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[资料] Gloves Are No Guarantee Your Doctor’s Hands Are Clean

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发表于 2012-1-31 11:41 | 显示全部楼层 |阅读模式

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本帖最后由 桃子妖妖 于 2012-1-31 11:45 编辑

Warning: Those latex gloves your doctor is wearing may be covered in germs.

A new study of hand hygiene in hospitals found that wearing latex gloves makes health care workers less likely to clean their hands before and after treating patients. The finding is concerning, researchers say, because germs can travel through latex gloves, and because they’re often worn when doctors work with bodily fluids and the sickest, most infectious patients. Taking off latex gloves can also cause a “back spray” effect, in which fluids and germs are snapped back onto the wearer’s hands.

As a result, doctors and nurses who don’t wash up after using latex gloves can spread infections through contaminated hands, said Dr. Sheldon Stone, lead author of the study and a senior lecturer in the department of medicine at the Royal Free Campus of University College London Medical School.

“If you’re a patient, you assume that if someone is wearing gloves they’re being careful and protecting you from infection,” he said. “But in fact, their hands could be very dirty.”
The study, published in the December issue of the journal Infection Control and Hospital Epidemiology, is the largest to look at glove use in hospitals and their effect on hand hygiene. The researchers looked at more than 7,000 doctor-patient interactions in 56 wards across 15 hospitals in England and Wales.

The researchers found that the overall hand-washing rate — regardless of whether gloves were worn — was just 47.7 percent, similar to compliance rates for hand hygiene in American hospitals, which average about 40 percent. But when gloves were used, the latest study found, hand washing in the 15 hospitals that were part of the research went down even further, to about 41 percent.(国内情况也许只有比这更糟糕)

“Gloves are often used when in contact with bodily fluids or the most infective patients, like MRSA patients,” Dr. Stone said. “So in the patient group or the clinical situation where you’re more likely to pick up potentially spreadable germs, health care workers are actually less likely to clean their hands afterward.”

The study found that health care workers wore gloves in roughly a quarter of all contacts with patients, and in 60 percent of those cases did not clean their hands either before or after treating the patient. Many of the interactions that were observed in the study took place in intensive care wards filled with elderly patients.

“These are all heavily dependent patients, and they’ve got the highest risk of having an infection when they’re in the hospital,” Dr. Stone said. “You want to be particularly careful around this population, and yet we’re seeing that hand disinfection before gloving is really very poor.”

It was unclear why doctors, nurses and other hospital workers were less likely to wash or disinfect their hands before and after donning gloves. But Dr. Stone and his colleagues speculated that they might be influenced by a widespread misconception that gloves are impermeable to pathogens. While gloves do lower the rate of hand contamination, germs can still get through. Dr. Stone said he and his colleagues wanted to dispel the myth and get across to hospital workers the idea of “The Dirty Hand in the Latex Glove.”(这个观念需要向医护人员尤其是保洁、护理工人们灌输)

“We want health care workers to avoid it,” he said. “It’s gross. And it’s not just a British phenomenon. I’m sure if you went all over you would find it.”

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发表于 2012-2-1 16:35 | 显示全部楼层
医护人员对乳胶手套的认识显然没有到这个层次。
这也就是一直在强调:脱手套后要洗手!
谢谢桃子老师的分享!
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发表于 2012-2-2 01:10 | 显示全部楼层
我简单翻译了一下,主要想锻炼一下自己英文阅读能力,水平有限,欢迎大家批评指正:

警告:这些你们医院医生佩戴的乳胶手套可能布满细菌!

  一项新的医院手卫生研究发现,佩戴乳胶手套使卫生保健工作者不太可能在治疗病人前后清洁他们的双手。关于这一发现,研究者说细菌可以穿过乳胶手套,是因为当医生与体液、最恶心的东西以及大多数传染病病人接触时会穿戴它们。脱去乳胶手套也会产生“回喷”效应,液体和细菌被回喷溅到穿戴着手上。

  Sheldon Stone博士(此研究的主要作者,其同时又是伦敦大学医学院附属Royal Free Campus医院医学部高级讲师)说:“使用乳胶手套后不洗手的医护人员可以通过污染的手传播感染”。他还说:“假如你是一个患者,某人正小心翼翼的带着手套,为的是保护你免受感染,然而事实上他们的手可能会非常的脏”。

  这项发表在12月的《感染控制与医院流行病学》杂志的研究,给予医院手套的使用情况以及它们在手卫生方面起到的作用以前所未有的关注。研究者观察了英国和威尔士15所医院56所病房7000多例医生与患者的相关交互作用。

  研究人员发现,不管是否戴手套,整体洗手率只有47.7%,这与美国医院手卫生平均40%的达标率相似。但是最新的研究发现,当穿戴手套时,在15家医院的洗手情况进一步下降到约41%。

  Stone博士说:“在与体液或大部分感染性疾病患者接触时经常会用到手套,例如MRSA感染者。因此在患者组或临床情况下,你更有可能沾染潜在的细菌,医护工作者实际上不太可能时候清洁双手。”

  研究发现,医护工作者戴手套机会约占所有与病人接触机会的1/4,这些案例中有60%是在治疗病人前后未清洁他们的双手。一些人在研究中观察到接触重症监护病房的老年患者普遍存在此类现象。

  Stone博士说:“这些都是严重依赖(医疗装备)的患者,并且当他们在医院的时候他们已经承受着最高的医院感染风险。你想特别小心对待这个群体,但是我们发现在穿戴手套前进行手消毒真的做的很差。”

  目前尚不清楚为什么医生、护士和其他医院工作人员不太可能在戴脱手套前后清洗或消毒他们的双手,但斯通博士和他的同事推测,这可能是由于一个普遍的误解,就是佩戴手套可以防止病原体渗入。虽然手套污染手的概率较低,但细菌仍然可以通过。Stone博士说,他和他的同事们想消除这个神话,并传达给医院工作人员“乳胶手套中有双肮脏的手”的思想。(完)

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