院长查房提高医务人员手卫生依从性

Ward round presided over by hospital director to improve health care workers' hand hygiene compliance

目的探讨医院感染管理科(院感科)参与业务院长查房对某基层医院医务人员手卫生执行情况的影响。方法调查该院2012年1—6月(对照组:院感科未参与业务院长查房)和2013年1—6月(实验组:院感科参与业务院长查房)手卫生执行情况,比较两组医务人员手卫生依从率及各科室手卫生用品消耗量。结果实验组医院感染例次率(1.49%)显著低于对照组(2.01%)(χ2=4.31,P<0.05);医务人员手卫生依从率为71.56%(3 249/4 540),显著高于对照组的44.00%(1 914/4 350)。实验组和对照组护士手卫生依从性均高于医生(χ2分别为151.30、179.92,均P<0.001);实验组各科室手卫生依从性由高至低依次为儿科、妇产科、外科、内科。实验组和对照组快速手消毒剂消耗量分别为5.38 mL/床日、1.88 mL/床日,洗手液消耗量分别为11.51 mL/床日、7.03 mL/床日。结论将手卫生纳入业务院长查房内容,取得院领导的重视,可明显提高医务人员手卫生依从性,降低医院感染发生率,确保医疗安全。

Objective To investigate the influence of participation of healthcare-associated infection （HAI）man-agement department in ward round presided over by hospital director on hand hygiene compliance of health care workers （HCWs）in a basic-level hospital.Methods Implementation of hand hygiene in January-June 2012 （control group ：HAI management department didn’t participate ward round）and January-June 2013 （trial group ：HAI management department participated ward round）were investigated,the compliance of hand hygiene of two groups of HCWs and consumption of hand hygiene products of each department were compared.Results HAI case rate in trail group was significantly lower than control group （1.49% vs 2.01% ）（χ2= 4.31,P〈0.05）;HCWs’hand hy-giene compliance rate was significantly higher than control group （71 . 56% [3 249/4 540 ]vs 44. 00% [1 914/4 350]）,hand hygiene compliance rates in nurses were higher than doctors of both groups（χ2= 151.30,179.92, respectively,bothP〈0.001）,hand hygiene compliance rate in trial group from high to low was department of pedi-atrics,obstetrics and gynecology,surgery,and internal medicine. The consumption of rapid hand disinfectant of trail group and control group was 5.38mL/bed-day and 1.88 mL/bed-day respectively,the consumption of hand sanitizer was 11.51 mL/bed-day and 7.03 mL/bed-day respectively.Conclusion Hand hygiene checked during the ward round presided over by hospital director can improve HCWs’hand hygiene compliance,reduce the incidence of HAI,and ensure medical safety.