院感管理中手卫生依从性的研究及原因分析

Research and Reason Analysis of Hand Hygiene Compliance in Hospital Infection Management

目的对医院医护人员在工作中手卫生现状进行调查和原因分析,提高整体防控水平和自觉监督意识,控制和降低院感的发生。方法依从性调查釆用操作跟踪、隐蔽观察考核。医务人员手卫生规范作为评判金标准。依从性原因调查采用问卷调查方法。结果洗手依从性从高到底依次为:护士(86.80%)>医生(62.08%)>清洁工(53.97%)>实习生(22.12%)。接触患者的体液、血液、排泄物、分泌物和伤口敷料等之后以及进行无菌操作、接触清洁、无菌物品之前洗手依从性超过90%,而从患者身体的污染部位移动到清洁部位和接触患者周围环境及物品后洗手依从性最低。工作量大,设施配备不合理,洗手不方便,降低了洗手的依从性。结论医院感染科要采取多种形式的医院感染知识培训,制定相关培训后效果的监督机制,与人事管理部门协调,尽力保障岗位中医务人员的定编数量,减轻医护人员工作压力。提供多种消毒设施,有效地预防和控制医院交叉感染,降低医院感染率。

Objective This paper tries to investigate and analyze the status of hand hygiene in medical staff at work,so as to improve the overall level of prevention and control and conscious supervision,so as to control and reduce the incidence of hospital infection.Methods Compliance surveys use operational tracking and covert observation assessment.The hand hygiene standards of medical personnel are used as the criteria for judging.The questionnaire survey method was used to investigate the reasons of compliance.Results The compliance of handwashing from high to low was：nurse（86.80%） doctor（62.08%） cleaner（53.97%） intern（22.12%）.Contact with the patient＇s body fluids,blood,excreta,secretions and wound dressings,etc.,and handwash compliance prior to aseptic handling,contact cleaning,and sterile articles exceeds 90%,moving from contaminated sites in the patient＇s body to clean areas and contact patient＇s surrounding environment and after washing hands were the lowest.Large workload,unreasonable facilities,and inconvenient hand washing reduce the compliance of hand washing.Conclusion The Department of Hospital Infectious Diseases should take various forms of training on the knowledge of hospital infections and formulate monitoring mechanisms for the effects of related training.In coordination with the personnel management department,it is necessary to ensure the number of positions of traditional Chinese medicine personnel and to reduce the work pressure of medical staff.Provide a variety of disinfection facilities to effectively prevent and control cross-infection in hospitals and reduce hospital infection rates.