第三方调查的绩效考核对改进医务人员手卫生依从性的效果

Effect of performance appraisal through third party survey on improving the compliance of hand hygiene among health care workers

目的了解医务人员手卫生执行的真实情况,为改进手卫生管理提供依据。方法某院2016年度实行手卫生绩效考核,同时邀请第三方(外院医院感染专职人员)对全院医务人员手卫生进行4次匿名调查,并比较医务人员手卫生依从率的变化。结果第三方调查的医务人员手卫生依从率为60.68%,其中上半年和下半年的手卫生依从率分别为52.72%、68.62%,差异有统计学意义(P<0.001)。重点科室(各重症监护病房、新生儿科)的手卫生依从率(87.44%)高于外科科室(64.71%)和内科科室(53.74%),差异均有统计学意义(均P<0.05)。医务人员在接触患者前、接触患者后以及接触患者周围环境后的手卫生依从率较低(分别为53.59%、58.07%、43.97%)。结论第三方手卫生调查能有效降低手卫生观察过程中的霍桑效应。手卫生绩效考核有助于改进医务人员手卫生依从性。

Objective To understand the actual implementation of hand hygiene(HH)of health care workers(HCWs),and provide evidence for improving HH management.Methods HH performance appraisal began to implement in a hospital in 2016,at the same time,third party(healthcare-associated infection management professionals in other hospitals)was invited to carry out 4 times of anonymous survey on HH among HCWs in the hospital,change in HH compliance rate among HCWs was compared.Results HH compliance of HCWs surveyed by the third party was 60.68%,HH rates in the first half and second half year were 52.72%and 68.62%respectively,difference was statistically significant(P<0.001).Compliance rate of HH in key departments(intensive care unit and neonatal department,87.44%)was higher than surgical departments(64.71%)and internal medicine departments(53.74%),difference was statistically significant(both P<0.05).HH compliance rates of HCWs before and after contact with patients and after contact with the surrounding environment of patients were all low(53.59%,58.07%,43.97%,respectively).Conclusion HH surveyed by the third party can effectively reduce the Hawthorne effect during the observation process.HH performance appraisal can significantly improve the compliance of HH among HCWs.