医务人员医院感染防控知信行及影响因素调查
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摘要
目的 了解内蒙古地区各级医院医务人员医院感染防控知识、态度、行为现状及影响因素,为预防和控制医院感染提供理论依据。方法 2018年1-6月分层随机抽取内蒙古地区不同等级的163所医院4 094名医务人员进行医院感染防控知识、态度、行为问卷调查。结果 共发放问卷4 094份,收回有效问卷4 016份,有效回收率为98.09%。4 016名医务人员医院感染防控知识、态度、行为得分分别为(36.37±6.68)、(214.75±35.62)、(190.64±36.76)分。医院感染防控知识医疗废物管理得分率最高,为78.11%(3 137/4 016);多药耐药菌的医院感染防控得分率最低,为66.71%(2 679/4 016)。医院感染防控态度、行为手卫生得分率最高,分别为80.85%(3 247/4 016)、74.13%(2 977/4 016),重点环节医院感染预防与控制得分率最低,分别为49.63%(1 993/4 016)、43.40%(1 743/4 016)。经逐步多元线性回归分析,医院等级、性别、工作岗位、年龄、职称均为医务人员医院感染防控知信行的影响因素(P<0.001)。Pearson相关性分析显示,医务人员医院感染防控知识与态度(r=0.782,P<0.001)、知识与行为(r=0.764,P<0.001)、态度与行为(r=0.714,P<0.001)之间均呈正性相关。结论 内蒙古地区各级医院医务人员医院感染防控知识、态度、行为有待进一步提升。各级医疗机构应运用综合有效的干预措施,加强医务人员医院感染防控知识储备,端正其态度,支持和促进医务人员防控行为。
OBJECTIVE To understand the current status and influencing factors of knowledge, attitude and practice(KAP) of nosocomial infection prevention and control of healthcare workers(HCW) in hospitals of different scales, so as to provide reference of nosocomial infection control and nosocomial infection outbreak prevention. METHODS 4094 healthcare workers from 163 hospitals of different scales was randomly selected to conduct knowledge, attitude and practice questionnaire in Jan. to Jun. 2018. RESULTS A total of 4 094 questionnaires have been provided, and 4016 effective questionnaires have been collected, with a collection ratio of 98.09%. The average scores of the 4016 HCWs' KAP were(36.37±6.68),(214.75±35.62) and(190.64±36.76), respectively. Among all nosocomial infection prevention and control knowledge scores, the scoring rate of medical waste management was the highest, which was 78.11%(3 137/4 016); whereas the scoring rate of multi-drug resistant organism-associated nosocomial infection prevention and control was the lowest, which was 66.71%(2 679/4 016). Among all parts of attitude and practice of nosocomial infection prevention and control, hand hygiene had the highest scores of 80.85%(3 247/4 016) and 74.13%(2 977/4 016), respectively; nosocomial infection prevention and control in key links had the lowest scores of 49.63%(1 993/4 016) and 43.40%(1 743/4 016), respectively. According to stepwise multiple linear regression analysis, hospital scale, gender, position, age and professional title were influencing factors of KAP of HCW nosocomial infection prevention and control(P<0.001). According to Pearson correlation analysis, there were significant positive correlation between knowledge and attitude(r=0.782,P<0.001), knowledge and practice(r=0.764,P<0.001), attitude and practice(r=0.714,P<0.001) of nosocomial infection prevention and control. CONCLUSION Nosocomial infection prevention and control KAP of HCW in hospitals of different scales needs further improvement in Inner Mongolia. Difference scales of hospitals should take comprehensive effective intervention measures, increase the HCW's knowledge of nosocomial infection prevention and control, correct the attitude, support and promote the HCW's practice of nosocomial infection prevention and control.
OBJECTIVE To understand the current status and influencing factors of knowledge, attitude and practice(KAP) of nosocomial infection prevention and control of healthcare workers(HCW) in hospitals of different scales, so as to provide reference of nosocomial infection control and nosocomial infection outbreak prevention. METHODS 4094 healthcare workers from 163 hospitals of different scales was randomly selected to conduct knowledge, attitude and practice questionnaire in Jan. to Jun. 2018. RESULTS A total of 4 094 questionnaires have been provided, and 4016 effective questionnaires have been collected, with a collection ratio of 98.09%. The average scores of the 4016 HCWs' KAP were(36.37±6.68),(214.75±35.62) and(190.64±36.76), respectively. Among all nosocomial infection prevention and control knowledge scores, the scoring rate of medical waste management was the highest, which was 78.11%(3 137/4 016); whereas the scoring rate of multi-drug resistant organism-associated nosocomial infection prevention and control was the lowest, which was 66.71%(2 679/4 016). Among all parts of attitude and practice of nosocomial infection prevention and control, hand hygiene had the highest scores of 80.85%(3 247/4 016) and 74.13%(2 977/4 016), respectively; nosocomial infection prevention and control in key links had the lowest scores of 49.63%(1 993/4 016) and 43.40%(1 743/4 016), respectively. According to stepwise multiple linear regression analysis, hospital scale, gender, position, age and professional title were influencing factors of KAP of HCW nosocomial infection prevention and control(P<0.001). According to Pearson correlation analysis, there were significant positive correlation between knowledge and attitude(r=0.782,P<0.001), knowledge and practice(r=0.764,P<0.001), attitude and practice(r=0.714,P<0.001) of nosocomial infection prevention and control. CONCLUSION Nosocomial infection prevention and control KAP of HCW in hospitals of different scales needs further improvement in Inner Mongolia. Difference scales of hospitals should take comprehensive effective intervention measures, increase the HCW's knowledge of nosocomial infection prevention and control, correct the attitude, support and promote the HCW's practice of nosocomial infection prevention and control.
引文
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[20] Sarani H,Balouchi A,Masinaeinezhad N,et al.Knowledge,attitude and practice of nurses about standard precautions for hospital-acquired infection in teaching hospitals affiliated to Zabol University of Medical Sciences (2014)[J].Global J Health Sci,2015,8(3):193-198.
[21] 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[J].中国感染控制杂志,2016,15(9):654-658.
[22] 王笑笑,胡国庆,陆烨.医务人员手卫生规范实施评价研究[J].中华医院感染学杂志,2013,23(24):6072-6074.
[23] 匡季秋,王守军,李银雪,等.医务人员手卫生培训策略及效果研究[J].中华医院感染学杂志,2015,25(4):950-952.
[24] APIC Implementation Guide-Guide to Hand Hygiene Prog-rams for Infection Prevention[R].Association for Professionals in Infection Control and Epidemiology,2015.
[25] 杨鑫,李巧利.2012年内蒙古自治区部分医疗机构医疗废物管理现状调查及分析[J].疾病监测与控制,2015,9(9):639-641.
[26] Woldegioris T,Bantie G,Getachew H.Nurses' knowledge and practice regarding prevention of surgical site infection in Bahir Dar,Northwest Ethiopia[J].Surg Infect,2018.DOI:10.1089/sur.2018.081
[27] 周静,陶丽,张立萍,等.连续4年多重耐药菌医院感染监测及干预效果评价[J].中国消毒学杂志,2016,33(4):364-366.
[28] 张莉,潘虹,柯云楠,等.农村医疗机构医务人员医院感染知识现况分析[J].中国公共卫生2017,33(5):827-830.
[29] 张秀平,刘海鹏,高群,等.新录用医务人员医院感染知识水平基线调查[J].安徽医学,2014,35(1):105-108.
[30] 周晓平,黄继峥,罗腾达,等.基层医疗机构医务人员医院感染知识培训需求调查与管理对策[J].中华医院感染学杂志,2015,25(21):5037-5040.
[31] Farzana R ,Usuf C ,Hughes G D .Nursing students' knowledge,attitude and practices of infection prevention and control guidelines at a tertiary institution in the Western Cape:a cross sectional study[J].Nurse Educ Today,2018,69:20-25.
[32] 赵丽,杨润芳,袁郝郝.医院感染知识培训在提高医务人员无菌技术操作中的作用[J].中华医院感染学杂志,2014,24(12):3082-3084.
[2] Koulenti D,Tsigou E,Rello J.Nosocomial pneumonia in 27 ICUs in Europe:perspectives from the EU-VAP/CAP study[J].European J Clin Microbiol Infect Dis,2016:1-8.
[3] Dudeck MA,Weiner LM,Allen-Bridson K,et al.National Healthcare Safety Network (NHSN) report,data summary for 2012,device-associated module[J].Am J Infect Control,2013,41(12):1148.
[4] Loveday HP,Wilson JA,Pratt RJ,et al.epic3:national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England[J].J Hosp Infect,2014,86:S1-S70.
[5] Kullin B,Meggersee R,D'Alton J,et al.Prevalence of gastrointestinal pathogenic bacteria in patients with diarrhoea attending Groote Schuur Hospital,Cape Town,South Africa[J].South Afr Med J,2015,105(2):121-125.
[6] European Centre for Disease Control.EUCLID-European multicenter prospective bi-annual point prevalence study of Clostridium difficile infection in hopsitalised patients with diarrhoea:the fuller picture of the incidence of Clostridium difficile infection(CDI) across Europe[R].Solna:ECDC,2014.
[7] Rahiman F,Chikte U,Hughes GD.Nursing students' knowledge,attitude and practices of infection prevention and control guidelines at a tertiary institution in the Western Cape:a cross sectional study[J].Nurse Education Today,2017,69:20-25.
[8] Ogoina D,Pondei K,Adetunji B,et al.Knowledge,attitude and practice of standard precautions of infection control by hospital workers in two tertiary hospitals in Nigeria[J].J Infect Prev,2015,16:16-22.
[9] Suliman M,Aloush S,Aljezawi M,et al.Knowledge and practices of isolation precautions among nurses in Jordan[J].Am J Infect Control 2018,46:680-684.
[10] 吴婷,商临萍,刘玲玉,等.三级甲等医院护士多重耐药菌感染防控知信行的调查分析[J].护理管理杂志,2014,14(4):232-234.
[11] WS/T 367-2012,医疗机构消毒技术规范[S].北京:中华人民共和国卫生部,2012.
[12] WS/T 311-2009,医院隔离技术规范[S].北京:中华人民共和国卫生部,2009.
[13] WS/T 313-2009,医务人员手卫生规范[S].北京:中华人民共和国卫生部,2009.
[14] 外科手术部位感染预防与控制技术指南(试行)[S].北京:中华人民共和国卫生部,2010.
[15] 导管相关血流感染预防与控制技术指南(试行)[S].北京:中华人民共和国卫生部,2010.
[16] 导尿管相关尿路感染预防与控制技术指南(试行)[S].北京:中华人民共和国卫生部,2010.
[17] 多重耐药菌医院感染预防与控制技术指南(试行)[S].北京:中华人民共和国卫生部,2011.
[18] 医疗卫生机构医疗废物管理办法[S].北京:中华人民共和国卫生部,2003.
[19] Mummah SA,Robinson TN,King AC,et al.IDEAS (In-tegrate,Design,Assess,and Share):a framework and toolkit of strategies for the development of more effective digital interventions to change health behavior[J].J Med Int Res,2016,18(12):e317.
[20] Sarani H,Balouchi A,Masinaeinezhad N,et al.Knowledge,attitude and practice of nurses about standard precautions for hospital-acquired infection in teaching hospitals affiliated to Zabol University of Medical Sciences (2014)[J].Global J Health Sci,2015,8(3):193-198.
[21] 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[J].中国感染控制杂志,2016,15(9):654-658.
[22] 王笑笑,胡国庆,陆烨.医务人员手卫生规范实施评价研究[J].中华医院感染学杂志,2013,23(24):6072-6074.
[23] 匡季秋,王守军,李银雪,等.医务人员手卫生培训策略及效果研究[J].中华医院感染学杂志,2015,25(4):950-952.
[24] APIC Implementation Guide-Guide to Hand Hygiene Prog-rams for Infection Prevention[R].Association for Professionals in Infection Control and Epidemiology,2015.
[25] 杨鑫,李巧利.2012年内蒙古自治区部分医疗机构医疗废物管理现状调查及分析[J].疾病监测与控制,2015,9(9):639-641.
[26] Woldegioris T,Bantie G,Getachew H.Nurses' knowledge and practice regarding prevention of surgical site infection in Bahir Dar,Northwest Ethiopia[J].Surg Infect,2018.DOI:10.1089/sur.2018.081
[27] 周静,陶丽,张立萍,等.连续4年多重耐药菌医院感染监测及干预效果评价[J].中国消毒学杂志,2016,33(4):364-366.
[28] 张莉,潘虹,柯云楠,等.农村医疗机构医务人员医院感染知识现况分析[J].中国公共卫生2017,33(5):827-830.
[29] 张秀平,刘海鹏,高群,等.新录用医务人员医院感染知识水平基线调查[J].安徽医学,2014,35(1):105-108.
[30] 周晓平,黄继峥,罗腾达,等.基层医疗机构医务人员医院感染知识培训需求调查与管理对策[J].中华医院感染学杂志,2015,25(21):5037-5040.
[31] Farzana R ,Usuf C ,Hughes G D .Nursing students' knowledge,attitude and practices of infection prevention and control guidelines at a tertiary institution in the Western Cape:a cross sectional study[J].Nurse Educ Today,2018,69:20-25.
[32] 赵丽,杨润芳,袁郝郝.医院感染知识培训在提高医务人员无菌技术操作中的作用[J].中华医院感染学杂志,2014,24(12):3082-3084.