行为转变理论对提高医护人员手卫生依从性的临床研究

A clinical study on behavioral change theory in improving hand hygiene compliance of medical staff

目的探讨行为转变理论对提高医护人员手部卫生知识及手卫生依从性的影响。方法2016年1—12月选取180例本院医护人员应用行为转变理论进行手部卫生知识及洗手依从性宣教，比较实施前后医护人员手部卫生知识及手卫生依从性情况。结果实施后医护人员对6步洗手法、洗手时间、洗手次数、洗手材料、洗手范围等知识知晓率分别为98．89％、97．77％、96．67％、97．22％、95．55％，高于实施前的82．22％、83．33％、78．89％、78．89％、77．22％，差异均有统计学意义（均P〈0．05）。实施后医护人员洗手依从率、洗手方法正确率、手部卫生合格率及患者满意率分别为95．55％、97．78％、98．88％、94．0％，高于实施前的86．11％、82．78％、82．22％、75．0％，差异均有统计学意义（均P〈0．05）。而实施后手部菌落检出率低于实施前（1．11％比17．78％，P〈0．05）。结论行为转变理论可提高医护人员手部卫生知识知晓率，提高医护人员洗手依从性及洗手卫生合格率，有助于预防医源性感染的发生。

Objective To explore the effect of behavioral change theory in improving hand hygiene knowledge and hand hygiene compliance of medical staff. Methods 180 cases of medical staff were applicated of behavioral change theory for hand hygiene knowledge and hand-washing compliance from January 2016 to December 2016. The health knowledge and hand hygiene compliance of medical staff before and after implementation were compared. Results The awareness rates of medical staff on the 6-step washing method, hand washing time, hand washing times, hand washing materials, hand washing range and other knowledge after implementation were 98.89%, 97.77%, 96.67%, 97.22%, 95.55%, higher than those before implementation （82.22%, 83,33%, 78.89%, 78.89%, 77.22%） （P〈0.05）. The compliance rate of hand washing, accuracy rate of hand washing, hand hygiene qualification rate, patient satisfaction rate after implementation were 95.55%, 97.78%, 98.88%, 97.00%, higher than those before implementation （86.11%, 82.78%, 82.22%, 75.00%） （P〈0.05）. The detection rate of hand bacterial colony after implementation was lower than that before implementation （1,11% vs. 17.78%, P〈0.05）. Conclusion The behavioral change theory can improve the awareness rate of hand hygiene knowledge, improve the compliance of hand-washing and hand-washing hygiene pass rate of medical staff, and helps to prevent the occurrence of iatrogenic infection.