全国多中心医院病区手卫生设施现况

Current situation of hand hygiene facilities in Chinese multicenter hospitals

目的了解我国医院病区手卫生设施设置基本现状。方法2016年采用多中心研究方式,抽取全国14个省(市、自治区)不同级别(省、地、县)医院及军队医院,对其病区的手卫生设施进行现场调查,分析比较2010、2016年不同病区不同区域手卫生设施配备情况。结果与2010年相比,2016年医院洗手池的总设置率从69.30%上升至77.20%(χ~2=37.68,P<0.01);2016年医院病区水龙头开关以感应式为主(39.39%),其次为手拧式和脚踏式,分别占29.65%和17.67%;干手方式以纸巾为主,占77.30%。使用纸巾干手所占比率从2010年的38.45%上升至2016年的77.30%,自然晾干所占比率从18.65%降至8.04%。医院速干手消毒剂总配置率从2010年的50.47%上升至2016年的75.64%,差异有统计学意义(χ~2=402.46,P<0.01)。2016年不同病区不同区域速干手消毒剂配置率比较,差异均具有统计学意义(呼吸内科:χ~2=69.49,P<0.01;普通外科:χ~2=66.97,P<0.01;ICU:χ~2=88.52,P<0.01)。速干手消毒剂的配置率以治疗室配置的比率最高(呼吸内科、普通外科、ICU的治疗室分别达89.50%、88.50%和88.54%),普通病区患者房间内和病区走廊配置率较低(60%左右)。除病区走廊配置率在56.25%外,ICU其他区域速干手消毒剂配置率均在80%以上。结论与2010年相比,2016年医院病区洗手池与速干手消毒剂的配置率有所提高,水龙头开关与干手方式有所改进,但各病区区域手卫生设施配置不均,与医院感染防控要求尚有一定距离,仍应继续改进手卫生设施。

Objective To understand the current situation of hand hygiene(HH)facilities in China.Methods A multicenter study was conducted to select different levels of hospitals(province,district,and county levels)and army hospitals in 14 provinces(municipalities and autonomous regions).HH facilities in hospital wards were conducted field survey,installation of HH facilities in different sections of different wards in 2010 and 2016 were compared.Results The total installation rate of hand wash sink in hospital increased from 69.30%in 2010 to 77.20%in 2016(χ2=37.68,P<0.01);in 2016,the faucet switch in hospital wards was mainly inductive(39.39%),follows by hand-type and foot-type switch,accounting for 29.65%and 17.67%respectively;the main way of hand drying was use of paper towel,accounting for 77.30%.The rate of hand drying by using paper towel increased from 38.45%in 2010 to 77.30%in 2016,rate of hand drying naturally fell from 18.65%to 8.04%.The total equipping rate of alcohol-based hand rub in hospitals increased from 50.47%in 2010 to 75.64%in 2016,difference was statistically significant(χ2=402.46,P<0.01).In 2016,equipping rate of alcohol-based hand rub in different sections of different wards were all significantly different(department of respiratory disease medicine:χ2=69.49,P<0.01;department of general surgery:χ2=66.97,P<0.01;intensive care unit[ICU]:χ2=88.52,P<0.01).The equipping rate of alcohol-based hand rub in treatment room was the highest(treatment rooms in departments of respiratory medicine,general surgery,and ICU were 89.50%,88.50%,and 88.54%respectively),equipping rate of alcohol-based hand rub in patients’rooms and corridor of common wards was lowest(about 60%).Except for the corridor equipping rate was 56.25%,equipping rate of alcohol-based hand rub in other sections of ICU were all over 80%.Conclusion Compared with 2010,the equipping of hand washing basin,alcohol-based hand rub,faucet switch,and hand drying method have improved significantly in 2016,but allocation of HH facilities is uneven in different wards,it is necessary to improve HH facilities to meet the requirement of healthcare-associated infection prevention and control.