医护人员手卫生执行情况及相关影响因素分析

Field observation of hand hygiene compliance among medical staffs before contacting patients and its impact factors

目的:了解在临床工作的医护人员对洗手认识及行为的情况,并探讨分析相关影响因素。方法:以问卷形式调查医护人员对主动洗手相关影响因素的认识,配合暗中观察其洗手行为。结果:医护人员执行平均洗手率为37.1%,快速手消毒剂(ABHR)的洗手率仅为3.1%;医护人员手卫生执行率与其洗手意识、是否提供和使用快速手消毒剂以及洗手设施是否完善相关:洗手率较高的医护人员意识较强、且较多使用快速手消毒剂(P<0.05);接触患者前和接触患者之间洗手率与有无洗手槽及离病房远近、是否提供擦手纸巾、有无热水等设施有明显相关性(P<0.05),接触患者后洗手率与此却无统计学意义上的相关性(P>0.05);医护人员手卫生执行与病房内是否提供快速手消毒剂也无统计学意义上的相关性。结论:应提高医护人员对洗手重要性的再认识,有针对性改善病房内洗手条件,提高医护人员对快速手消毒剂的接受度,从而真正有效地提高医护人员的洗手依从性。

Objective：To understand the knowledge and action on hand-washing among medical staffs in the clinical work,and to investigate its impact factors.Methods：The questionnaire method was used to investigate the midical staffs in recognizing the related impact factors of initiative hand-washing,and coordinated with observing their concrete operation in secret.Results：The average handwashing compliance in medical staff was 37.1% ,much higher than that （3.1%） in medical staff with alcohol-based hand rub（ABHR）.It was demonstrated that the consciousness on han-washing,the presence of the ABHR and perfecting hand-washing equipment made great sense statistically in the hand hygiene compliance before contacting patients.The medical staffs of higher hand-washing rate had strogner consciousness and used ABHR more（P〈0.05）.The water trough of hand-washing,the distance to the ward,the paper towel for hand-washing and hot water made great sense statistically in the hand-washing compliance before contacting patients and in contacting patients （P〈 0.05）.The hand-washing rate had no statistical correlation from those above mentioned after contacting patients （P〉0.05）.The ABHR had no statistical correlation from hand hygiene compliance among medical staff.Conclusion：It can be concluded that it is essential to strengthen the consciousness on hand-washing among medical staff,enlarge the continuous investment for specific hard-ware improvement and improve the acceptance degree of medical staff on ABHR.Thus it can improve the dependence of medical staffs really and effectively.