今年,世卫组织的“挽救生命:清洁双手”运动的重点是在照护机构采取适当的手部卫生措施。
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2020年在许多方面都是史无前例的,其中之一就是在与SARS-CoV-2斗争中对适当的手部卫生习惯给予了极大的关注。手部卫生最终获得了决策者,管理者,医护人员和公众的全球认可,这是预防感染的基石。世界卫生组织(WHO)在全球COVID-19大流行的背景下,发动了“拯救生命:清洁双手”运动以及“水,清洁和卫生( WASH)运动。
在大流行的背景下,世卫组织发起了几项举措,包括新的世卫组织和联合国儿童基金会全民手卫生计划(https://www.who.int/water_sanitation_health/sanitation-waste/sanitation/hand-hygiene-for-all/en /)作为一种全社会方法,不断改善手部卫生习惯,以制止SARS-CoV-2的传播并维持大流行以外的良好习惯。为实现这些目标,应在医疗保健和公共场所提供适当的基础设施,包括学校和公共交通工具,并且所有关键参与者均应采取适当的行为来洗手。
今年,世卫组织的“挽救生命:清洁双手”运动的重点是在照护机构采取适当的手部卫生措施。多年来,这一直是世卫组织提供卫生保健过程中世卫组织患者安全战略的核心,但现在比以往任何时候都更为重要。此外,2021年被指定为国际卫生保健工作者年(https://www.who.int/campaigns/annual-theme/year-of-health-and-care-workers-2021):重点是对他们的保护也是最重要的。
在护理时有效实施手部卫生措施的首要前提是“系统改变”,这意味着在护理时应提供适当的基础设施和用品,以便卫生工作人员可以在需要时及时清洁双手。这就需要不间断地提供优质的酒精基洗手液(ABHR),清洁水,肥皂,一次性毛巾和足够数量的功能性水槽。虽然有效的感染预防与控制(IPC)计划在卫生保健设施应符合世界卫生组织最低要求,2020年全球WASH报告显示,有三分之一的手部卫生设备没有在适当的医疗点。最近的一项系统评价显示,在低收入国家中,危重病人的护理过程中手部卫生依从性仅为9%。如此令人震惊的数据,再加上持续不断的COVID-19大流行,凸显了迫切需要进一步努力以增强全球合规性并倡导最佳实践。尽管开始提供疫苗,但手部卫生和适当使用个人防护设备对于COVID-19和非COVID-19患者的安全护理仍然至关重要。
有效的手部卫生不仅可以减轻与医疗保健有关的感染的负担,而且还可以减少抗菌素耐药性的传播,而且还是安全的COVID-19疫苗接种的关键IPC措施。ABHR是卫生保健中手卫生的首选方法,因为它在护理时很容易获得,可以快速杀死微生物(在20-30秒内),并且皮肤可以很好地耐受。这些优势可以帮助克服遵守法规的行为障碍。鉴于当前的短缺,许多国家已经使用世卫组织推荐的配方,成功地将本地ABHR生产建立为设施内的低成本替代品。
为了强调通过实施最佳医疗保健实践挽救生命的迫切需要,2021年5月5日的口号是“第二次挽救生命–清洁双手”(图1)。世卫组织的运动呼吁采取行动的关键利益攸关方(表1),在当前状况和更广泛的意义上,他们在护理现场实现最佳手部卫生方面都可以发挥关键作用,如“手部卫生”所倡导的那样,有助于加强社会的主动参与。
所有信息均可在WHO WHO SAVE LIVES:“清洁双手”活动网页(https://www.who.int/campaigns/save-lives-clean-your-hands)上找到,其中包括一个宣传工具包,提供有关该运动目标的指导,重要消息以及如何参与其中。
Full Text
The year 2020 was unprecedented in many ways, one of which was the tremendous attention given to appropriate hand hygiene practices in the fight against SARS-CoV-2. Hand hygiene has finally gained global recognition from policy-makers, health managers, health care workers and the general public as a keystone in infection prevention. The World Health Organization (WHO) placed increased focus on hand hygiene in the context of the global COVID-19 pandemic, in addition to its longstanding efforts through both the global SAVE LIVES: Clean Your Hands campaign and the Water, Sanitation and Hygiene (WASH) Programme.
In the context of the pandemic WHO launched several initiatives, including the new WHO and UNICEF Hand Hygiene for All initiative (https://www.who.int/water_sanitation_health/sanitation-waste/sanitation/hand-hygiene-for-all/en/) to consistently improve hand hygiene practices as a whole-of-society approach to stop the spread of SARS-CoV-2 and sustain good practices beyond the pandemic. To achieve these goals, adequate infrastructures should be provided in health care and public settings, including for example schools and public transportations, and appropriate behaviour to clean hands when needed should be taken by all key players.
This year, WHO's SAVE LIVES: Clean Your Hands campaign focuses on achieving appropriate hand hygiene action at the point of care. This has been at the core of WHO patient safety strategies during health care delivery for many years, but is now more critical than ever. Furthermore, 2021 has been designated the International Year of Health and Care Workers (https://www.who.int/campaigns/annual-theme/year-of-health-and-care-workers-2021): focusing on their protection is also paramount.
The first prerequisite for effective implementation of hand hygiene action at the point of care is “system change” meaning that the appropriate infrastructure and supplies should be available at the point of care so that health workers can clean their hands promptly when needed. This requires reliable and uninterrupted provision of good-quality alcohol-based handrub (ABHR), supplies of clean water, soap, single-use towels and an adequate number of functioning sinks. Although effective infection prevention and control (IPC) programmes in health care facilities should meet WHO minimum requirements [1], the 2020 global WASH report revealed that one in three facilities do not have adequate hand hygiene stations at the point of care [2]. A recent systematic review showed that hand hygiene compliance is only around 9% during care of critically ill patients in low-income countries [3]; such shocking data, in conjunction with the ongoing COVID-19 pandemic, highlight the urgent need for additional efforts to strengthen global compliance and champion best practices. Although vaccines are starting to be delivered, hand hygiene and appropriate use of personal protective equipment remain crucial for safe care of both COVID-19 and non-COVID-19 patients.
Effective hand hygiene not only reduces the burden of health care-associated infections and the spread of antimicrobial resistance but is also a key IPC measure for safe COVID-19 vaccination [4]. ABHR is the preferred method for hand hygiene in health care as it can be easily accessible at the point of care, kills microorganisms quickly (within 20–30 seconds) and is well tolerated by the skin. These advantages can help to overcome behavioural barriers to compliance. In the light of current shortages, many countries have successfully established local ABHR production as a low-cost alternative within facilities, using WHO-recommended formulations [5].
To highlight the urgent need to save lives by implementing best practices in health care delivery, the slogan for 5 May 2021 is “Seconds save lives – clean your hands” (Figure 1). The WHO campaign calls to action key stakeholders (Table I) who can play critical roles in achieving optimal hand hygiene at the point of care, in both the current situation and a broader sense, helping to strengthen society involvement as promoted by the Hand Hygiene for All initiative.
All the information is available on the WHO SAVE LIVES: Clean Your Hands campaign webpage (https://www.who.int/campaigns/save-lives-clean-your-hands), including an advocacy toolkit offering guidance on the campaign's objectives, key messages and how to get involved.
原文链接:
https://www.sciencedirect.com/science/article/pii/S0196655321001152
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