医療現場における手指衛生の評価

抄録

Hand hygiene of healthcare workers (HCWs) in hospitals may basically be achieved according to the guideline published by Center for Disease Control and Prevention (CDC, USA) in 2002. However, in some cases, the compliance rate of the hand hygiene practice of HCWs in daily healthcare seems to be low because of several reasons. A questionnaire survey of 60 HCWs at Social Insurance Omiya General Hospital revealed that 96.7% of them have skin chapping on their hand, and they practice hand hygiene inadequately. Colony forming unit (CFU) examination carried out by the glove-juice method after hand washing using medicated soap showed no significant reduction of the baseline CFU count. An alcohol-based disinfection by means of individual methods of HCWs significantly reduced the baseline CFU count; however, the CFU value varied widely depending on individual HCW. In contrast, the alcohol-based disinfection carried out under procedural direction resulted in a high-rate reduction of the baseline CFU count, approximately 1/20 of that obtained before procedural direction. It was, therefore, noticed that the selection of an agent according to the purpose of hand-hygiene and the periodic procedural direction for its usage are important to accomplish efficient hand hygiene for HCWs in hospitals.