护士工作站物体表面致病菌与护理人员手卫生现况调查

Investigation on pathogenic bacteria on the surface of nurse workstation and hand hygiene of nursing staff

目的探讨护士工作站物体表面病原菌与护理人员手卫生的相关性,为医院感染的预防控制提供参考。方法选取2016年6月医院25个科室护士工作站及50名护理人员,对护士工作站电脑键盘、鼠标、放置电脑的桌面前部三个部位在消毒前后分别采样,进行病原菌培养及菌株鉴定,同时随机对护理人员现场观察手卫生依从性,调查对手卫生的态度。结果 25个护士工作站物体表面在消毒前75个采样标本均有病原菌检出,其中金黄色葡萄球菌检出率最高为54.67%,枯草杆菌、不动杆菌、微球菌、大肠埃希菌、变形菌属、铜绿假单胞菌、溶血链球菌及其他致病菌检出率分别为46.67%、36.00%、29.33%、21.33%、10.67%、6.67%、5.33%、5.33%;护士工作站的键盘、鼠标及桌面消毒后检出菌量明显低于消毒前,比较差异有统计学意义(P<0.05);观察到护理人员应洗手次数共367次,实际洗手次数62次,依从性为16.89%;护理人员工作年限≥20年、职称为中高级、本科及以上文化程度者手卫生依从性,高于工作年限<20年、职称为初级、大专及以下文化程度者,比较差异有统计学意义(P<0.05);护理工作年限≥20年、职称为中高级者对手卫生的态度评分高于工作年限<20年、职称为初级者,比较差异有统计学意义(P<0.05)。结论护士工作站物体表面病原菌污染较为严重,与护理人员手卫生依从性及对手卫生的态度关系密切,应提高对护理人员的手卫生依从性及态度,定期对工作站进行消毒,降低污染。

OBJECTIVE To discuss the correlation between pathogenic bacteria on the surface of nurse workstation and hand hygiene of nursing staff,so as to provide guidances for the prevention and control of nosocomial infection.METHODS A total of 25 nurse workstations and 50 nursing staff from different departments in Jun.2016 were selected.The computer keyboard,mouse and the front part of the computer desktop were sampled separately before and after disinfection,and the pathogenic bacteria were cultured and identified.The hand hygiene compliance of nursing staff was randomly observed,and their attitudes to hand hygiene were investigated.RESULTS Totally all 75 specimens from the surface of 25 nurse workstations were detected of pathogenic bacteria before disinfection,the detection rate of Staphylococcus aureus was 54.67%,and the detection rates of Bacillus subtilis,Acinetobacter,Micrococcus,Escherichia coli,Proteus,Pseudomonas aeruginosa,Streptococcus haemolyticus and other pathogenic bacteria were 46.67%,36.00%,29.33%,21.33%,10.67%,6.67%,5.33%,and 5.33%,respectively.The detection bacteria rate of keyboard,mouse and desktop after disinfection were significantly lower than those before disinfection,and the difference was statistically significant（P〈0.05）.It was observed that the nursing staff should wash their hands 367 times,but the actual number was 62 times,and the compliance was 16.89%..The hand hygiene compliance of nursing staff working for≥ 20 years,with intermediate or senior title,and with education level of bachelor or higher were higher than those with working period20years,junior title,and with education level of junior college or lower,and the difference was statistically significant（P0.05）.The scores of attitude to hand hygiene of nursing staff with working period≥ 20 years and with intermediate or senior title were higher than those with working period 20 years and junior title,and the difference was statistically significant（P0.05）.CONCLUSION The pathogenic bacteria on the surface of nurse workstation was serious,and was closely related with hand hygiene compliance and the attitude to hand hygiene of nursing staff.It should improve the hand hygiene compliance and attitude of nursing staff,periodically disinfect the workstation,and reduce pollution.