监测手卫生用品消耗量对提高医务人员手卫生依从性的调查研究

Investigation of hand hygiene products consumption monitoring to improve hand hygiene compliance of medical personnel

目的探讨监测手卫生用品每床日消耗量对医务人员手卫生依从性、医院感染发病率的影响，间接了解医务人员手卫生的执行率。方法院感专职人员及各临床科室的感控员，每月不定期对医务人员手卫生的执行情况进行观察并记录，统计手卫生用品每床日的消耗量，每季度进行反馈；2012年1至12月设为对照组，对手卫生用品每床日消耗量监测的2013年1至12月设为观察组，比较对照组与观察组手卫生用品每床日的消耗量、医院感染例次率、医务人员洗手的依从率。结果对手卫生用品消耗量监测后，医务人员手卫生依从性较监测前明显提高，医生由34．3％提高至62．8％，护士由53．5％提高至78．1％，差异有统计学意义（P〈0．01）；各科室速干手消毒剂、抗菌皂液平均每床日消耗量由监测前的2．7ml、4．9ml，分别提高至监测后的6．44ml、9．78ml，差异有统计学意义（P〈0．01）；护士手卫生依从性高于医生，各科手卫生依从性由高到低依次为儿科、妇产科、骨科、脑外科、内科、普外科。结论监测手卫生用品消耗量，定期反馈通报，能够促进医务人员提高手卫生执行的依从率，降低医院感染发病率。

Objective To investigate the impacof hand hygiene productconsumption monitoring on hand hygiene compliance of medical personnel, the incidence of nosocomial infections, and to indirectly understand the rate of implementation of medical staff hand hygiene. MethodFull-time staff of nosocomial infectionand infection controllerof all clinical departmentobserved and recorded the implementation condition of medical staff hand hygiene time to time monthly. Counted hand hygiene productconsumption pebed peday, quarterly feedback. Hand hygiene productconsumption pebed peday from January to Decembe2012 waseacontrol group, hand hygiene productconsumption pebed peday from January to Decembe2013 waseaobservation group. Compared hand hygiene productconsumption pebed peday, the rate of nosocomial infections, the compliance rate of medical staff hand washing. ResultAftehand hygiene productconsumption monitoring, the compliance of medical staff hand hygiene significantly improved （doctors： 62.8% vs.34.3%; nurses： 78.1% vs.53.5%）, with statistically significandifference（P〈0.01）. The pebed peday consumption of alcohol-based hand disinfectant, antibacterial soap of all departmentbefore monitoring were 2.7 ml, 4.9 ml respectively, those aftemonitoring were 6.44 ml, 9.78 ml, with statistically significandifference（P〈0.01）. Nursehand hygiene compliance wahighethan doctorhand hygiene compliance, departmentin descending ordeof hand hygiene compliance were pediatrics, obstetricand gynecology, orthopedics, neurosurgery, internal medicine, general surgery. Conclusion Hand hygiene productconsumption monitoring and regulafeedback can improve the compliance of medical staff hand hygiene, reduce the incidence of nosocomial infections.