官微已推送——【最新热点】 神助攻！用它来促进手卫生？！

焚膏继晷

【最新热点】 神助攻！用它来促进手卫生？！2016-06-17 SIFIC热点团队 SIFIC官微

众所周知，手卫生是降低医院感染最简单、 最有效、最方便、最经济的措施。然而，医务人员手卫生依从性偏低是一个全球性的问题，也是院感工作中的老大难问题。前几天，在APIC第43届年会上，美国一个感控小组发布了一种利用图像与情感结合的手卫生促进方案，您愿意试试么？

视觉触发，提高手卫生依从性

翻译：莫延花、陈燕琼、陈志锦

编写：陈志锦

审核：陈志锦

您可以利用“心理暗示”让医务人员增加洗手频次？答案是肯定的，因为这是6月11日感染控制和流行病学专业协会(APIC)第43届年会上提出的一项新研究。

感染控制小组在底特律亨利福特卫生系统使用细菌生长的图像来引起医务人员的厌恶感觉，并以此激励其遵守手卫生指南。该团队开发了一本包含不同类型和不同污染程度的细菌培养图像的书，通过三磷酸腺苷(ATP)仪器来显示。他们在手卫生依从率低的医院使用这些图像进行测试。

在两个月期间，他们随访了这些医疗机构10次，从其员工手上采样进行细菌培养，然后向他们展示了他们手上相似的污染菌培养图片。结果显示，进行测试的医疗机构的手卫生依从性上升11-46个百分点。

该项目的共同领导人、感染预防专家—阿什利·格雷戈里说：“医院的工作人员看着这本书，想象自己的皮肤有类似污染，他们就想主动洗手 。在这个示例中，通过串联不遵守手卫生的污染菌图像和手卫生指南来感化医务人员，或许可以改变他们的洗手行为和手卫生依从性。”

该项目还能促使医务人员(HCP)清洁自己的工作环境。通过ATP仪显像来比较手机、移动工作站和电脑鼠标的细菌数，医务人员能够对周围环境表面的污染可视化。

2016年APIC 主席，科罗拉多州儿童医院注册护士和流行病学家—苏珊•多兰女士，她说：“手卫生是预防感染传播最重要手段之一，然而，手卫生也是最难改善的指标之一。亨利福特卫生系统团队证明了这种方法的视觉化设计是成功的，它能为医疗机构寻找改变手卫生习惯并提高手卫生依从性提供有效的策略。”

亨利•福特的感染控制小组的灵感来源于英国圣约翰研究所对印度村庄的最新研究，发现利用情感激励因素比传统信息更有效地促进手卫生行为变化。

根据疾病预防和控制中心的数据显示，美国急诊医院每年有超过700000人发生医院感染。相关循证资料显示，有效的手卫生有助于减少感染的传播。尽管这些证据中医务人员手卫生依从性不足50%。

6月11-13日在北卡罗来纳州夏洛特市举行的 APIC 2016年会，是世界上最全面的感染预防会议，由来自世界各地近4000位专家和专业人士出席60多个教育会议和研讨会。会议旨在为感染预防专家、医生、研究人员、流行病学家、教育家、管理者和医疗技术人员提供可行策略，并可以马上实施，以改善预防方案和促进医疗安全。

英文原文

Visual Triggers Increase Hand Hygiene Compliance

Can you use the “ick factor” to get healthcare workers to clean their hands more often? Yes, according to a new study being presented on June 11 at the 43rd Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).

The infection control team at Henry Ford Health System in Detroit used images of bacterial growth to provoke feelings of disgust and motivate hospital staff to comply with hand hygiene guidelines. The team developed a book of images containing bacterial cultures of differing types and levels of contamination, as measured by Adenosine Triphosphate (ATP) meter readings. They tested the images on hospital units that had low hand hygiene compliance rates, and over a two-month period, they visited those units 10 times, sampled workers’ hands for bacteria, and then showed them pictures of cultures similar to the contamination on their hands. Compliance increased by between 11 and 46 percentage points in units where the study was conducted.

“Hospital staff wanted to wash their hands after looking at the book and picturing similar contamination on their own skin,” said Ashley Gregory, MSL (ASCP), an infection prevention specialist who co-led the project. “Using this example, other institutions may be able to change behavior and improve their hand hygiene compliance rates by influencing staff to connect the images of microbial contamination with non-adherence to hand hygiene guidelines.”

The program also motivated healthcare personnel (HCP) to take ownership of the environmental cleaning of their workspace. By comparing the ATP readings taken from phones, mobile work stations, and computer mouse devices to the photos in the book of germ images, HCP were able to visualize the contamination on the surfaces surrounding them.

“Hand hygiene is one of the most important ways to prevent the spread of infection, and yet it can be one of the most difficult benchmarks to improve,” said APIC 2016 president Susan Dolan, RN, MS, CIC, hospital epidemiologist, Children’s Hospital Colorado. “The visual nature of this approach proved successful for the team at Henry Ford Health System, and it may offer an effective strategy for other healthcare facilities that are looking for ways to change behavior and improve hand hygiene compliance.”

Henry Ford’s infection control team was inspired by new research from St. John’s Research Institute in the United Kingdom, which found that leveraging emotional motivators in Indian villages was more effective at promoting behavioral changes in hand hygiene than traditional messaging.

According to the Centers for Disease Control and Prevention, more than 700,000 healthcare-associated infections occur in U.S. acute care hospitals every year. It is well documented that effective hand hygiene helps reduce the spread of infections. Despite this evidence, HCP practice hand hygiene less than half of the times they should.

APIC 2016 Annual Conference, June 11-13 in Charlotte, N.C., is the most comprehensive infection prevention conference in the world, with more than 60 educational sessions and workshops led by experts from across the globe and attended by nearly 4,000 professionals. The conference aims to provide infection preventionists, physicians, researchers, epidemiologists, educators, administrators, and medical technologists with strategies that can be implemented immediately to improve prevention programs and make healthcare safer.

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[本文图片来源于互联网，如有侵权请告知]

图文编辑：小小牧童

审稿：马嘉睿 高晓东

狼头

这个用习大大洗手的图像就更好了

FS忘忧草

非常好的内容，感谢老师整理的笔记，感谢分享！

美丽感控

佩服老师们的不懈努力，才有这么好的文章和翻译！

ynosmile

利用视觉的方法提高手卫生依从性是行之有效的方法。印象比较深的是一次协作医院的医院感染课，在讲医院感染知识的同时少不了手卫生，把课件讲完后，大家反映印象最深的竟然是课件上的手卫生图片。