泸州市某结核病定点医疗机构医务人员结核感染控制知信行调查分析

Investigation and Analysis on the Health Care Workers’ KAP of Tuberculosis Infection Control in Appointed Hospital in Luzhou

目的分析泸州市某结核病定点医疗机构医务人员结核感染控制(下称感控)知信行情况,并提出科学建议。方法 2018年采用问卷法对泸县人民医院423名医务人员结核病感控知识、行为意向和行为进行横断面调查,并进行分析。结果结核感控知识知晓方面,平均知晓率为61.25%,对开展咳嗽筛查、提供防护口罩等分属哪类防护措施知晓率稍高75.65~94.80%,结核属于空气传播和应采取空气传播阻断方式知晓率低仅13.24%和12.53%,共用未消毒餐具与结核传播不相关知晓率较低(40.19%),临床医生、护士、辅检人员及行政后勤人员4类职业人员知晓率差异经检验有统计学意义(χ2=8.49,P<0.05);感控行为意向方面,平均得分2.27分,感控行为意向建立不够;感控行为方面,适用对象中仅26.95%认识到院内工作结核感染的高风险,仅49.06%会每次佩戴医用防护口罩时检查气密性,73.05%人员不会在病床旁和卫生间采集痰标本,进入结核病房时94.08%选择佩戴医用防护口罩、50.78%选择让患者佩戴外科口罩、65.07%选择提供纸巾让其在咳嗽时覆盖口鼻。结论泸州市结核病定点医疗机构医务人员对结核感控知晓水平不高,感控行为意向建立不够,感控行为实施较差,还需进一步加强感控知识和技能培训,重点内容包括结核感染传播基本知识、分诊、口罩佩戴等,强化感控管理措施、环境工程和个人防护措施落实到位,降低院内结核感染风险。

Objective To analyze the awareness of health care workers’(HCWs) knowledge, attitude and practice(KAP) about the control of tuberculosis(TB) infection in appointed hospital in Luzhou city, and to propose the scientific advices. Methods A cross-sectional investigation was conducted about KAP of TB infection control among 423 HCWs in Luxian People’s Hospital in 2018. Results In the knowledge of TB infection control,the average awareness rate of TB infection control was61.25%.The awareness rates of protective measures such as cough screening and wearing medical protective masks were slightly higher(75.65-94.80%). And the awareness rate of that TB belongs to air borne and air transmission interruption should be taken was low,only 13.24% and 12.53%. The awareness rate of sharing unsterilized tableware not related to TB transmission was low, only40.19%. The difference of awareness rate between clinicians, nurses, assistants and administrative support personnel those four professions was statistically significant(χ2=8.49,P<0.05). In the TB infection control behavioral intention,the average score was 2.27,the behavioral intention was not well established. In the area of infection control behaviors, only 26.95% of them recognized the high risk of TB infection in the hospital, only 49.06% of them would check the tightness when wearing a medical protective mask every time,and 73.05% of them would not collect the sputum specimens at the bedside or in the bathroom. When entering the TB room,94.08% of them chose wearing medical protective mask, 50.78% of them let the patients wearing surgical masks, and65.07% chose providing tissue to the patient to cover the nose and mouth when couching.Conclusion The awareness of TB infection control of HCWs in appointed hospital in Luzhou was still at a low level, the behavioral intention was not well established, and the infection control behaviors were poorly implemented. We need to strengthen the training of TB infection control knowledge and skills further, and focus on the knowledge of the spread of TB infection, triage,wearing masks etc., we should strengthen the infection control measures of management,environmental engineering and personal protective,so that to reduce the risk of TB infection in the hospital.