Higiene de manos en urgencias: grado de cumplimiento, determinantes y su evolucion en el tiempo / Hand hygiene in the emergency department: degree of compliance, predictors and change over time

RESUMEN

Objetivo: Conocer el grado de cumplimiento (GC) de la higiene de manos (HM), sus factores determinantes y su evolución en el tiempo en un servicio de urgencias (SU). Método: Estudio transversal desarrollado entre 2005 y 2010 en el SU del Hospital General Universitario de Alicante. Un observador evaluó la realización de la HM según los 5 momentos de la Organización Mundial de la Salud (OMS). El estudio de asociación entre las variables explicativas (edad, sexo, disponer de solución alcohólica en formato de bolsillo, asistencia a sesiones formativas, conocer (..) (AU)

ABSTRACT

Objective: To determine the degree of compliance with hand hygiene measures, predictors, and change over time in an emergency department. Methods: Cross-sectional study between 2005 and 2010 in the emergency department of Hospital General Universitario de Alicante, Spain. An observer assessed staff compliance with the World Health Organization's 5-moments approach to hand hygiene. We also studied the association between compliance and such potential predictors as age, sex, availability of pocket-sized alcohol hand rubs, and attendance at training sessions; the Χ² test was used to compare compliance between the 2005-2007 and 2008-2010 periods. A multivariate logistic regression model was then constructed. Results: Compliance was observed in 41.1% in the 2005-2007 period and 42.3% in the 2008-2010 period. Hygiene at the moment before touching a patient improved significantly (16.3% in 2005-2007 and 29.8% in 2008-2010). The moment of best compliance was after touching patient surroundings (67.1% in 2008-2010). Factors associated with hand hygiene compliance changed over time with the exception of a stable association in both periods between hygiene at the moment before touching a patient and the availability of pocket-sized alcohol hand rubs. Conclusions: Emergency departments should seek improvements in hygiene by providing training on the importance of hand hygiene before a patient is touched, particularly before clean/aseptic procedures, and by promoting the use of pocket-sized alcohol rubs (AU)