医疗机构新生儿游泳卫生现状及相关影响因素分析

Analysis of Hygiene Status of Newborn Swimming in Hospital and Countermeasures of Supervision

目的了解广州地区提供新生儿游泳医疗机构卫生现状,探讨管理对策。方法于2014年3—4月对广州地区提供新生儿游泳服务的机构进行随机抽样调查,通过现场调研及自填问卷方式了解目前该类机构的卫生服务现状;采用t检验、卡方检验和多元Logistic回归,分析机构服务能力特征对护理卫生学指标合格率的影响。结果共纳入提供新生儿游泳的医疗机构54所,占所调研新生儿游泳机构的61.7%。96.5%以上的操作人员拥有护士资质,88.0%以上的人员已取得新生儿游泳专项培训合格证,88.2%的医疗机构拥有母婴保健执业许可证;各级医疗机构级别越高,在设备配备、人员考核、卫生消毒以及细菌微生物指标检测等方面结果也越好,体现在手卫生操作考核合格率及手卫生细菌微生物检测,机构间差别有统计学差异(P<0.05);二级及以下机构各项卫生消毒检查(包括保洁容器、墙面、空气、毛巾、游泳池、地面、工作台)的规范合格率最高仅为76.0%,最低为52.9%。影响医疗机构护理卫生状况的主要因素为医疗机构类别,类别高的,各项服务和护理卫生措施更加完善。结论目前医疗机构新生儿游泳卫生水平参差不齐,部分机构新生儿游泳服务存在隐患,亟需制定国家或地区卫生监管制度和行业规范,以保障新生儿健康和安全。

Objectives The objective was to analyze the hygiene status of newborn swimming pools in hospital and to discuss the countermeasures in-depth.Methods A field investigation and questionnaire survey were conducted in infant swimming pools in medical institutions in Guangzhou area from March to April in 2014 to explore the healthcare service characteristics.T-test,Chi-square test and binary logistic regression analysis were employed to explore the relationship between hygienic target and institution characteristics.Results This study included 54 institutions with complete data from eligible questionnaires and inspection results used for analysis,which accounted for 61.7% in all swimming pools.95.6% operation staff had Chinese RN license and up to 88.0% personnel had newborn swimming special training certificates.88.2% hospital had maternal and infant healthcare practice license.Management measures such as equipment,personnel assessments,sterilizing and bacteria microbial indicators results,were established and implemented better in high-grade medical institutions than other relative lower-grade institutions.There was significant difference in hand hygiene examinations and bacteria microbial detection among different level hospitals（P〈0.05）.The disinfection sanitary status of the secondary and the following institutions including percentage of passing of cleaning container,wall,ground,workbench,air,and a towel was only up to 76.0%,with lowest percentage 52.9%.We found that categories of medical institutions had significant association with the hygiene status of newborn swimming（P〈0.05）.Conclusions The hygiene status were uneven among hospitals which had great risk to newborn infants.Health supervisory system and industry standards of nation and region should be established urgently to keep the health and safety of newborn infants.