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DOI: 10.1055/s-2001-15102
Compliance der Händedesinfektion auf Intensivstationen
Compliance with hand hygiene in intensive care unitsPublication History
Publication Date:
31 December 2001 (online)
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Grundproblematik und Fragestellung: Nosokomiale Infektionen stellen im Krankenhaus ein erhebliches Problem dar. Auf deutschen Intensivstationen liegt die Prävalenz bei 15,3 %. Adäquat durchgeführte Händehygiene ist der wichtigste Faktor, um eine Reduktion von nosokomialen Infektionen zu erreichen. Vor diesem Hintergrund stellen sich folgende Fragen: 1. Wie hoch ist die Compliance der Händedesinfektion auf Intensivstationen? 2. Welchen Einfluss hat die personelle Ausstattung auf die Händedesinfektion?
Methode: In einer prospektiven Beobachtungsstudie wurde im Mai 1996 und im November 1997 auf acht Intensivstationen die Compliance der Händedesinfektion beobachtet. Infektionsrelevante Handlungsabläufe waren Umgang mit Beatmungsgeräten, Gefäß-Zugängen, Harnwegkathetern und Wundverbänden. Zusätzlich wurden die Anzahl der Patienten und des Pflegepersonals erfasst und der Patienten-Pflegepersonal-Schlüssel berechnet.
Ergebnisse: Insgesamt wurden 1879 hygienerelevante Handlungen beobachtet. Die Compliance lag zwischen 25,7 und 83,2 % (Mittelwert 55,2 %). Die am häufigsten beobachteten Handlungen waren Manipulationen an Gefäß-Zugängen (52,7 %), die höchste Compliance der Händedesinfektion konnte bei Manipulationen am Beatmungszubehör beobachtet werden (91,8 %). Bei ungünstigerem Patienten-Pflegepersonal-Schlüssel sank die Compliance nicht, sondern veränderte sich kaum bzw. stieg zum Teil an.
Folgerungen: Die Compliance der Händedesinfektion ist vergleichbar mit anderen Studien, ist aber auf einigen Stationen noch stark verbesserungsfähig. In dieser Studie ist die Compliance eher stationsspezifisch als vom Patienten-Pflegepersonal-Schlüssel abhängig.
Compliance with hand hygiene in intensive care units
Introduction: Nosocomial infections are an important problem in modern hospitals. The prevalence in German intensive care units is 15.3 %. Hand washing or hand disinfection is believed to be the most important means of preventing nosocomial infections. We wished to answer the following questions: 1. How good is the compliance of hand hygiene on intensive care units? 2. Is compliance associated with the patient/nurse-ratio?
Method: In a study of 8 intensive care units the compliance of hand hygiene was observed on two occasions, once in May 1996 and again in November 1997. The prime necessity for hand disinfection occurred when handling ventilation devices, intravascular catheters, urinary catheters and dressings. In addition the patient/nurse-ratio was calculated.
Results: A total of 1,879 infection-relevant handlings were observed. The compliance of hand hygiene ranged from 25.7 to 83.2 % (mean 55.2 %). The most commonly observed handlings were the manipulation of venous catheters (52.7 %), the highest compliance was observed with the manipulation of ventilation equipment (91.8 %). With a better patient nurse ratio the compliance did not improve but remained the same or was even reduced.
Discussion: The compliance of hand disinfection is similar to other study results, but on some intensive care units there was considerable room for improvement. In this study the compliance of hand hygiene is more of a constant factor in individual intensive care units than associated with the patient/nurse-ratio.
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Korrespondenz
Tim Eckmanns
Institut für Hygiene Zentralbereich
Krankenhaushygiene und Infektionsprävention
Heubnerweg 6
14059 Berlin
Phone: 030/450570005
Fax: 030/450570904
Email: tim.eckmanns@charite.de