Bir üniversite hastanesindeki sağlık personelinin el hijyeni uyum oranlarının değerlendirilmesi: Prospektif bir çalışma
Öz
Amaç: Bu çalışmanın amacı, 2014 ve 2018 yılları arasında yoğun bakım ünitelerinde (YBÜ) sağlık çalışanlarının el hijyeni uyum oranını saptamaktır.
Gereç ve Yöntem: Bu araştırma yedi YBÜ’de (Çocuk Sağlığı ve Hastalıkları, Yenidoğan, İç Hastalıkları, Anestezi ve Reanimasyon, Göğüs Hastalıkları, Nöroloji ve Kalp Damar Cerrahisi) çalışan doktor, hemşire ve yardımcı sağlık personelinin el hijyeni uyumunu değerlendiren prospektif, gözlemsel bir çalışmadır. El hijyeni uyumu enfeksiyon kontrol hemşireleri tarafından Dünya Sağlık Örgütü (DSÖ) beş endikasyonuna göre Ocak 2014 ile Aralık 2018 arasında haberli gözlem şeklinde yapılmıştır. Ayrıca, yüksek ve düşük el hijyeni uyumluluğuna sahip bireylere kişisel geri bildirimler verilmiştir.
Bulgular: Toplam 24153 el hijyeni fırsat gözlemi (2014: 5695, 2015: 5307, 2016: 4563, 2017: 4821, 2018: 3767) yapıldı. Çalışmamızda 2014'ün ilk döneminde el hijyeni uyum oranı %25,6 idi. Tüm çalışanların el hijyeni uyum oranı sırasıyla; 2014: %32,0, 2015: %55,7, 2016: %61,0, 2017: %55,6 ve 2018: %68,1 olmuştur. Mesleklere göre; el hijyeni uyum oranları hemşirelerde %37 ile %70, yardımcı sağlık personelinde %20 ile %51, doktorlarda %28 ile %49 arasındaydı.
Sonuç: Hastanemizde el hijyeni kurallarına uyum, sürekli çabalarla nispeten zayıf seviyelerden ortalama seviyelere yükselmiştir. El hijyeni uyum oranlarını %70'lerin üstüne çıkarmak için daha fazla destekleyici çalışmaya ihtiyaç vardır.
Anahtar Kelimeler
el hijyeni enfeksiyon kontrolü hastane epidemiyolojisi hastane enfeksiyonları
Kaynakça
- Boyce JM, Pittet D. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol. 2002; 23 (S12): S3–40.
- Khan HA, Baig FK, Mehboob R. Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pac J Trop Biomed. 2017; 7 (5): 478–82.
- WHO Gözlemciler İçin Rehber. Geneva; 2007 [cited 2019 May 17]. Available from: https://dosyamerkez.saglik.gov.tr/Eklenti/4223,9dsorehberpdf.pdf?0
- Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the Proportion of Healthcare-Associated Infections That Are Reasonably Preventable and the Related Mortality and Costs. Infect Control Hosp Epidemiol. 2011; 32 (2): 101–14.
- Artan Y, Sözeri İ, Durmaz Akyol A. Yoğun Bakımda Çalışan Yardımcı Hizmet Personelinin El Hijyeni Uyumunun Değerlendirilmesi. Yoğun Bakım Hemşireliği Derg. 2018; 22 (1): 10–8.
- Arda B, Şenol Ş, Taşbakan MI, Yamazhan T, Sipahi OR, Arsu G, et al. Ege Üniversitesi Tıp Fakültesi Yoğun Bakım Ünitelerinde El Temizliği Kurallarına Uyumun Değerlendirilmesi. Yoğun Bakım Derg. 2005 [cited 2019 May 17]; 5 (3): 182–6.
- WHO Guidelines on Hand Hygiene in Health Care First Global Patient Safety Challenge Clean Care is Safer Care. Geneva; 2009 [cited 2019 May 17]. Available from: https://apps.who.int/iris/bitstream/handle/10665/44102/9789241597906_eng.pdf;jsessionid=55D7E677A7D37C74FC602B784D9C6FFF?sequence=1
- Güçlü E, Tuna N, Yahyaoğlu M, Utku AÇ, Özcan Ö, Ceylan S, et al. Eğitimin ve Alkol Bazlı El Antiseptiklerinin Hastanede Yaygınlaştırılmasının El Hijyeni Uyumuna Etkisi. Flora. 2012; 17 (2): 118–25.
- Awoke N, Geda B, Arba A, Tekalign T, Paulos K. Nurses Practice of Hand Hygiene in Hiwot Fana Specialized University Hospital, Harari Regional State, Eastern Ethiopia: Observational Study. Nurs Res Pract. 2018: 2654947
- Yawson AE, Hesse AAJ. Hand Hygiene Practices And Resources İn A Teaching Hospital İn Ghana. J Infect Dev Ctries. 2013 Apr 17; 7 (04): 338–47.
- 11. Sönmezer MÇ, Gülhan B, Otuzoğlu M, Yakut Hİ, Tezer H. Evaluation of Hand Hygiene Compliance of Health Personnel in the Pediatric Intensive Care Unit. Turkish J Pediatr Dis. 2014 Jun 20; 8 (2): 75–8.
- Demirdal T, Uyar S, Demirtürk N. Bir Üniversite Hastanesinde Çalışanlarda El Yıkama Uygulamalarının ve Bilgi Düzeylerinin Değerlendirmesi. Med J Kocatepe. 2007;8 (3): 39–43.
- Lai C-C, Lu M-C, Tang H-J, Chen Y-H, Wu Y-H, Chiang H-T, et al. Implementation Of A National Quality İmprovement Program To Enhance Hand Hygiene İn Nursing Homes İn Taiwan. J Microbiol Immunol Infect. 2019 Apr 1 [cited 2019 May 17]; 52 (2): 345–51.
- Grayson ML, Stewardson AJ, Russo PL, Ryan KE, Olsen KL, Havers SM, et al. Effects Of The Australian National Hand Hygiene Initiative After 8 Years On İnfection Control Practices, Health-Care Worker Education, And Clinical Outcomes: A Longitudinal Study. Lancet Infect Dis. 2018 Nov 1 [cited 2019 May 17]; 18 (11): 1269–77.
- Uyan A, Aksoy F, Azak E, Meriç Koç M, Alkan Çeviker S, Ataman Hatipoğlu Ç, et al. Hand Hygiene Compliance in Some Intensive Care Units of Turkey: Results of Multicentre Asklepeion Study. Mediterr J Infect Microb Antimicrob 2018;7:37 doi: 10.4274/mjima.2018.37
- Farhoudi F, Sanaei Dashti A, Hoshangi Davani M, Ghalebi N, Sajadi G, Taghizadeh R. Impact of WHO Hand Hygiene Improvement Program Implementation: A Quasi-Experimental Trial. Biomed Res Int. 2016 [cited 2019 May 17]; 2016: 7026169. 96 Ege Tıp Dergisi / Ege Journal of Medicine
- Alshammari M, Reynolds K, Verhougstraete M, O’Rourke M. Comparison of Perceived and Observed Hand Hygiene Compliance in Healthcare Workers in MERS-CoV Endemic Regions. Healthcare. 2018 Oct 7 [cited 2019 May 17]; 6 (4): 122.
- Biswas A, Bhattacharya S Das, Singh AK, Saha M. Addressing Hand Hygiene Compliance in a Low-Resource Neonatal Intensive Care Unit: a Quality Improvement Project. J Pediatric Infect Dis Soc. J Pediatric Infect Dis Soc. 2018 Sep 4. doi: 10.1093/jpids/piy076
- Uyan A, Durmuş G, Sezak N, Pepe F, Kaygusuz T, Öztoprak N, et al. Is Nurse Workforce Sufficient in Intensive Care Units in Turkey? Results of the Multicenter Karia Study. Mediterr J Infect Microb Antimicrob. 2017; 6: 20.
- Uyan A, Durmuş G, Sezak N, Özdemir B, Kaygusuz T, Öztoprak N, et al. Are Soap, Paper Towel and Alcohol-based Disinfectants Easily Accessible in Intensive Care Units in Turkey?: Results of the Phokai Study. Mediterr J Infect Microbes Antimicrob. 2019 doi: 10.4274/mjima.2018.20.
Evaluation of hygiene compliance rates among healthcare workers in a university hospital: A prospective study
Öz
Aim: The aim of this study was to determine the hand hygiene (HH) compliance of the health workers in the intensive care units (ICUs) between the years 2014 and 2018. Materials and Methods: A prospective, observational study assessed the hospital care HH compliance among doctors and nurses and auxiliary staff in seven ICUs (Pediatrics, Neonatal, Internal Medicine, Anesthesia and Reanimation, Chest Diseases, Neurology and Cardiovascular Surgery) of our setting.
Unblinded observations were conducted by infection control nurses between January 2014 and December 2018 according to the five indications based on World Health Organization (WHO) guidelines. Practical HH training was continued during the HH observations of employees at ICUs in our hospital. In addition, personal feedback was given to individuals with high and low HH compliance.
Results: A total of 24153 HH opportunity (2014: 5695, 2015: 5307, 2016: 4563, 2017: 4821, 2018: 3767) observations were made. In the first period of 2014, the rate of HH compliance was 25.6%. The HH compliance rates of all employees were as follows: 2014: 34%, 2015: 55.7%, 2016: 61.0%, 2017: 55.6% and 2018: 68.1%. According to occupations; HH compliance rates were found to range between 37% and 70% in nurses, 20% and 51% in auxiliary healthcare personnel, 28% and 49% in doctors.
Conclusion: In our hospital compliance with HH rules increased from relatively poor levels to relatively average levels via continuous efforts. Further supportive studies are needed to increase HH compliance rates above 70%.
Anahtar Kelimeler
Hand hygiene infection control hospital epidemiology nosocomial infections
Kaynakça
- Boyce JM, Pittet D. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol. 2002; 23 (S12): S3–40.
- Khan HA, Baig FK, Mehboob R. Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pac J Trop Biomed. 2017; 7 (5): 478–82.
- WHO Gözlemciler İçin Rehber. Geneva; 2007 [cited 2019 May 17]. Available from: https://dosyamerkez.saglik.gov.tr/Eklenti/4223,9dsorehberpdf.pdf?0
- Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the Proportion of Healthcare-Associated Infections That Are Reasonably Preventable and the Related Mortality and Costs. Infect Control Hosp Epidemiol. 2011; 32 (2): 101–14.
- Artan Y, Sözeri İ, Durmaz Akyol A. Yoğun Bakımda Çalışan Yardımcı Hizmet Personelinin El Hijyeni Uyumunun Değerlendirilmesi. Yoğun Bakım Hemşireliği Derg. 2018; 22 (1): 10–8.
- Arda B, Şenol Ş, Taşbakan MI, Yamazhan T, Sipahi OR, Arsu G, et al. Ege Üniversitesi Tıp Fakültesi Yoğun Bakım Ünitelerinde El Temizliği Kurallarına Uyumun Değerlendirilmesi. Yoğun Bakım Derg. 2005 [cited 2019 May 17]; 5 (3): 182–6.
- WHO Guidelines on Hand Hygiene in Health Care First Global Patient Safety Challenge Clean Care is Safer Care. Geneva; 2009 [cited 2019 May 17]. Available from: https://apps.who.int/iris/bitstream/handle/10665/44102/9789241597906_eng.pdf;jsessionid=55D7E677A7D37C74FC602B784D9C6FFF?sequence=1
- Güçlü E, Tuna N, Yahyaoğlu M, Utku AÇ, Özcan Ö, Ceylan S, et al. Eğitimin ve Alkol Bazlı El Antiseptiklerinin Hastanede Yaygınlaştırılmasının El Hijyeni Uyumuna Etkisi. Flora. 2012; 17 (2): 118–25.
- Awoke N, Geda B, Arba A, Tekalign T, Paulos K. Nurses Practice of Hand Hygiene in Hiwot Fana Specialized University Hospital, Harari Regional State, Eastern Ethiopia: Observational Study. Nurs Res Pract. 2018: 2654947
- Yawson AE, Hesse AAJ. Hand Hygiene Practices And Resources İn A Teaching Hospital İn Ghana. J Infect Dev Ctries. 2013 Apr 17; 7 (04): 338–47.
- 11. Sönmezer MÇ, Gülhan B, Otuzoğlu M, Yakut Hİ, Tezer H. Evaluation of Hand Hygiene Compliance of Health Personnel in the Pediatric Intensive Care Unit. Turkish J Pediatr Dis. 2014 Jun 20; 8 (2): 75–8.
- Demirdal T, Uyar S, Demirtürk N. Bir Üniversite Hastanesinde Çalışanlarda El Yıkama Uygulamalarının ve Bilgi Düzeylerinin Değerlendirmesi. Med J Kocatepe. 2007;8 (3): 39–43.
- Lai C-C, Lu M-C, Tang H-J, Chen Y-H, Wu Y-H, Chiang H-T, et al. Implementation Of A National Quality İmprovement Program To Enhance Hand Hygiene İn Nursing Homes İn Taiwan. J Microbiol Immunol Infect. 2019 Apr 1 [cited 2019 May 17]; 52 (2): 345–51.
- Grayson ML, Stewardson AJ, Russo PL, Ryan KE, Olsen KL, Havers SM, et al. Effects Of The Australian National Hand Hygiene Initiative After 8 Years On İnfection Control Practices, Health-Care Worker Education, And Clinical Outcomes: A Longitudinal Study. Lancet Infect Dis. 2018 Nov 1 [cited 2019 May 17]; 18 (11): 1269–77.
- Uyan A, Aksoy F, Azak E, Meriç Koç M, Alkan Çeviker S, Ataman Hatipoğlu Ç, et al. Hand Hygiene Compliance in Some Intensive Care Units of Turkey: Results of Multicentre Asklepeion Study. Mediterr J Infect Microb Antimicrob 2018;7:37 doi: 10.4274/mjima.2018.37
- Farhoudi F, Sanaei Dashti A, Hoshangi Davani M, Ghalebi N, Sajadi G, Taghizadeh R. Impact of WHO Hand Hygiene Improvement Program Implementation: A Quasi-Experimental Trial. Biomed Res Int. 2016 [cited 2019 May 17]; 2016: 7026169. 96 Ege Tıp Dergisi / Ege Journal of Medicine
- Alshammari M, Reynolds K, Verhougstraete M, O’Rourke M. Comparison of Perceived and Observed Hand Hygiene Compliance in Healthcare Workers in MERS-CoV Endemic Regions. Healthcare. 2018 Oct 7 [cited 2019 May 17]; 6 (4): 122.
- Biswas A, Bhattacharya S Das, Singh AK, Saha M. Addressing Hand Hygiene Compliance in a Low-Resource Neonatal Intensive Care Unit: a Quality Improvement Project. J Pediatric Infect Dis Soc. J Pediatric Infect Dis Soc. 2018 Sep 4. doi: 10.1093/jpids/piy076
- Uyan A, Durmuş G, Sezak N, Pepe F, Kaygusuz T, Öztoprak N, et al. Is Nurse Workforce Sufficient in Intensive Care Units in Turkey? Results of the Multicenter Karia Study. Mediterr J Infect Microb Antimicrob. 2017; 6: 20.
- Uyan A, Durmuş G, Sezak N, Özdemir B, Kaygusuz T, Öztoprak N, et al. Are Soap, Paper Towel and Alcohol-based Disinfectants Easily Accessible in Intensive Care Units in Turkey?: Results of the Phokai Study. Mediterr J Infect Microbes Antimicrob. 2019 doi: 10.4274/mjima.2018.20.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2020 |
| Gönderilme Tarihi | 26 Haziran 2019 |
| Yayımlandığı Sayı | Yıl 2020 |
Kaynak Göster