提高医务人员手卫生依从性的干预方法研究

Interventional Measures for Improving Hand Hygiene Compliance among Healthcare Workers

目的探讨提高医务人员手卫生依从性的有效方法,降低医院感染发生。方法自2005年起,采取多种干预措施提高医务人员的手卫生依从性,2005-2006年,采取改善手卫生设施、完善制度、组织培训的干预措施;2007年执行内部监督反馈制度;2008年引入了患者满意度调查的外部监督;2009年倡导患者手卫生行为;现场观察各年医务人员手卫生执行率,比较分析各年间医务人员手卫生依从性和医院感染发生率的差异。结果通过干预,2005-2009年医务人员手卫生依从性逐年上升,从33.29%上升至82.46%,医院感染发生率逐年下降,从6.05%下降至4.94%,差异有统计学意义(P<0.01)。结论改善手卫生设施、形式多样的反复培训、强化内外监督以及奖惩结合的管理是提高医务人员手卫生执行率合理、有效的干预方法。

OBJECTIVE To explore the efficient measures to improve hand hygiene compliance （HHC） among the healthcare workers and to reduce the incidence of nosocomial infections （INI）. METHODS Since 2005, we had taken various measures to improve HHC among the healthcare workers. From 2005 to 2006, we had improved facilities of hand hygiene, formulated ＂Guidelines of hand hygiene （GHH）.＂, and organized a variety of training courses. We had taken inside supervision of GHH implementation and feedback in 2007 and operated outside supervision mechanism through the ＂patient content survey＂ in 2008. Till 2009 we advocated the hand hygiene system among the patients. The hand hygiene rate （HHR） of healthcare workers was observed and evaluated. RESULTS HHR has risen from 33. 29% to 82. 46% （P〈0.01） and INI has fallen from 6. 05% to 4. 94% （P〈0.01） from 2005 to 2009 by the measures mentioned above. CONCLUSIONS Combined improvement of hand hygiene facilities, intensive training in various ways, and enhanced supervision system from inside and outside with administration system of awards and penalties, can be the efficient measures for improving HHR among healthcare workers.