不同干手方法对医护人员手二次污染的研究

Secondary pollution of medical staff's hands by using different hand-dry methods

目的:防止临床医护人员洗手后由于干手方法选择不当导致的二次污染,规范医护人员的干手方法,探讨规范的人性化干手措施。方法:随机选择临床科室医护人员200名,随机分为A、B、C、D四组,A组采用自然晾干法,B组采用干手纸巾法,C组采用干手器烘手法,D组采用个人毛巾法,对洗手前、后和不同方法干手后的手细菌污染情况进行观察对比。结果:四组医护人员接触病人后洗手前,手细菌数无统计学差异;按六步洗手法洗手后,均洗手合格,手细菌数无统计学差异;但采用不同的干手法后,手细菌数有很大差异:自然晾干法手细菌数为(0.29±0.58)cfu/cm2、干手纸巾法细菌数为(0.51±0.73)cfu/cm2、干手器烘手法细菌数为(5.76±4.11)cfu/cm2、个人毛巾法细菌数为(7.33±5.58)cfu/cm2。A、B两组比较,P>0.05,说明采用自然晾干法与干手纸巾法,手细菌数无统计学差异;A、B两组与C、D两组比较,均得到P<0.05,说明采用自然晾干法、干手纸巾法比个人毛巾法、干手器烘手法的细菌数少,用个人毛巾擦手和干手器烘手对手存在二次污染,且手部污染菌大多是多重耐药菌,与医院感染的细菌具有一致性。结论:干手措施是保证手卫生质量的关键环节,采用干手纸巾法和自然晾干法可有效降低医护人员洗手后对手部的二次污染,从而有效降低因医护人员手污染而导致的医院多重耐药菌感染发生率。

Objective： To keep the clinical medical staff＇s hands from secondary pollution caused by using different hand-dry methods after washing hands, to standardize the hand-dry methods of medical staff and to explore a normative and humaanized hand-dry method. Methods： Totally 200 clinical medical staff were randomly recntited and divided into 4 groups,namely A,B,C, and D. We used natural air method in Group A, hand-dry paper towel method in Group B,hand-drier method in Group C, and personal towel method in Group D. We observed and compared the bacteria pollution state in hands of 4 groups before and after washing hands.Results： The number of bacteria before washing hands after contacting with patients and after washing hands in 4 groups had no significant difference （P〉0.05）. But after washing hands by using different hand-dry methods, the number of bacteria in hands in four groups had obvious difference. The number of bacteria in group A, B, C and D were 0.29±0.58, 0.51±0.73, 5.76±4.11, and 7.33±5.58 respectively. The difference between Group A and B had no significance（P〉0.05）, but the difference between Group A, B and Group C, D had significance （P〈0.05）. There was a secondary pollution by using personal towel method and hand-drier method. Most of pollution bacteria in hands were multiple medicine resistance bacteria which were consistent with the infected bacteria in hospitals. Conclusion：Hand-dry method is a key link to ensure hands health quality. Hand-dry paper towel method and natural air method can effectively reduce the secondary pollution of bacteria in hands after washing hand and reduce the infection of multiple medicine resistance bacteria caused by the hands pollution of medical staff.