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정재심,최정화,이순행,김양수 대한기초간호자연과학회 2003 Journal of korean biological nursing science Vol.5 No.2
The effect of hand hygiene was measured by hand culture before and after hand hygiene for 86 nurses, doctors, and nurses aide/housekeepers in Surgical Intensive Care Unit. The subjects were asked to press their dominant hand in hand-shaped Mannitol salt agar immediately after patient contact and then washed their hand by preferred hand hygiene agents [soap and water, waterless alcohol gel, or 4% chlorhexidine gluconate detergent(CHG)], and cultured one hand again. Amount of isolated microorganism was calculated by counting the number of divided areas(1 x 1cm) which is culture positive in hand culture plate. The amount of microorganisms were significantly reduced from 58.1(±38.59) to 27.4(±30.4) cells after hand hygiene. The staff nurse's hand hygiene was more effective compared to medical doctors and nurses aide/housekeepers. Methicillin-resistant Staphylococcus aureus(MRSA) was isolated in 41(47.1%) subjects ; but only removed 100% in 28(32.2%) subjects. When the amount of hand microorganisms was compared by subject's preferred hand hygiene agents, it was decreased in order of 4% CHG, waterless alcohol solution, soap and water, and water. The hand hygiene practice was inadequate to reduce hand microorganisms and significantly different by occupations. Further research and development of hand hygiene improvement program which emphasize the quality of hand hygiene is recommended.
정재심,임도연,박진희,우준희 대한의료관련감염관리학회 2010 의료관련감염관리 Vol.15 No.2
Background: This study aimed to assess the status of infection control during influenza A pandemic (H1N1) 2009. Methods: A questionnaire survey was conducted in November 2009 at the 100 hospitals designated by the Korea Centers for Disease Control and Prevention (KCDC) as influenza A pandemic (H1N1) 2009-treatment institutions. Results: In 32.3% of the hospitals, the ventilation system of the influenza A pandemic (H1N1) 2009 isolation ward was separated from the hospital’s ventilation system. With regard to wearing personal protective equipment while caring for patients with H1N1 infection, during usual patient contact, masks were always worn by all medical staff at all the hospitals; however, medical staff at 38.7% and 51.6% of the hospitals did not wear gloves and gowns, respectively. During aerosol-generating procedures, some medical staff wore surgical masks, whereas medical staff at 10% and 23.3% of the hospitals did not wear gowns and protective goggles, respectively. In all, 64.5% of the hospitals responded that the contents of the guidelines established by the KCDC were insufficient for reference purposes in actual practice. Conclusion: Some of influenza A pandemic (H1N1) 2009-treatment institutions are believed to be inadequate in facilities, infection control during patient treatment, and administrative measures among their efforts to prevent transmission in hospital. In preparation against the outbreak of similar diseases in the future, the government needs to establish guidelines highly applicable by medical staff, to secure exclusive spaces and personnel for treating infectious disease patients, and to develop personal protective gear support and management systems.
정재심,최준길,정인숙,인혜경,박기동,백경란,Jeong, Jae-Sim,Choi, Jun-Kil,Jeong, Ihn-Sook,In, Hye-Kyung,Park, Ki-Dong,Paek, Kyong-Ran 대한예방의학회 2007 예방의학회지 Vol.40 No.3
Objectives : This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. Methods : Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. Results : Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. Conclusions : This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to promote adherence to hand washing.
접촉주의 강화 및 적극적 감시배양 적용에 따른 중환자실에서의 메티실린내성 황색포도알균 감소효과
정재심,최승매,황동희,우준희 대한의료관련감염관리학회 2010 의료관련감염관리 Vol.15 No.2
Background: This study investigated the effectiveness of reinforced contact precautions and active surveillance cultures (ASCs) in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections (HAIs). Methods: A before- and after-experimental study was performed at the intensive care unit (ICU) in a university-affiliated hospital. Reinforced contact precautions were applied to all patients, and ASCs for MRSA were performed for newly admitted patients at the time of admission and once a week thereafter. The HAIs were investigated in accordance with the National Nosocomial Infections Surveillance (NNIS) definitions and compared before and after the interventions. The data were analyzed using descriptive statistics. Results: The number of HAIs caused by MRSA decreased from 2.2 to 0.5 per 100 patients discharged (P=0.02) and from 3.6 to 1.0 per 1,000 patient-days (P=0.032). The number of overall HAIs decreased from 7.6 to 4.0 per 100 patients discharged (P=0.011) and from 12.7 to 7.3 per 1,000 patient-days (P=0.034). The invasive device-associated infections caused by MRSA and other pathogens decreased, but the decrease was not statistically significant. Conclusion: Reinforced contact precautions and ASCs were effective in decreasing both MRSA infections and overall HAIs in the ICU. Further, it was assumed that the incidence of device-associated infections would have decreased if the intervention period was extended.