上海某社区医院医务人员手卫生依从性调查分析

Investigation and analysis of hand hygiene compliance among medical staff in a community hospital in Shanghai

目的 探讨医务人员手卫生依从性现况及其影响因素,以便规范手卫生方法及提高手卫生依从率.方法 在2023年3月-5月期间通过直接观察法,根据标准制定花木社区卫生服务中心《手卫生依从性及执行情况督察表》,对该中心183名医务人员手卫生相关知识进行调查,同时现场观察手卫生依从率和正确率.结果 六步洗手法正确率,从科室来说,门诊护理洗手准确率高于其他科室(χ^(2)=11.476,P<0.05);从职业分类来说,护士洗手准确率高于医生、医技人员等(χ^(2)=26.015,P<0.001);从性别来说,女性洗手准确率高于男性(χ^(2)=5.513,P<0.05),而洗手准确率与年龄、职称无显著性差异(P>0.05).此次手卫生依从性调查结果显示,无论变量X如何变化,在五个洗手时机中,无菌操作前手卫生依从性100%,接触患者血液、体液、分泌物后手卫生依从性也较高,而在接触患者前手卫生依从性最差.手卫生知识知晓度调查结果显示,从科室来说,门诊护理手卫生知识知晓度要明显高于其他科室(χ^(2)=10.385,P<0.05);从职业来说,护士手卫生知识知晓度要高于医生、医技人员等(χ^(2)=20.43,P<0.001),而手卫生知识知晓情况与性别、年龄、职称无显著性差异(P>0.05).结论 门诊护理团队的手卫生依从性、洗手正确率及手卫生知识知晓率最高,护理人员的手卫生依从性要高于医生、医技及保洁人员,重点科室手卫生依从性要略高于非重点科室,整体接触病人前的手卫生依从性最差,需进一步加强对医务人员手卫生的培训及监管,提高手卫生依从率及正确率,从而有效控制医院感染的发生.

Objective To explore the current situation analysis and influencing factors of hand hygiene compliance among medical personnel,in order to standardize hand hygiene methods and improve hand hygiene compliance rate.Methods From March to May 2023,a direct observation method was used to develop the"Hand Hygiene Compliance and Implementation Inspection Form"for our center according to the standards.A survey was conducted on hand hygiene related knowledge among 183 medical staff in Shanghai Huamu Community Health Service Center,and the hand hygiene compliance and accuracy rates were observed on-site.Results The accuracy rate of the six step washing technique was higher in outpatient nursing than in other departments(χ^(2)=11.476,P<0.05).In terms of occupational classification,the accuracy rate of nurses'hand washing was higher than that of doctors and medical technicians(χ^(2)=26.015,P<0.001).In terms of gender,the accuracy rate of women's hand washing was higher than that of men(χ^(2)=5.513,P<0.05),but there was no significant difference in hand washing accuracy compared to age and professional title(P>0.05).The results of the hand hygiene compliance survey showed that regardless of the change in quantity X,among the five hand washing opportunities,the hand hygiene compliance before sterile operation was 100%,and the hand hygiene compliance was also higher after contact with patient blood,body fluids,and secretions,while the hand hygiene compliance was the worst before contact with the patient.The survey results of hand hygiene knowledge awareness showed that in terms of departments,the awareness of hand hygiene knowledge in outpatient nursing was significantly higher than that in other departments(χ^(2)=10.385,P<0.05),and in terms of profession,the awareness of hand hygiene knowledge in nurses was higher than that of doctors,medical technicians,etc.(χ^(2)=20.43,P<0.001).However,there was no significant diference in hand hygiene knowledge awareness with gender,age,and professional title(P>0.05).Conclusion The outpatient nursing team has the highest hand hygiene compliance,correct hand washing rate,and awareness rate of hand hygiene knowledge.The hand hygiene compliance of nursing staff is higher than that of doctors,medical technicians,and cleaning personnel.The hand hygiene compliance of key departments is slightly higher than that of non key departments,and the overall hand hygiene compliance before contact with patients is the worst.It is necessary to further strengthen the training and supervision of hand hygiene for medical staff to improve hand hygiene compliance and accuracy,Thus effectively controlling the occurrence of hospital infections.