基于扎根理论的医务人员手卫生执行影响因素及改进措施分析

Analysis on influencing factors and improving measures of hand hygiene implementation among healthcare workers based on the Grounded Theory

目的探讨医务人员手卫生执行影响因素及改进措施。方法 2016年6月—8月,采用立意抽样法选取某院在岗医务人员和各级医院医院感染管理科专职人员进行个人深入访谈。参照扎根理论的定性分析方法对转录资料进行三级编码,利用Nvivo 8软件整理访谈资料、编码并撰写备忘录。结果共调查111人,其中医务人员89人,医院感染管理科专职人员22人。通过三级编码抽象出医务人员手卫生执行重要影响因素6个,并将其进一步归属为个人认知、行为能力和社会支持3个层面,最终通过核心编码构建出整体理论框架。结论临床工作中应采取合理措施加强在职医务人员手卫生培训,改善手卫生设施,强化监督管理,切实提高手卫生执行率。

Objective To explore the influencing factors and improving measures of hand hygiene among healthcare workers. Methods From June to August 2016, several healthcare workers from clinical departments and nosocomial infection control department in Chengdu were selected by purposive sampling method. Data was collected by individual in-depth interviews, and was three-rank coded by Nvivo 8 software based on Grounded Theory. Results After three-rank coding, 6 important influencing factors were generalized which were re-categorized into 3 levels： personal cognition, behavior capacity and social support. At the last, the whole framework of the theory was constructed through core coding. Conclusion In clinical practice, we should take reasonable measures to strengthen the training of hand hygiene, improve the hand hygiene facilities, strengthen supervision and management, and effectively improve the implementation rate of hand hygiene.