基层医院医护人员洗手依从性现状及管理措施

Current status of hand-washing compliance of medical staffs in grass-root hospitals and administration strategies

目的调查医院医护人员手卫生及洗手依从性现状,探讨手卫生与医院感染的相关性,制定手卫生管理对策。方法随机抽查临床科室部分医护人员手污染的现状、了解医护人员手携带细菌的种类及性质,分析手污染的原因。结果医护人员在常规医疗活动中,手部细菌携带率为100.0%,洗手后细菌携带率为29.6%;携带的细菌主要是:大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、产碱假单胞菌、变形菌属、产气肠杆菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌和肠球菌属等。结论医护人员手部污染是医院感染的重要危险因素,必须强化医护人员预防医院感染的理念,提高对洗手的认知性和依从性,优化手卫生措施,有效预防与控制经手传播的医院感染。

OBJECTIVE To investigate the status of hand hygiene and hand-washing compliance of medical staffs and approach the correlation between hand hygiene and nosocomial infections to institute the administration strategy of hand hygiene.METHODS The random inspection of hand hygiene was performed for random selected medical staffs in clinical departments.The species of carrying pathogens were determined,and the reasons for contamination were analyzed.RESULTS The carrying rate of pathogenic bacteria before hand-washing was 100.0% while that after hand-washing was 29.6%.The carrying pathogenic bacteria mostly comprised of Escherichia coli,Klebsiella pneumouia,Pseudomonas aeruginosa,P.alcaligenes,Proteus,Enterobacter aerogenes,Staphylococcus aureus,coagulase negative Staphylococcus,Enterococci and so on.CONCLUSION The hand contamination is an important risk factor for nosocomial infections.We should strengthen hospital infections awareness of medical staffs,enhance the recognition and compliance of hand-washing and optimize hand hygiene measures to prevent and effectively control the nosocomial infections communicated through hands.