“120”救护车手卫生相关状况的观察研究

An observational study of hand hygiene in 120 ambulance service

目的 深入了解某省会城市“120”救护车的手卫生设施及出诊工作者的手卫生执行情况.方法 采用世界卫生组织标准监督观察表,跟车对某省会城市4所急救分中心“120”救护车的手卫生设施及出车工作者的手卫生行为进行现场观察.结果 21 d观察7辆救护车80次出诊发现,救护车手卫生设施配置与摆放有限;出现手卫生机会656次,总体依从性3.04％,接触患者前、清洁无菌操作前、可能接触患者体液后、接触患者后及接触患者周围环境后的依从性分别为0（0/291）、1.96％（1/51）、13.64％（3/22）、5.21％（16/307）、0（0/2）.结论 “120”院前急救手卫生状况不容乐观,亟待加强培训,促进患者安全和职业防护.

Objective To investigate into hand hygiene facilities and worker＆#39;s practice of hand hygiene during 120 ambulance services in a capital city.Methods With the standard Observation Form publicized by the World Health Organization,field observation was carried out to monitor hand hygiene facilities and the practice of hand hygiene in workers during ambulance services provided by four service centers.Results A total of seven ambulances and 80 times of services were observed across a span of 21 days.The provision and position of hand hygiene facilities were found very limited in these ambulances.Of 656 times of presence of indictors for hand hygiene,the overall compliance rate was 3.04% reflecting the practice of hand hygiene in ambulance workers.The compliance rate was found to be 0 （0/291）,1.96% （1/51）,13.64% （3/22）,5.21% （16/307） and 0（0/2） before touching patients,after body fluids exposure risk,before clean/aseptic procedures and after touching patients＆#39; surroundings respectively.Conclusions Poor practice of hand hygiene which was revealed in 120 ambulance services suggests the great need for education and training to improve patient safety and occupational health.