J CI标准下儿童外科医护人员手卫生时间点执行情况调查

Survey on the Implementation Status of Hand Hygiene of Medical Staff at Time Points in Pedi-atric Surgery under JCI Standard

【目的】调查医疗机构评审联合委员会国际部（joint commission international，JCI）标准下儿童外科病房医护人员手卫生时间点执行情况，分析JCI标准下手卫生管理制度对儿童外科医护人员手卫生执行率的影响。【方法】2013年1月连续7个白昼工作时间段，对本院骨科、泌尿外科、普外科、新生儿外科等共6个儿童外科病区100名医务人员（医生25名，护士75名），按照JCI标准下手卫生管理要求进行现场调查，参照WHO《医务人员手卫生指南》，对调查对象在手卫生时间点的洗手行为进行统计分析，并与2012年同期手卫生执行率比较。【结果】记录835次需实施手卫生情况，实际实施手卫生586次，执行率为70．18％，显著高于本院2012年同期执行率（70．18％ vs 51．30％，P＜0．05）。护士手卫生总执行率（76．98％）高于医生手卫生总执行率（63．34％），医护不同时间点手卫生执行率有较大差异（P ＜0．05）。【结论】JCI标准下手卫生管理制度强调细节管理，注重培训，能进一步提高医务人员手卫生意识，规范医务人员手卫生行为，促进手卫生执行率的提高。

[Objective]To investigate the implementation of hand hygiene of medical staff at time points in pediatric surgical ward under joint commission international（JCI）standard,and to analyze the effect of hand hygiene management system under JCI standard on implementation rate of hand hygiene of medical staff in ped-iatric surgery.[Methods]According to JCI standard,spot investigation was performed for 100 medical staff （25 doctors and 75 nurses）in 6 pediatric surgical departments including orthopedics,urinary surgery,general surgery and neonatal surgery of our hospital at 7 consecutive day work time in Jan.2013.With reference to hand hygiene directory for medical staff by WHO,handwashing behavior of all subjects at time points of hand hygiene was analyzed by statistical method,and compared with implementation rate of hand hygiene at the same period in 2012.[Results]The implementation status of hand hygiene was recorded for 835 times,and the actual implementation of hand hygiene was 586 times.The implementation rate was 70.18%,which was markedly higher than that at the same period in 2012（51.30%）（P〈0.05）.The total implementation rate of hand hygiene of nurses was 76.98%,which was higher than that of doctors（63.34%）.There was significant difference in the implementation rate of hand hygiene at different time points between nurses and doctors（P〈0.05）.[Conclusion]Hand hygiene management system under JCI standard emphasizes the detail management and pays attention to training in order to further improve the knowledge of hand hygiene,standardize hand hy-giene behavior and promote the improvement of implementation rate of hand hygiene of medical staff.