精细化管理ICU医护人员手卫生依从性中的应用

Application of fine management in hand hygiene compliance of ICU nurses

目的:探讨集束化护理干预策略对提高ICU医护人员手卫生依从性的影响。方法:对医护人员实施精细化管理:(1)建立管理机构;(2)改善设施;(3)患者问询制;(4)检查落实,榜样激励法;(5)组织全员培训。将2014年1~12月未实施的医护人员作为实施前,2015年1~12月实施精细化管理的医护人员作为实施后,实施前后要求调查员每周不定期对科室医护人员手卫生依从性至少观察调研两次,每次观察至少5人,每人至少观察10 min。对实施前后医护人员手卫生依从性进行比较分析。结果:实施后医护人员手卫生依从率为83.56%,明显高于实施前的53.66%,差异有统计学意义(P<0.05)。结论:精细化护理可提高ICU医护人员手卫生依从性,减少院内感染的发生。

Objective ： To discuss the influence of cluster nursing intervention strategy on increase of hand hygiene compliance of ICU nurses. Methods： Fine management was carried out medical personnel： （1） establish a management institution. （2） improve the facilities. （3） establish inpatient enquiry system. （4） check the implementation of related regulations, and carry out example motivation method;and （5） organize the training of entire staff. The medical personnel not receiving fine management from January to December 2014 were taken as the objects of observation before implementation of fine management, and the medical personnel receiving fine management from January to December 2015 were takes as the objects of observation after implementation of fine management. The investigator was required to irregularly observe the hand hygiene compliance of medical personnel from different departments at least two times a week before and after implementation of fine management, and at least 5 medical personnel should be observed, and each person was observed for at least 10 minutes. Then, the hand hygiene compliance of medical personnel was compared and analyzed before and after implementation of fine management. Results： The medical personnel after the implementation of fine management had their hand hygiene compliance up to 83.56%, significantly higher than 53.66% before the implementation of fine management, and the difference was statistically significant （ P 〈 0.05 ）. Conclusion ： Fine nursing could improve the hand hygiene compliance of ICU medical personnel and reduce the cross infection in the hospital.