从行政干预入手全面提升手卫生执行力

Improving hand hygiene executive ability by administrative intervention

目的以行政干预为主导,采取多模式干预措施,全面提升安徽省各级医疗机构医护人员手卫生规范执行力。方法 2014年4月—2016年12月,持续3年在安徽省各级医疗机构实施《加强手卫生管理活动方案》,采用PDCA管理模式,分计划、实施、检查、改进提高及成效评价等阶段分步实施,并对1 353所医院进行干预前后各项手卫生相关管理指标调查,对干预效果进行评价。结果活动终期对手卫生管理进行全面评价,结果显示85.29%(58/68)的三级医院和84.07%(227/270)的二级医院、66.63%(595/893)的一级医院手卫生设施配备完善。92.65%(63/68)的三级、100.00%(270/270)的二级和50.06%(447/893)的一级医院均进行全员手卫生知识的培训。干预前后手卫生依从性由36.68%提升至61.93%,洗手正确率由37.60%上升至89.28%,相关知识知晓率由41.20%提高至86.07%。每床日手消毒剂用量由2.59 m L提升至7.10 m L。结论从行政干预入手,采取多模式干预措施,能有效提高手卫生管理质量,全面提升手卫生规范执行力。

Objective To improve hand hygiene executive ability of healthcare workers in medical institutions in Anhui Province by multi-modal interventions with the administrative intervention as the guide. Methods The PDCA management mode was adopted in a step-by-step implementation of plan, implementation, inspection, improvement, and effectiveness evaluation in Anhui Province from April 2014 to December 2016. The management indicators of hand hygiene before and after the intervention in 1 353 hospitals were investigated and evaluated. Results The overall evaluation of the hand hygiene at the end of the implemention showed that 85.29% （58/68） of the tertiary hospitals, 84.07% （227/270） of the second-class hospitals and 66.63% （595/893） of the primary-level hospitals had well-equipped hand hygiene facilities. About 92.65% （63/68） of the tertiary hospitals, 100.00% （270/270） of the second-class hospitals and 50.06% （447/893） of the primary-level hospitals had staff training of hand hygiene knowledge. The compliance of hand hygiene before and after intervention increased from 36.68% to 61.93%, the correct rate of hand washing increased from 37.60% to 89.28%, the awareness rate of related knowledge increased from 41.20% to 86.07%, and the dosage of hand disinfectant increased from 2.59 mL to 7.10 mL. Conclusion To take multi-model interventions with the administrative intervention as the guide, can effectively improve the quality of hand hygiene management and the executive force.