外科免刷式洗手次数对手消毒效果的影响度研究

Study on the influence degree of hand-washing frequency on the brushless rub hand-disinfection effection in surgical department

目的:研究外科免刷式揉搓法洗手次数对手消毒效果的影响程度,为制定外科免刷式手消毒的临床路径提供较为科学的参考依据。方法:将207人随机分为对照组和实验组,各组均采用免刷式揉搓法进行洗手和消毒手。对照组有1、2、3遍洗手,实验组设有4个小组,实验1、2组为洗手2遍后分别用不同消毒液消毒手1遍,实验3组为消毒手1遍后洗手1遍,实验4组为洗手1遍后消毒手1遍,分别手部采样、送检、培养48小时后计菌落数,以统一标准判断洗手与消毒手的合格率。结果:对照组洗手(消毒手)合格率依次为50%、54. 1%、58. 3%,洗手次数每增加1遍,其合格率提高约4. 1%,两者呈正相关;实验各组消毒手合格率均为100%,与对照组比较P<0. 001,与洗手次数无关。结论:洗手次数对手消毒效果的影响程度取决于是否进行手消毒。揉搓洗手时,洗手次数对洗手(手消毒)合格率有一定的影响,即洗手(手消毒)合格率随着洗手次数的增加而升高;揉搓洗手+手消毒时,手消毒合格率与揉搓洗手及其次数无关,洗手次数对手消毒合格率无影响,对医疗单位制定外科免刷式手消毒的临床路径有一定的参考价值。

Objective: To study the influence degree of hand-washing frequency on the brushless rub hand-disinfection effection in surgical department. Provide a scientific basis for the development of clinical routes for surgical brushless hand disinfection. Methods: The subjects were randomly divided into a controlled group and an experimental group. The subjects' hands and arms of each group was washed and disinfected with a form of brushless rubbing method. In controlled group,the subjects' hands and arms were respectively washed once, twice, and three times. In experimental group, there were four subgroups. In the first and second subgroups of the experiment group, the subjects' hands and arms were washed twice ,then disinfected with Ai fu Jia or Jie Fu Rou.In the third subgroup, the subjects' hands and arms were disinfected with any kind of qualified disinfectant, then washed once. In the fourth subgroup, the subjects' hands and arms were washed once, then disinfected with any kind of qualified disinfectant. and then sampled and submitted according to the standard of hand sampling method, then observed the number of sample colonies after 48 hours of culture. Results: The pass rate of the hand washing (disinfecting hand) in the controlled group was respectively 50%, 54.1% and 58.3%. For each additional number of hand washings, the pass rate increased by about 4.1%, their relationship were positively correlated. Compared with the controlled group, the pass rate of the disinfection hands in each subgroup of the experimental group was 100%( P <0.001), regardless of the number of hand washings. Conclusions: The degree of impact of hand washing on the disinfection effect depends on whether or not hand disinfection is performed. The number of hand washing has a certain influence on the passing rate of hand washing (hand disinfection), that is, the passing rate of hand washing (hand disinfection) increases as the number of hand washing increases when brushless washing hand only usded. When both washing hands and hands disinfection used, the hand disinfection rate is irrelevant to whether or not the hand washing is used or repeated. The number of hand washings has no effect on the disinfection rate. It has certain reference value for the medical unit to develop a clinical path of surgical brushless hand disinfection.