多途径观察医务人员手卫生依从性的比较研究

Comparison of hand hygiene compliance of health care workers observed through multiple methods

目的了解隐蔽式观察法调查手卫生依从性的现况,比较医务人员隐蔽式观察法与直接观察法及监控观察法获取的手卫生依从率,为进一步提高手卫生依从性提供有效监测方法及手段。方法收集某院监控观察法、隐蔽式观察法、直接观察法获取的手卫生依从性数据及手卫生用品消耗量,观察人员均经统一培训,探讨3种方法与手卫生消耗量的相关性。结果不同观察法获取的手卫生依从率差异有统计学意义(χ^(2)=17.401,P<0.001);直接观察法手卫生依从率最高,为95.08%;隐蔽式观察法手卫生依从率最低,为50.83%。新生儿科手卫生用品消耗量最高,为119.14 mL/床日,儿科手卫生用品消耗量最低,为10.39 mL/床日。监控观察法(r=0.975,P=0.005)与隐蔽式观察法(r=0.949,P=0.012)与手卫生用品消耗量具有较好相关性,隐蔽式观察法显示手卫生依从率最高的科室为新生儿科,为90.00%。结论可采用综合监控观察法及手卫生用品每床日消耗量的方法,间接反映真实的手卫生依从性。

Objective To investigate the current status of hand hygiene(HH)compliance with concealed observation method,compare compliance rates of HH of health care workers(HCWs)obtained through concealed observation method,direct observation method and monitoring observation method,provide effective surveillance methods and means for further improving HH compliance.Methods Data about HH compliance and HH products consumption in a hospital obtained through monitoring observation method,concealed observation method,and direct observation method were collected,all observed HCWs have received unified training,the correlation among three me-thods and HH consumption were explored.Results Differences in HH compliance rates obtained by different observation methods were statistically significant(χ^(2)=17.401,P<0.001).The direct observation method had the highest HH compliance rate at 95.08%,while the concealed observation method had the lowest HH compliance rate at 50.83%.The daily consumption of HH products was highest in department of neonatology,at 119.14 mL/bed-day,and lowest in department of pediatrics,at 10.39 mL/bed-day.The monitoring observation method(r=0.975,P=0.005)and the concealed observation method(r=0.949,P=0.012)had a good correlation with the consumption of HH products.The concealed observation method showed that the department with the highest HH compliance rate was department of neonatology,at 90.00%.Conclusion The actual HH compliance can be indirectly reflected by comprehensive monitoring observation method and the consumption of HH products per bed-day.