BACKGROUND Hand hygiene compliance even before infection-prone procedures (indication 2, 'before aseptic tasks', according to the World Health Organization (WHO)) remains disappointing. AIM To improve hand hygiene compliance by implementing gloved hand disinfection as a resource-neutral process optimization strategy. METHODS We performed a three-phase intervention study on a stem cell transplant ward. After baseline evaluation of hand hygiene compliance (phase 1) gloved hand disinfection was allowed (phase 2) and restricted (phase 3) to evaluate and differentiate intervention derived from learning and time effects. The incidence of severe infections as well as of hospital-acquired multidrug-resistant bacteria was recorded by active surveillance. FINDINGS Hand hygiene compliance improved significantly from 50% to 76% (P < 0.001) when gloved hand disinfection was allowed. The biggest increase was for infection-prone procedures (WHO 2) from 31% to 65%; P < 0.001. Severe infections decreased by trend (from 6.0 to 2.5 per 1000 patient-days) whereas transmission of multidrug-resistant organisms was not affected. CONCLUSION Gloved hand disinfection significantly improved compliance with the hand hygiene, especially in activities relevant to infections and infection prevention. Thus, this process optimization may be an additional, easy implementable, resource-neutral tool for a highly vulnerable patient cohort.

中文翻译：

---

戴手套的手消毒对干细胞病房中易于感染的程序之前的手卫生的影响。

背景技术甚至在易于感染的程序之前（根据世界卫生组织（WHO）的指示2，“在无菌任务之前”）的手卫生依从性仍然令人失望。目的通过实施带手套的手部消毒作为资源中和的过程优化策略来提高手部卫生要求。方法我们对干细胞移植病房进行了三个阶段的干预研究。在对手卫生依从性进行基线评估（第1阶段）之后，允许戴手套的手部消毒（第2阶段）并限制使用手套式手消毒（第3阶段），以评估和区分源自学习和时间影响的干预措施。通过主动监测来记录严重感染的发生率以及医院获得的耐多药细菌的发生率。研究发现手部卫生状况从50％显着提高到76％（P <0。001）允许戴手套的手消毒。增加幅度最大的是易感染程序（WHO 2），从31％增至65％；P ＜0.001。严重感染呈下降趋势（从每1000病人日的6.0下降到2.5），而耐多药微生物的传播不受影响。结论戴手套的手消毒可大大改善手卫生的依从性，尤其是在与感染和预防感染有关的活动中。因此，对于高度脆弱的患者群体，此过程优化可能是附加的，易于实现的，资源中立的工具。每千个病人日5个），而耐多药生物的传播不受影响。结论戴手套的手消毒可大大改善手卫生的依从性，尤其是在与感染和预防感染有关的活动中。因此，对于高度脆弱的患者群体，此过程优化可能是附加的，易于实现的，资源中立的工具。每千个病人日5个），而耐多药生物的传播不受影响。结论戴手套的手消毒可大大改善手卫生的依从性，尤其是在与感染和预防感染有关的活动中。因此，对于高度脆弱的患者群体，此过程优化可能是附加的，易于实现的，资源中立的工具。