强化医护人员手卫生干预对急诊患者感染的影响

Impact of strengthening interventions to hand hygiene of health care workers on infections in emergency department patients

目的分析强化医护人员手卫生干预对急诊患者感染的影响,降低急诊患者的医院感染率。方法选择2013年1月-2014年12月进行急诊抢救的患者180例,医院于2014年1月开始强化医护人员手卫生干预,按患者院前急救时医护人员是否行手卫生干预分为两组,对照组和干预组各90例,比较两组患者的感染率、医护人员的手卫生依从性和医护人员手卫生知识的掌握。结果对照组26例患者发生医院感染,感染率28.89%,而干预组仅14例发生医院感染,感染率15.56%;干预组患者肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、变形菌属等检出株数明显少于对照组,差异有统计学意义(P<0.05);干预后医师、护士、其他临床人员、其他非临床人员的手卫生依从率分别为87.50%、68.57%、63.64%和55.56%,明显高于干预前58.33%、42.86%、36.36%、27.78%,差异有统计学意义(P<0.05);干预后医护人员洗手方法、洗手重要性、洗手指征及总得分明显高于干预前,差异有统计学意义(P<0.05)。结论强化医护人员手卫生干预可以提高医护人员手卫生知识的掌握,提高其手卫生依从性,降低急诊患者感染率。

OBJECTIVE To observe the effect of strengthening interventions to hand hygiene of health care workers on infections in emergency department patients so as to reduce the incidence of nosocomial infections in the emer- gency department patients. METHODS A total of 180 patients who were treated in the emergency department from Jan 2013 to Dec 2014 were enrolled in the study. The intervention to the hand hygiene of the health care workers was strengthened by Jan 2014, the enrolled patients were divided into the control group and the intervention group according to the status of the health care workers＇ taking the interventions to hand hygiene at pre-hospital emergen- cy treatment, with 90 cases in each group. The incidence of infections was compared between the two groups of patients, and the hand hygiene compliance and awareness of hand hygiene knowledge of the health care workers were observed. RESULTS The nosocomial infections occurred in 26 patients in the control group, with the infection rate of 28.89 %; the nosocomial infections occurred in only 14 patients in the observation group, with the infection rate of 15.56%. The number of the isolated Klebsiella pneurnoniae, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, or Proteus spp strains was significantly smaller in the intervention group than in the con- trol group （P〈0.05）. The hand hygiene compliance of the doctors, nurses, other clinical staff, and other non- clinical staff was respectively 87.50%, 68.57%, 63.64%, and 55.56% after the intervention, significantly high- er than 58.33%, 42.86%, 36.36%, and 27.78% before the intervention （P〈0.05）. The hand washing method, importance of hand washing, hand washing indications, and total scores of the health care workers were signifi- cantly higher after the intervention than before the intervention （P〈0.05）. CONCLUSION Strengthening the in- terventions to hand hygiene of the health care workers can facilitate the understanding of hand hygiene knowledge of the health care workers, raise the hand hygiene compliance, and reduce the incidence of infections in the emergency department patients.