儿科医务人员手卫生干预效果评价

Effect of hand hygiene interventions of health care workers of pediatric department

目的通过开展手卫生教育干预活动,提高儿科医务人员手卫生依从性。方法按照WHO手卫生改善策略实施干预,采用观察法监测干预前342个手卫生时点和干预后328个手卫生时点医务人员手卫生依从性,统计快速手消毒剂、洗手液消耗量,用ATP监测手卫生合格率。结果经过手卫生干预,儿科医务人员手卫生依从率从24.0%提高至47.9%;护士手卫生依从率从干预前的26.3%提高至52.3%,医师手卫生依从率从干预前的17.9%提高至39.3%;体液暴露后时点医务人员手卫生依从率最高,其次是在无菌操作前;在接触患者后及接触患者周围物品后医务人员手卫生依从率均较低;快速手消毒剂和洗手液每床位日消耗量和手卫生ATP合格率干预后明显提高。结论 WHO手卫生改善策略在我国医疗机构中也是适用和有效的。

OBJECTIVE To conduct the hand hygiene campaign of medical staff in the pediatric department so as to improve the pediatric medical staff hand hygiene compliance .METHODS The WHO hand hygiene improvement strategy was implemented to improve hand hygiene compliance to 342 hand hygiene opportunities before the intervention and 328 after the intervention .The effect of hand hygiene campaign were collected and evaluated by the questionnaire of WHO hand hygiene observation ,consumption of alcohol-based hand rub （AHR） ,liquid soap , and the quality of hand hygiene by adenosine triphosphate （ATP） test .RESULTS The hand hygiene compliance increased significantly from 24 .0% to 47 .9% after the intervention . The hand hygiene compliance of nurses increased from 26 .3% to 52 .3% after the intervention ,and that of doctors increased from 17 .9% to 39 .3% .The hand hygiene compliance of the medical staff was the highest at the time point of exposure to body fluid ,followed by the time point before the aseptic operation ;the hand hygiene compliance of the medical staff was low before the conduct with the patients or with the surrounding objects of the patients .The consumption of AHR and the ATP pass rate raised significantly after the intervention .CONCLUSION The WHO strategy and derived tools are evidence-based and ready-to-use in planning and conducting hand hygiene promotion in medical institutions in China .