揭阳市二级以上综合医院医护人员手卫生执行情况及依从性调查

Compliance on hand-hygiene among medical staffs working at secondary and teriary general hospitals in Jieyang

目的了解揭阳市二级以上综合医院医护人员的手部卫生认知水平、手卫生执行情况及影响因素。方法现场观察医护人员手卫生执行情况,问卷调查医护人员的手部卫生认知水平和影响手卫生执行因素及改进措施。结果医护人员接触病人黏膜、破损皮肤或伤口前和直接接触病人前洗手执行率为36.76%和29.51%;直接接触病人前、后(x2=15.32,P=0.001),接触病人黏膜、破损皮肤或伤口前、后(x2=8.95,P=0.002)以及医疗护理前、后(x2=9.63,P=0.001)的洗手执行率差异均有统计学意义;洗手方式以使用洗手液为主,占65.63%;干手方式以一次性纸巾擦干为主,占62.54%;医生使用白大褂擦手明显多于护士(x2=4.46,P=0.03);医护人员一次洗手超过30 s仅占14.98%;工作忙、经常洗手损伤皮肤是影响手部卫生依从性的主要因素。结论医护人员手部卫生知识掌握较好,但洗手执行率偏低。加强培训和完善洗手设施,提供快速手消毒剂等措施,使手卫生制度执行规范化。

Objective To find out the cognitive level of medical staffs hand hygiene, hand hygiene execution conditions and influencing factors in Jieyang. Methods The hand hygiene compliance was observed in randomly sampled, the complexion of the medical staff hand hygiene and impact of hand hygiene execution factors and improvement measures were investigated by questionnaire. Results The medical staffs contact with the patient＇s mucous membranes, the broken skin or wounds and direct contact with patients wash their hands before implementation rate of 36.76 % and 29.51%; direct contact with patients before and after @2=15.32, P=0.O01） contact with the patient＇s mucous membranes, the broken skin or wounds before after（x2=8.95, P=0.002） as well as medical care（x2=9.63, P=-0.001）; the implementation rate differences of hand-washing were statistically significant;65.63 % of medical staffs washed hands with hand sanitizer and 62.54 % of the medical staffs dried hands with disposable paper towel; doctors used white coat towels significantly more than nurses （x^4.46,P=-0.03）; the medical staffs wash their hands more than 30 s accounted for only 14.98 %;heavy workload and often wash hands damage the skin were regarded as the most important factor that influenced the hand hygiene compliance. Conclusion The state of knowledge of hand hygiene among medical staffs was relatively good, but the hand hygiene compliance was low. The implementation of standardized hand hygiene system is through by the strengthen training and improve the hand-washing facilities, provide quick hand disinfectants and other measures.