医护人员对隔离病房多重耐药菌患者实施治疗护理时手卫生依从性状况调查分析

Investigation of the medical personnel's hand hygiene compliance when taking care of the patients infected with multidrug resistant organism in the isolation room

目的探讨医护人员对隔离病房多重耐药菌(multidrug resistant organism,MDRO)患者实施治疗护理时手卫生依从性状况。方法调查本院5个重症监护室中治疗护理单间隔离MDRO患者的医生136名、护士282名的手卫生依从性状况。了解医务人员手卫生依从性、医护人员对不同隔离时间MDRO患者手卫生依从性情况、医护人员不同洁手方法及在实施不同操作时手卫生依从性情况。结果医护人员手卫生执行率为66.08%,MDRO患者隔离时间>14d的医护人员手卫生依从性最高(80.27%),7-14d的较低(61.11%),<7d的最低(55.15%);医护人员在出隔离室时手卫生依从性最高(90.23%),手从污染部位移至清洁部位时手卫生依从性最低(39.73%);医护人员使用速干手消毒剂洗手法多于用皂液洗手法。结论医护人员治疗护理MDRO患者手卫生依从性较高,但还未完全达标,需要通过加强管理及培训教育等方法提高医护人员的手卫生依从性。

Objective To investigate the hand hygiene compliance（HHC）in medical staff who work in the isolation ward treating patients with multidrug resistant organisms（MDRO）.Methods A total of 136 doctors and 282 nurses who worked in 5 ICUs taking care of patients infected with MDRO in isolation ward were investigated on their hand hygiene compliance,including their ways of hand-washing,their hand hygiene compliance when dealing with MDRO patients with different segregation intervals and doing different manipulations.Results The ratio of HHC of medical staff was 66.08%.The HHC ratio of medical staff was highest in MDRO patients with isolation time 〉14 d（80.27%）,lower in those during 7-14 d（61.11%） and lowest in those 〈7 d（55.15%）.Alcohol-based products were more used to wash hands than soaps.The best HHC was 90.23% when health care personnel left the isolation ward,and the worst was 39.73% when their hands moved from the contaminated sites to clean parts.Conclusions HHC in medical personnel is good but is still below the standard.Management should be strengthened and more training and education are needed to raise the HHC.