感染控制管理中手卫生依从性的研究

Study on hand hygiene compliance in infection control and management

目的研究及分析感染控制管理中手卫生依从性的原因。方法于2018年5月至2019年12月在本院选择90名医务人员作为观察对象,通过操作跟踪、隐蔽观察考核等方式调查依从性。判定金标准为医务人员手卫生规范。通过调查问卷的方式调查不同类别、不同操作医务人员洗手依从性、影响手卫生的原因。结果护士洗手依从性最高,为86.83%,依次为医生62.09%,清洁工53.33%,实习生22.11%。洗手依从性≥90%的为医务人员同患者体液、分泌物、血液、伤口辅料、排泄物接触后、接触清洁物品、无菌物品、进行无菌操作之前,自患者身体污染部位向清洁部位移动、与患者周围物品、环境接触后三者是洗手依从性最低的3项。洗手依从性降低的主要原因为日常工作量大、不合理的设施配备、洗手不方便。结论医院感染科需要建立健全监督管理机制,开展不同形式的医院感染知识学习培训,同人事管理部门做好配合与协作,保证医务人员岗位定编数量和质量,减轻工作负担。落实各类消毒实施,对医院交叉感染进行有效预防与控制,减少医院感染的发生。

Objective To study and analyze the causes of hand hygiene compliance in infection control management.Methods A total of 90 medical personnel in our hospital were selected as the objects from May 2018 to December 2019.The compliance was investigated through operation tracking and covert observation and assessment.The hand hygiene standard for medical personnel was used as the gold standard.The compliance of hand washing and the reasons affecting hand hygiene of different types and different operations of medical personnel were investigated through questionnaires.Results Nurses had the highest compliance with hand washing(86.83%),followed by doctors(62.09%),cleaners(53.33%)and interns(22.11%).The compliance of medical personnel with hand-washing was≥90%after contacting with body fluids,secretions,blood,wound accessories and excreta of patients and before contacting clean articles,sterile articles and sterile operations.Moving from the contaminated part of the patient′s body to the clean part,contact with articles around the patient,and easing contact were the three items with the lowest hand-washing compliance.The main reasons for the decrease of hand-washing compliance included heavy daily workload,unreasonable facilities and inconvenient hand-washing.Conclusion The hospital infection department needs to establish and perfect the supervision and management mechanism,carry out different forms of hospital infection knowledge learning and training,cooperate with personnel management departments well,ensure the quantity and quality of medical personnel′s post allocation,and reduce the workload.All kinds of disinfection should be implemented to effectively prevent and control hospital cross infection and reduce the occurrence of hospital infection.