门诊3种洗手液应用效果评估及医务人员手消毒依从性调查

Effect of 3 kinds of hand washings and investigation of the hand disinfection dependence in outpatient staffs

目的为门诊手消毒提供洗手液选择的依据,对医护人员手消毒依从性差的原因进行分析。方法根据给予洗手液的不同,将门诊医师及护师共248人(医师160人、护师各88人)随机分为A组(洁芙柔免洗手消毒凝胶)、B组(威露士健康洗手液)、C组(卫华汉得福消毒液)3个研究组,以及D组(肥皂水,对照组),3个研究组及对照组每组各62人(医师40人、护师各22人)。对比各组洗手前后菌落数、干手时间及手部皮肤评分。并评价医护人员对手消毒的依从性。结果与本组洗手前比较,洗手后4组菌落数均明显减少,差异均有统计学意义(P<0.05)。组间比较,A组洗手后菌落数少于其他3组(P<0.05)。3个实验组间平均干手时间比较,差异无统计学意义(P>0.05)。洗手后1个月,B组手部皮肤自评分优于其他3组,差异均有统计学意义(P<0.05)。导致医护人员对手消毒依从性差的原因包括工作忙节奏太快、干手时间长浪费时间、对洗手剂使用不了解、皮肤干燥龟裂不适、医源性感染认识不足;护师依从性优于医师,差异有统计学意义(P<0.05)。结论 3种常用洗手液均能达到有效的杀菌目的,威露士可以推荐用于门诊常规手消毒。护师对手消毒的依从性优于医师。

Objective To provide basis in hand washings selecting and analyze the reasons of negative dependence in doctors and nurses. Methods Two hundred and forty-eight outpatient staffs,which including 160 doctors and 88 nurses,were divided into four different groups by different hand washings： Group A with Jifro hand antiseptic wash free gel,Group B with Walch hand washing,Group C with Weihua antiseptic liquid,and Ggroup D is soap liquid as control group,62 cases（ 40 doctors and 22 nurses） in each group. Bacterial colony,hand drying time and hand skin assessment were observed. The hand disinfection dependence in doctors and nurses was assessed. Results The bacterial colony was decreased in the four groups before and after hand washing（ P〈0. 05）. Compared with the other three groups,the bacterial colony in Jifro group was lowest（ P〉0. 05）. The hand drying time in three grous was the same（ P〈0. 05）. The hand skin assessment in Walch group was better than the other groups（ P〈0. 05）. The hand disinfection dependence analysis showed that too busy,do not know the method and doses of hand washings,do not understand the hospital infection completely and wash hands in time in nurses were better than in doctors（ P〈0. 01）. Conclusion The three hand washings were effectively in hand hygiene,Walch was prior selection. The hand disinfection dependence in doctors was worsen than nurses.