新型冠状病毒肺炎疫情期间医疗机构工作人员手卫生特征的Meta分析

Hand hygiene characteristics of staff in medical institutions during the epidemic period of coronavirus disease 2019: a Meta-analysis

目的 分析新型冠状病毒肺炎(简称新冠肺炎)疫情期间医疗机构工作人员手卫生依从性的特征,提出基于循证的干预政策,以提升手卫生依从性。方法 检索2020年1月—2021年10月PubMed、Embase、Cochrane图书馆、Web of Science、中国知网、万方数据、维普和中国生物医学文献数据库关于新型冠状病毒疫情期间医疗机构工作人员手卫生依从性的相关文献,由2名研究者独立筛选文献、提取资料、评价质量后,采用DerSimonian和Laird模型进行Meta分析。结果 纳入手卫生依从性相关文献10篇,医疗机构工作人员2 377名。新冠肺炎疫情期间总体手卫生依从率为74%(95%CI:68%~79%)。亚组分析结果显示,医院不同职业工作人员手卫生依从率从高到低依次为护士、医生、其他员工,分别为80%(95%CI:74%~87%)、76%(95%CI:71%~81%)、70%(95%CI:62%~77%)。工作人员在接触患者体液后手卫生依从率最高(91%,95%CI:88%~94%),而接触患者前手卫生依从率最低(68%,95%CI:62%~74%)。结论 在新冠肺炎疫情期间,医疗机构工作人员手卫生依从率有较大提升。辅助人员是手卫生依从率提升的重点关注人员,接触患者前是手卫生依从性干预的重点时刻。

Objective To analyze the characteristics of hand hygiene(HH) compliance of staff in medical institutions(MIs) during the epidemic period of coronavirus disease 2019(COVID-19), and put forward evidence-based intervention policies for improving HH compliance. Methods Relevant literatures on HH compliance of staff in MIs during the epidemic period of COVID-19 were retrieved from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure(CNKI), Wanfang Data, VIP and China Biology Medicine disc(CBMdisc) in January 2020-October 2021, two researchers independently screened the literature, extracted data and evaluated the quality, Meta-analysis was conducted with DerSimonian and Laird models. Results A total of 10 literatures on HH compliance involving 2 377 staff in MIs were included in this study. The overall HH compliance during the COVID-19 epidemic period was 74%(95%CI: 68%-79%). Subgroup analysis results showed HH compliance rates of staff of different professions in hospitals from high to low were nurses, doctors and other employees, which were 80%(95%CI: 74%-87%), 76%(95%CI: 71%-81%) and 70%(95%CI: 62%-77%) respectively. Staff in MIs had the highest HH compliance(91%, 95%CI: 88%-94%) after contact with patient body fluid, while the lowest HH compliance(68%, 95%CI: 62%-74%) before contact with patient. Conclusion During the epidemic period of COVID-19, HH compliance of staff in MIs has been greatly improved. Auxiliary personnel are the key personnel to improve HH compliance, before contacting patients is the key moment of HH compliance intervention.