ICU护士手卫生认知及依从性分析

Cognition and compliance of hand hygiene of ICU nurses

目的了解重症监护病房(ICU)护士手卫生认知、依从性及洗手方法,分析其影响因素,以减少医院感染的发生率。方法问卷调查结合现场观察法,对3所三甲医院ICU、儿童重症监护病房(NICU)、急诊重症监护病房(EICU)护士手卫生现状进行调查。结果 3所医院分别占90.26%、91.79%、92.82%的护士认为直接接触患者体液、有明显污迹污染、处理完污物后均应洗手;频繁洗手刺激皮肤是影响手卫生的最主要因素占65.51%,工作繁忙占48.21%;现场观察中使用一次性手套代替洗手占53.33%,直接接触患者前、后洗手仅占43.33%、63.33%,而下班前洗手100.00%。结论 ICU洗手设备较齐全,护士手卫生意识较强,但手卫生依从率仍较低,护士自我防护意识强于保护患者,故在加强手卫生监管同时,强化培训,转变服务于患者的观念。

OBJECTIVE To analyze the awareness and compliance of the hand hygiene among the nurses in the intensive care unit and observe the influencing factors so as to reduce the incidence of nosocomial infections. METHODS The questionnaire combined with on-site observation was adopted to study the status of hand hygiene of the nurses in the ICU, neonate intensive care unit （NICU）, and emergency intensive care unit （EICU） of three class A hospitals. RESULTS Totally 90.26%, 91.79%, or 92.82% of the nurses in the three hospitals thought that they should wash their hands after contacting the patient＇s body fluids; 65.51% thought the frequent hand- washing stimulated the skin, 48.21% were too busy too wash. The on-site observation found that 53.33 % wore the disposable gloves instead of washing hands, only 4a. 33% and 63. 33% washed their hands before and after direct contact with patients, but 100. 00% washed their hands after work. CONCLUSION The ICU is fully equipped with the washing facilities, the nurses can aware of the hand hygiene, but the hand hygiene compliance is low, the nurses knowledge about self--protection should be strengthened so as to intensify the idea of serving the patients.