頁籤選單縮合
題名 | 某醫學中心門診醫檢人員戴手套抽血執行酒精性乾洗手之評估=Evaluation of Hand Rubbing on Gloves in an Outpatient Phlebotomy Station in a Medical Center |
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作者 | 趙雪嵐; 吳冠陞; 林惠賢; 陳瑞光; 李欣蓉; 謝依倫; 李靜嫻; 柯金美; 盧惠華; 黃煜琇; 陳月汝; 陳垚生; | 書刊名 | 感染控制雜誌 |
卷期 | 23:1 2013.02[民102.02] |
頁次 | 頁14-24 |
分類號 | 419.38 |
關鍵詞 | 酒精性乾洗手; 菌落數; 乳膠檢診手套; Alcohol-based hand rub; Bacterial load; Latex examination gloves; |
語文 | 中文(Chinese) |
英文摘要 | The reuse of gloves is currently a controversial issue and is not recommended in the 2009 WHO hand hygiene guidelines. Important questions such as how many times gloves can be reused and how to effectively decontaminate gloved hands between patients while maintaining patient safety and the protective function of the gloves remain unanswered. In Taiwan, laboratories in the outpatient clinic face an enormous patient load requiring phlebotomy. Adherence to hand hygiene in accordance with the World Health Organization (WHO) guidelines becomes unfeasible in practice due to the time constraint and heavy workload. The aim of this study was to evaluate glove integrity and the microbial efficacy of decontamination by alcohol hand rubbing on latex examination-gloved hands between patients. In the setting of performing phlebotomies in outpatient clinics, the experimental group wore gloves without change while using alcohol hand rubs between patients. Control group A followed the WHO guidelines, changing gloves and performing alcohol hand rubs between patients. Control group B neither changed gloves nor practiced hand hygiene between patients. After phlebotomies were performed in 5, 10, and 20 patients, the gloved and degloved hands were cultured for common pathogens (gram-negative bacteria and Staphylococcus aureus). Glove integrity was tested by filling the gloves with ink-stained water. Eight phlebotomy technicians participated in the study, each performing the protocol in the experimental and control A and B groups, timing each protocol. The median total bacterial colony count of gloved hands in the experimental and control A and B groups were 2, 605, and 1160 colony-forming units (CFU). The bacterial colony counts found for the degloved hands were the reverse of this. In control group B, S. aureus (2 CFU) and methicillin-resistant S. aureus (6 CFU) were cultured from degloved hands. In the experimental group, there was a significant increase in bacterial colony count on gloved hands after performing phlebotomy on 5 patients as compared to that of control group B (p = 0.03) and in the total bacterial colony count between the experimental group and control group A (p<0.001). However, there was no significant difference in the bacterial counts on degloved hands in either group (p=0.08). Glove integrity was lower in the experimental group (83.3%) than in control group A (97.8%) (p<0.001). Decontamination by using alcohol hand rubs on gloved hands between patients effectively lowers bacterial counts, but at the cost of its protective efficacy, reducing glove integrity. |
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