števila bolnikov s prenešenim MRSA na oddelku, so pomembno izboljšali upoštevanje higiene rok od 72% na 82% (p < 0,05). (Izvleček skrajšan pri 2000 znakih).
Descriptors		INTENSIVE CARE UNITS CROSS INFECTION HANDWASHING NURSING STAFF, HOSPITAL