3种不同处理因素对医务人员手卫生依从率的影响

Influence of three different handling factors in health care workers' hand hygiene compliance rate

目的探讨不同处理因素对临床医务人员手卫生依从率的影响。方法选择2012年7—12月某院8个临床科室作为研究对象,7月份对其进行手卫生依从率本底资料调查;8—10月,对其中6个临床科室免费提供手消毒剂＋综合干预,其中2个科室仅采取综合干预;11—12月对入选科室仅采取综合干预,不免费提供手消毒剂。比较医护人员手卫生依从率及医院感染情况。结果 2012年7—12月临床科室手卫生依从率为59.50%,各月份手卫生依从率比较,差异有统计学意义（P〈0.01）,其中7月份手卫生依从率最低（36.73%）;采取免费提供手消毒剂＋综合干预措施后,各月份医务人员手卫生依从率（57.20%-72.08%）明显提高,且取消免费手消毒剂后,各月份手卫生依从率（65.20%-65.50%）仍维持在较高水平。8—10月各科室手卫生依从率（45.41%-73.63%）均高于7月份（18.97%-47.17%,均P≤0.05）;除重症监护室（ICU）北区外,11—12月各科室手卫生依从率（61.67%-72.73%）高于7月份（均P〈0.05）。医院感染率由7月份的3.39%降至11—12月的1.75%,呈下降趋势（χ^2=5.122,P=0.024）。结论免费提供手消毒剂对提高医务人员手卫生依从性有积极推动作用,但不是必要条件;反复强化医务人员手卫生意识是提高手卫生依从性的关键措施。

Objective To investigate the influence of different handling factors in the hand hygiene compliance rate of health care workers＇（HCWs）.Methods Eight clinical departments in July-December 2012 were selected for study,the baseline data of hand hygiene in July were investigated.In August-October,6 departments were provided free hand disinfectant,only 2 departments took comprehensive intervention measures;in November-December,all selected hospitals took intervention measures,but without being provided free hand disinfectant.Hand hygiene compliance rates among HCWs were compared.Results The overall hand compliance rate of HCWs in July-December 2012 was 59.50%,hand compliance rate of different months were significantly different（P〈0.01）,compliance rate was lowest in July（36.73%）,after providing free hand disinfectant plus performing comprehensive intervention,hand compliance rates of different months increased obviously（57.20%-72.08%）;When disinfectant was not provided free,compliance rate in each month still maintained a high level（65.20%-65.50%）;compliance rates in August-October were all higher than July（[45.41%-73.63%]vs [18.97%-47.17%]）（all P≤0.05）;except north section of intensive care unit（ICU）,compliance rates in November-December（61.67%-72.73%）were both higher than July（both P〈0.05）.Healthcare-associated infection rate decreased from3.39%in July to 1.75%in November-December（χ^2=5.122,P=0.024）.Conclusion Providing free hand disinfectant can promote HCWs＇ hand hygiene compliance,repeated stressing hand hygiene awareness is the key measure to improve hand hygiene compliance.