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1.
Am J Infect Control ; 46(12): 1381-1386, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30509358

RESUMO

BACKGROUND: Health care-associated infections (HAIs) are avoidable through good hand hygiene (HH) practices. Hand hygiene compliance systems (HHCSs) have been shown to reliably measure HH adherence, but data on their effectiveness at reducing HAI rates are limited. METHODS: This nonrandomized, pre-post intervention study was conducted at a community hospital in the United States. HAI rates were examined before and after implementation of a HHCS. Preintervention began in January 2014 and intervention began in March 2015; data were collected through September 2017. Additional infection-specific interventions were carried out. HAIs were calculated as incidence rate ratios. RESULTS: The preintervention and intervention periods included 14,297 and 36,890 patients, respectively. The HHCS recorded an average of 696,928 HH opportunities/month. A significant reduction in the rate of catheter-associated urinary tract infections was observed during the intervention: IRR, 0.55; 95% CI, 0.35-0.87. Similarly, a significant reduction in the rate of central line-associated bloodstream infections was observed: IRR, 0.45; 95% CI, 0.23-0.89. DISCUSSION AND CONCLUSIONS: These findings suggest that monitoring HH practices with an automated system, in addition to other infection control measures, may be an effective means of reducing HAIs. Further studies are needed to isolate the potential role of HHCSs in the reduction of HAIs.


Assuntos
Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes , Higiene das Mãos/normas , Pessoal de Saúde , Controle de Infecções/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/prevenção & controle , Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Venoso Central/efeitos adversos , Criança , Pré-Escolar , Feminino , Hospitais Comunitários , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estados Unidos , Infecções Urinárias/prevenção & controle , Adulto Jovem
2.
Am J Infect Control ; 45(5): 492-497, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28139265

RESUMO

BACKGROUND: Consistent hand hygiene is key to reducing health care-associated infections (HAIs) and assessing compliance with hand hygiene protocols is vital for hospital infection control staff. A new automated hand hygiene compliance system (HHCS) was trialed as an alternative to human observers in an intensive care unit and an intensive care stepdown unit at a hospital facility in the northeastern United States. METHODS: Using a retrospective cohort design, researchers investigated whether implementation of the HHCS resulted in improved hand hygiene compliance and a reduction in common HAI rates. Pearson χ2 tests were used to assess changes in compliance, and incidence rate ratios were used to test for significant differences in infection rates. RESULTS: During the study period, the HHCS collected many more hand hygiene events compared with human observers (632,404 vs 480) and ensured that the hospital met its compliance goals (95%+). Although decreases in multidrug-resistant organisms, central line-associated bloodstream infections, and catheter-associated urinary tract infection rates were observed, they represented nonsignificant differences. DISCUSSION AND CONCLUSIONS: Human hand hygiene observers may not report accurate measures of compliance. The HHCS is a promising new tool for fine-grained assessment of hand hygiene compliance. Further study is needed to examine the association between the HHCS and HAI rate reduction.


Assuntos
Terapia Comportamental/métodos , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Desinfecção/métodos , Desinfecção/estatística & dados numéricos , Fidelidade a Diretrizes , Higiene das Mãos/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Automação/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos , Adulto Jovem
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