医务人员手部卫生状况调查研究

Hand Hygiene among Clinical Medical Staff:A Survey Study

目的通过对医务人员手部卫生状况进行调查分析,寻找存在的问题并提出改进措施,从而降低医院感染的发生。方法通过问卷并结合现场观察手卫生过程和采样的方法对医务人员进行调查,调查内容包括洗手频率、洗手方法、干手方法、影响手卫生执行的相关因素、手卫生知识的知晓情况、洗手前后手的带菌情况等。结果有89.5%的医务人员接受过手卫生知识的培训,有97.6%的医务人员认为洗手可以减少医院感染,有1.1%的医务人员认为手卫生对临床治疗结果无影响;洗手前手部细菌总数平均为54.327 CFU/cm2,但洗手后手部带菌量明显减少,手部细菌总数平均为8.520 CFU/cm2(P<0.001);无菌操作组洗手前后手部细菌总数均低于总体水平(P<0.05),其余组与总体间洗手前后差异均无统计学意义;护士掌握正确洗手方法和洗手合格率明显高于医师(P<0.01)。结论临床医务人员存在着不重视手卫生和不规范洗手问题,应加强宣传教育,提高医务人员手卫生依从性,降低因手接触而引起的医院感染的发生率。

OBJECTIVE To investigate and analyze the hand hygiene status among clinical medical staff to find the problems and propose the improvement measures so as to reduce the incidence of nosocomial infection.METHODS The medical staff were investigated by questionnaire in conjunction with on-site observation of hand hygiene procedures and sampling methods.The irvestigated topics included hand-washing frequency,hand-washing methods,drying methods,related factors of affecting the implementation of hand hygiene,the awareness of hand hygiene knowledge,and the bacteria status in hand-carrying before and after hand-washing and so on.RESULTS 89.5% of the medical staff had accepted the education about the hand hygiene knowledge,97.6% of the medical staff considered washing hands could reduce the hospital infection,and only 1.1% of them considered hand hygiene had no relation to clinical treating result.Before hand washing the general bacterial count was 54.327 CFU/cm2,and after hand washing,the quantity of bacteria in hand-carrying was significantly lower,the general bacterial count was 8.520 CFU/cm2（P0.001）.The bacterial counts of aseptic group of hand-washing before and after were lower than the overall level（P0.05）,and the bacterial count of the other group showed no difference with the overall level between the hand-washing before and after.About the correct hand washing methods and passing rate of hand-washing,rate of nurse was significantly higher than that of the doctor.CONCLUSIONS There are the problems of neglect of hand hygiene and non-standard hand-washing methods among the clinical medical staff,so it′s very urgent to strengthen training and education,especially for the medical staff from emergency and medical technology departments.The hospital should strengthen education to enhance knowledge and awareness of hand hygiene,to improve hand hygiene compliance of medical staff and to reduce the incidence of nosocomial infection caused by hand contact.