提高外科手消毒正确率的干预研究

Intervention Study of Improving the Accuracy of Surgical Hand Disinfection

目的了解外科医生实施外科手消毒正确率及干预措施的效果。方法在不知情的情况下,由受过专门培训的调查员,按照统一的方法和表格,通过数字视频观察所有外科医生实施外科手消毒操作的正确率;采取签署目标责任书、拍摄外科手消毒操作视频、建立微信公众平台和微信群,发布培训视频、规培中心考核、个人反馈及会议反馈等干预措施。结果随着一系列干预措施的实施与推进,外科手消毒正确率从干预前的50.45%提升至干预后期的93.21%,提升效果差异有统计学意义(χ2=113.67,P<0.05);相关科室外科手消毒正确率呈上升趋势并提升明显(P<0.05),干预措施实施的Ⅱ、Ⅲ期,外科手消毒正确率稳定在90.00%以上。结论借助微信平台进行在职培训,标准细化,信息传递通畅并及时反馈,对提高外科手消毒正确率至关重要;持续有效的监管是保证外科手消毒正确率的重要手段。

Objective To investigate the accuracy and interventional effect of surgical hand disinfection for surgeons. Methods Trained investigators used a standard method and form to observe the accuracy of surgical hand disinfection for all the surgeons without them being aware using digital video. The interventions included signing the responsibility commitment, making surgical hand disinfection videos, setting up a Weehat platform and a group chat. Meanwhile, we uploaded training video, training center evaluation, personal feedback, and meeting feedback, etc. Results With the implementation of a range of interventions, the accuracy of surgical hand disinfection increased from 50.45% （pre-intervention） to 93.21% （post-intervention）. The difference was statistically significant （X2=113.67, P〈0.05）. All departments saw a significant increasing accuracy of surgical hand disinfection （P〈0.05）. During phases II and III of the intervention, the accuracy of surgical hand disinfection reached over 90.00%.Conclusion We used Wechat platform for on-the-job training, which could lead to standard refinement and information transmission unobstructed and timely feedback. They are vital for improving accuracy of surgical hand disinfection. In addition, effective ongoing supervision is a key to maintaining accuracy of surgical hand disinfection.