脱防护用品的不同方式对医务人员污染情况的对比研究

Comparative study on the pollution of medical staff by different removal methods in protective equipment

目的:比较3种不同的脱防护用品方式在耗时、对医务人员的污染情况等方面的差异,探索对医务人员感染风险更小的脱防护用品方式。方法:固定1人熟练掌握3种脱防护用品的方式,方式A为传统方法(医院隔离技术规范中推荐方法),方式B和C为改良方法,分别穿脱20次,采用计时、荧光标记法等方法比较3种方式在耗时、污染情况方面的差异;设计主观感受量表,选择20名医务人员,同时采用3种脱防护用品方式进行穿脱,对难易度、舒适性、实用性、安全性进行满意程度评价打分。结果:3种不同脱防护用品方式耗时比较,差异均无统计学意义(P>0.05);对身体污染情况比较,差异有统计学意义,方式B对身体污染程度低于另外两种(P<0.05);通过对数据的一般特征分析发现,方式B能有效减低手部污染。使用Cronbachα系数评估主观感受量表研究数据的可靠程度,其值为0.714,研究数据信度质量较高,方式A的难易度、舒适性、实用性方面满意程度得分最高,方式B的安全性得分高于方式A及方式C。3种方式最容易污染的部位均为胸腹部,其次为上肢及手部,最不易污染的部位均是双下肢。结论:防护服、鞋套、手套一并脱卸的方式B可减少医务人员身体污染,从而可能降低感染风险,且其安全性更高,临床应用和推广的价值较高。

Objective:To compare the differences of three different removal methods in protective equipment in terms of time consuming and pollution to medical staff,and to explore a method with less infection risk to medical staff.Methods:Fix 1 person skilled in 3 methods of removing protective equipment.Method A was a traditional method(recommended method in the hospital isolation technical specifications),and method B and C were improved ones.The person who had mastered these 3 removal methods takes off protective equipment 20 times respectively.The differences in time consumption and pollution were compared by means of timing and fluorescent labeling.Designed a subjective feeling scale and 20 medical staff were selected to take off protective equipment in 3 methods at the same time,then they evaluated and scored for 3 removal methods according to the difficulty,comfort,practicality and safety.Results:3 different methods were compared in time and body pollution,there was no statistical significance in time consuming,there was statistical significance in body pollution(P<0.05),and the degree of body pollution of method B was lower than that of the other two methods.Through the analysis of the general characteristics of the data,the method B could effectively reduce the degree of hand pollution.Cronbach α coefficient was used to evaluate the reliability of the data of the subjective feeling scale,whose value was 0.714,it indicated that the reliability of the data was of high quality.The results showed that method A had the highest satisfaction degree in terms of difficulty,comfort and practicability.But in terms of safety,method B scored higher than method A and method C.The most easily polluted parts were chest and abdomen,followed by upper limbs and hands,and the least easily polluted parts were both lower limbs.Conclusion:The method B of removing protective clothing,shoes covers and gloves at the same time has advantages in reducing the body pollution of medical stuff,thus more possibly reducing the risk of infection.From the subjective perception,method B is safer and worth being promoted and applied vigorously.