文档介绍：如何推动手卫生
手卫生有效吗?
In 1846, Ignaz Semmelweis observed that women whose babies were delivered by students and physicians in the First Clinic at the General Hospital of Vienna consistently had a higher mortality rate than those whose babies were delivered by midwives in the Second Clinic. Perhaps because of the known deodorizing effect of pounds, as of May 1847, he insisted that students and physicians clean their hands with a chlorine solution between each patient in the clinic. The maternal mortality rate in the First Clinic subsequently dropped dramatically and remained low for years.
Maternal Mortality due to Postpartum Infection
General Hospital, Vienna, Austria, 1841-1850
0
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1841
1842
1843
1844
1845
1846
1847
1848
1849
1850
Maternal Mortality (%)
MDs
Midwives
严格洗手后病死率的变化
Semmelweis’ Hand Hygiene Intervention
~ Hand antisepsis reduces the frequency of patient infections ~
Adapted from: Hosp Epidemiol Infect Control, 2nd Edition, 1999.
提高手卫生依从性可以降低MDRO Improved Hand pliance and Association with Reduced Incidence of Multidrug-anisms
A sustained improvement in pliance was associated with an ongoing decrease in HO MDRO rates across a large healthcare system; a similar decrease in C. difficile was not observed.
洗手?
在病区和诊室,
请立即停用固体肥皂!
手卫生设施不足
这些情景是否也发生在你的身边
干手方式“金标准”:
首选白大褂
次选甩手运动
但是,在很多医疗活动中,我们的手卫生依从性并不理想! 4%~100%
不同情景
接触病人前—21%
接触患者后—47%
接触不同的病人之间
接触体液后
做侵入性操作前
……
不同人群
医生--32%
护士—48%
工人
保洁
……
Erasmus V. Infect Control Hosp Epidemiol, 2010,31(3):283-294