基于“教学相长”理念的医护人员手卫生干预效果评价

The effects of “to teach is to learn” idea on improving hand hygiene compliance of health care workers

目的评价基于"教学相长"理念的医护人员手卫生干预效果,为提高医护人员手卫生依从性和控制医院感染提供依据。方法采用整群随机抽样方法,抽取浙江省立同德医院外科4个住院病区在职医护人员108人,按抽取顺序分别纳入干预组和对照组。对照组开展手卫生常规培训,干预组基于"教学相长"理念,由医护人员指导患者及其陪护人员正确洗手方法,评价两组干预3、 6、 9和12个月后的手卫生知识、态度、行为和依从性。结果干预12个月后,干预组医护人员接触患者前、清洁/无菌操作前、接触患者后、接触患者体液后和接触患者周围环境后5个时刻及总体的手卫生依从率分别为60.83%、 63.33%、 80.00%、 99.17%、 80.83%和76.83%;对照组分别为38.33%、 40.83%、64.17%、 95.83%、 52.50%和58.33%。干预组医护人员5个时刻及总体手卫生依从率的提高幅度均大于对照组(P<0.05);干预组手卫生知识知晓率、态度持有率和行为形成率分别为94.55%、 92.73%和85.45%;对照组分别为86.79%、60.38%和52.83%;干预组手卫生态度持有率和行为形成率提高幅度均大于对照组(P<0.05),两组手卫生知识知晓率差异无统计学意义(P>0.05)。结论基于"教学相长"理念的干预能提高医护人员手卫生依从性,养成正确的手卫生习惯。

Objective To investigate the effect of teaching and learning intervention measures on improving hand hygiene compliance of health care workers,and to provide a basis for improving the compliance of health care workers'hand hygiene and controlling hospital infections.Methods A total of 108 in-service health care workers in the Tongde Hospital of Zhejiang Province were selected,and the control group implemented the conventional hand hygiene promotion strategy based on hand hygiene training.The intervention group was based on the concept of“to teach is to learn”and the method of teaching the patients and their caregivers to wash their hands properly.The knowledge,attitudes,behaviors and compliance of hand hygiene after 3,6,9 and 12 months of intervention between two groups were evaluated.Results After 12 months of intervention,the hand hygiene compliance rates of the health care workers in the intervention group before contacting the patients,before cleaning/aseptic operation,after contacting with the patient,after contacting with the patient's body fluid,after contacting with the patient's environment and overall was 60.83%,63.33%,80.00%,99.17%,80.83%and 76.83%;the above rates in the control group were 38.33%,40.83%,64.17%,95.83%,52.50%and 58.33%,respectively.The improvement of hand hygiene compliance rate in the intervention group were higher than those in the control group(P<0.05).The health knowledge awareness rate,attitude correctness rate and behavior formation rate in the intervention group were 94.55%,92.73%and 85.45%,respectively;the above rates in the control group was 86.79%,60.38%and 52.83%,respectively;the rates of having the right hand hygiene attitude and behavior were higher in the intervention group than those in the control group(P<0.05),but there was no statistical significant difference in the awareness of hand hygiene knowledge between the two groups.(P>0.05).Conclusion Intervention based on the concept of“to teach is to learn”can improve the compliance of hand hygiene among health care workers and develop good habits of hand hygiene.