三种不同卫生手消毒方法的消毒效果及成本分析
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摘要
目的评价3种不同卫生手消毒方法的消毒效果、经济和时间成本支出,探索一种更优的卫生手消毒方法,从而提高手卫生依从性。方法将某院2016年3月—7月门诊抽血患者随机分为3组,5名采血护士对3组患者进行采血操作时,分别使用直接卫生手消毒法(A组)、戴手套+卫生手消毒法(B组)和换手套+卫生手消毒法(C组)进行卫生手消毒。每组各采样210份手部或手套表面标本进行细菌学检测,以比较3组卫生手消毒的消毒效果,并比较3组经济成本和时间成本的区别。结果 3种卫生手消毒方法的消毒效果合格率均为100%;A、B、C组的总经济成本支出分别为9.66、21.98、185.66元,总时间成本支出分别为5 250、6 860、14 700 s;3种卫生手消毒方法均无锐器伤发生。结论由于直接卫生手消毒没有执行标准预防原则,因此戴手套+卫生手消毒是3种卫生手消毒方法中最优的一种方法,不仅消毒效果一致,还可以节约经济成本和时间成本,从而提高医务人员的手卫生依从性。
Objective To explore a better hygienic hand disinfection method to improve hand hygiene compliance, by evaluating and comparing the disinfection effects and the economic and time cost expenditures of three different types of hygienic hand disinfection methods. Methods From March to July 2016, patients undergoing blood collection were randomly divided into three groups, and five blood collection nurses used one different type of hygienic hand disinfection method in each group when performing blood collection operation on the patients,including: direct hygienic hand disinfection(group A); wearing gloves, and doing hygienic hand disinfection without putting off gloves(group B); and changing gloves for each patient, and doing hygienic hand disinfection after putting off gloves(group C). Two hundred and ten specimens of the nurses' hands or gloves surface after hand hygiene were collected from each group for the comparison of hygienic hand disinfection effect, and the differences in economic cost and time cost were compared. Results The passing rates of the disinfection effect of the three different types of sanitary hand disinfection methods were all 100%. The economic cost of group A, B, and C was 9.66, 21.98, and 185.66 yuan,respectively, and the time cost of group A, B, and C was 5 250, 6 860, and 14 700 seconds, respectively. No sharp injury occurred. Conclusion Since direct hygienic hand disinfection does not implement the standard prevention principle,the method of wearing gloves and doing hygienic hand disinfection without putting off gloves is the best in the three different hygienic hand disinfection methods, which not only has the same disinfection effect, but also can save economic cost and time cost, which may improve the medical personnel's hand hygiene compliance.
Objective To explore a better hygienic hand disinfection method to improve hand hygiene compliance, by evaluating and comparing the disinfection effects and the economic and time cost expenditures of three different types of hygienic hand disinfection methods. Methods From March to July 2016, patients undergoing blood collection were randomly divided into three groups, and five blood collection nurses used one different type of hygienic hand disinfection method in each group when performing blood collection operation on the patients,including: direct hygienic hand disinfection(group A); wearing gloves, and doing hygienic hand disinfection without putting off gloves(group B); and changing gloves for each patient, and doing hygienic hand disinfection after putting off gloves(group C). Two hundred and ten specimens of the nurses' hands or gloves surface after hand hygiene were collected from each group for the comparison of hygienic hand disinfection effect, and the differences in economic cost and time cost were compared. Results The passing rates of the disinfection effect of the three different types of sanitary hand disinfection methods were all 100%. The economic cost of group A, B, and C was 9.66, 21.98, and 185.66 yuan,respectively, and the time cost of group A, B, and C was 5 250, 6 860, and 14 700 seconds, respectively. No sharp injury occurred. Conclusion Since direct hygienic hand disinfection does not implement the standard prevention principle,the method of wearing gloves and doing hygienic hand disinfection without putting off gloves is the best in the three different hygienic hand disinfection methods, which not only has the same disinfection effect, but also can save economic cost and time cost, which may improve the medical personnel's hand hygiene compliance.
引文
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2孙家苓.医护人员手卫生状况的研究进展.当代护士(学术版),2014(4):18-20.
3董全芳.护理干预对于提高医护人员手卫生依从性的临床研究.中华实验和临床感染病杂志(电子版),2015,9(3):366-369.
4潘虹,柯云楠,韩硕,等.基于WHO手卫生评估框架的医院手卫生现状分析.中国医院管理,2016,36(5):61-63.
5张菊,叶丹,陈梅,等.速干手消毒剂对手套表面消毒效果及手卫生依从性影响的研究.华西医学,2017,32(3):371-374.
6中华人民共和国卫生部.医务人员手卫生规范:WS/T 313-2009,2009.
7中华人民共和国国家质量监督检验检疫总局,中国国家标准化管理委员会.医院消毒卫生标准:GB 15982-2012,2012.
8廖素英,陈丽勤.门诊采血室护理人员对手卫生依从性的调查与对策.现代医药卫生,2016,32(24):3894-3895.
9徐丹慧,侯铁英,李卫光,等.中国医院手卫生知识知晓及依从性现状调查.中国感染控制杂志,2016,15(9):654-658,664.
10王学玲.医务人员洗手现状及其影响因素.医学理论与实践,2013,26(1):33-35.
11陈宁,余红梅.医院手卫生依从性提高干预措施研究进展.中国预防医学杂志,2016,17(8):617-620.
12赵延慧,邹琴,李晓玲.手卫生依从性及其管理对策的研究进展.护理学报,2016,23(6):38-40.
13毕娜,王建荣,蔡永琴.静脉输液护士手卫生依从性的质性研究.解放军护理杂志,2013,30(12):21-23.
14卢春娟,陈佳新,刘洁琼,等.大型医疗机构连续静脉采血人员手卫生策略的探讨.中华医院感染学杂志,2017,27(18):4277-4281.
15饶思友,邓琼,周芸,等.手套外速干手消毒效果评价.实用临床医学,2016,17(5):4-5,29.
16赖艺岚,李顺好,温玉婵,等.一次性普通乳胶手套使用延时更换干预的效果研究.中国实用医药,2014,9(22):272-273.
17中国医师协会检验医师分会,儿科疾病检验医学专家委员会,世界华人检验与病理医师协会.中国末梢采血操作共识.中华医学杂志,2018,98(22):1752-1760.
2孙家苓.医护人员手卫生状况的研究进展.当代护士(学术版),2014(4):18-20.
3董全芳.护理干预对于提高医护人员手卫生依从性的临床研究.中华实验和临床感染病杂志(电子版),2015,9(3):366-369.
4潘虹,柯云楠,韩硕,等.基于WHO手卫生评估框架的医院手卫生现状分析.中国医院管理,2016,36(5):61-63.
5张菊,叶丹,陈梅,等.速干手消毒剂对手套表面消毒效果及手卫生依从性影响的研究.华西医学,2017,32(3):371-374.
6中华人民共和国卫生部.医务人员手卫生规范:WS/T 313-2009,2009.
7中华人民共和国国家质量监督检验检疫总局,中国国家标准化管理委员会.医院消毒卫生标准:GB 15982-2012,2012.
8廖素英,陈丽勤.门诊采血室护理人员对手卫生依从性的调查与对策.现代医药卫生,2016,32(24):3894-3895.
9徐丹慧,侯铁英,李卫光,等.中国医院手卫生知识知晓及依从性现状调查.中国感染控制杂志,2016,15(9):654-658,664.
10王学玲.医务人员洗手现状及其影响因素.医学理论与实践,2013,26(1):33-35.
11陈宁,余红梅.医院手卫生依从性提高干预措施研究进展.中国预防医学杂志,2016,17(8):617-620.
12赵延慧,邹琴,李晓玲.手卫生依从性及其管理对策的研究进展.护理学报,2016,23(6):38-40.
13毕娜,王建荣,蔡永琴.静脉输液护士手卫生依从性的质性研究.解放军护理杂志,2013,30(12):21-23.
14卢春娟,陈佳新,刘洁琼,等.大型医疗机构连续静脉采血人员手卫生策略的探讨.中华医院感染学杂志,2017,27(18):4277-4281.
15饶思友,邓琼,周芸,等.手套外速干手消毒效果评价.实用临床医学,2016,17(5):4-5,29.
16赖艺岚,李顺好,温玉婵,等.一次性普通乳胶手套使用延时更换干预的效果研究.中国实用医药,2014,9(22):272-273.
17中国医师协会检验医师分会,儿科疾病检验医学专家委员会,世界华人检验与病理医师协会.中国末梢采血操作共识.中华医学杂志,2018,98(22):1752-1760.