医护人员手卫生认知、依从性及影响因素分析

Cognition,compliance and influencing factors of hand hygiene among medical staffs

目的调查医护人员手卫生认知和依从性,分析影响因素,为提高医护人员手卫生状况提供指导依据。方法2018年1月-6月对2家医院的186名医护人员进行手卫生知识、执行情况、依从性和影响因素调查。结果医护人员手卫生依从率仅为60. 0%,不同年龄段医护人员手卫生依从性差异有统计学意义(P <0. 05)。手卫生知识平均得分88. 2±7. 8,不同年龄段和职业差异有统计学意义(P <0. 05)。仅手部可见污渍时,戴无菌手套前,侵入性操作前,接触患者体液、排泄物或分泌物后等4种情况下依从率超过90. 0%,而手从患者污染部位移向清洁部位前,饭前便后,洗手时长,合理的干手措施等4种情况下依从率低于60. 0%。90. 9%医护人员认为洗手池旁无干手设施是影响洗手依从性的主要因素。结论医护人员缺乏手卫生知识,手卫生依从性较差,其可能的原因有洗手干手设施设备不完善、医护人员自身洗手意识差、工作繁忙和压力大等,应当增加洗手干手设施的便捷性和实用性,提高医护人员洗手知识和意识,不断提升科学洗手的依从性。

Objective To survey the knowledge,implementation and compliance of hand hygiene among medical staffs,and to analyze the influencing factors of compliance,so as to provide guidance for improving the hand hygiene status among medical staffs.Methods From January to June 2018,186 medical staffs were selected randomly from 2 hospitals to investigate the cognition,implementation,compliance and influencing factors.Results The qualified rate of hand hygiene was 60.0%.There was significant difference in the compliance of hand hygiene among medical staffs of different age groups(P<0.05).The average score of hand hygiene knowledge was 88.2±7.8,and there were significant differences in the scores of hand hygiene cognitive questionnaires of different age groups and occupational groups(P<0.05).The compliance exceeded90.0%only in four cases:'when stains were visible on hands','before wearing sterile gloves','before invasive operation',and'after touching patients’body fluids,excreta or secretions',while the compliance was less than 60.0%in other 4 situations:'when hand moved from the contaminated part of patients to the clean part','before eating or after defecation','duration of washing hand',and'rational hand drying measures'.About 90.9%of the medical staffs believed that'without hand drying facilities beside the sink'was the main factor affecting the compliance of hand washing.Conclusion The knowledge of hand hygiene is lack,and compliance of hand hygiene is poor among medical staffs.The possible reasons are imperfect hand washing or drying facilities,poor consciousness of washing hand,heavy workload,and so on.The convenience and practicability of hand washing and drying facilities should be increased,the knowledge and awareness of hand washing should be improved for furthermore improving the compliance of scientific hand washing.