摘要
目的应用感控工作间APP辅助隐蔽式现场观察法调查医护人员手卫生依从性。方法选取2016年1月—2018年10月某院全体医护人员为研究对象,于2017年1月开始采用感控工作间APP辅助隐蔽式现场观察法调查医护人员手卫生依从率,并比较2016年(采用纸质调查表辅助隐蔽式现场观察法)、2017年、2018年1—10月的手卫生依从率差异。结果 2016、2017年、2018年1—10月分别调查医护人员1 201、1 237、1 234名,调查手卫生指征6 539、22 708、17 509次。2016年采用纸质调查表辅助隐蔽式现场观察法调查手卫生依从率为89.45%,2017年应用感控工作间APP辅助隐蔽式现场观察法调查手卫生依从率为60.76%,2018年1—10月手卫生依从率提高至69.06%。不同年份医护人员手卫生依从率比较,差异有统计学意义(P<0.001)。结论应用感控工作间APP辅助隐蔽式现场观察法较纸质调查表辅助隐蔽式现场观察法可获取更准确的医护人员手卫生依从性数据,对提高手卫生依从性有指导意义。
Objective To apply infection control workshop APP-assisted concealed on-the-spot observation method in surveying hand hygiene(HH) compliance of health care workers(HCWs).Methods All HCWs in a hospital from January 2016 to October 2018 were surveyed,infection control workshop APP-assisted concealed on-the-spot observation method was adopted to survey HH compliance rates of HCWs since January 2017,difference in HH compliance rates in 2016(adopting paper questionnaire-assisted concealed on-the-spot observation method),2017,and January-October of 2018 were compared.Results In 2016,2017,and January-October of 2018,1 201,1 237,and 1 234 HCWs were surveyed respectively,6 539,22 708,and 17 509 HH indications were surveyed respectively.HH compliance rate was 89.45% in 2016 revealed by paper questionnaire-assisted concealed on-the-spot observation method,60.76% in 2017 revealed by APP-assisted concealed on-the-spot observation method,and increased to 69.06%in January-October of 2018.Compliance rates of HH among HCWs in different years were significantly different(P<0.001).Conclusion Compared with paper questionnaire-assisted concealed on-the-spot observation,infection control workshop APP-assisted concealed on-the-spot observation method can obtain more accurate data of HH compliance of HCWs,which is of guiding significance for improving HH compliance.
引文
[1]戴燕红.肝移植ICU病房医院感染的预防与护理体会[J].大家健康,2013,7(11):285-286.
[2]郑树森.肝移植[M].2版.北京:人民卫生出版社,2012:599-612.
[3] Chou DT,Achan P,Ramachandran M.The World Health Organization ‘5 moments of hand hygiene’:the scientific foundation[J].J Bone Joint Surg Br,2012,94(4):441-445.
[4]张春华,孙勇,马学先,等.手卫生成本与医院感染发病率的研究[J].中国感染控制杂志,2016,15(3):195-197.
[5] World Health Organization.WHO guidelines on hand hygiene in health care[S].Geneva,Switzerlang,WHO,2009.
[6] Boyce JM.Hand hygiene compliance monitoring:current perspectives from the USA[J].J Hosp Infect,2008,70(Suppl1):2-7.
[7] Ellingson K,Haas JP,Aiello AE,et al.Strategies to prevent healthcare-associated infections through hand hygiene[J].Infect Control Hosp Epidemiol,2014,35(8):937-960.
[8]中华人民共和国卫生部.医务人员手卫生规范[S].北京,2009.
[9] World Health Organization.Hand hygiene technical reference manual[EB/OL].[2018-1-24].http://www.doc88.com/p-3177686996098.html.
[10]孔晓明,王志棣,朱晓露.直观教育法对提高医护人员手卫生依从性的效果研究[J].当代临床医刊,2016,29(4):2323-2324.
[11]Eckmanns T,Bessert J,Behnke M,et al.Compliance with antiseptic handrub use in intensive care:the Hawthorne effect[J].Infect Control Hosp Epidemiol,2006,27(9):931-934.
[12]雷晓婷,林红,孙慧,等.2010—2012年综合性医院医务人员手卫生依从率的系统综述[J].中国感染控制杂志,2014,13(6):339-344,352.
[13]Erasmus V,Daha TJ,Brug H,et al.Systematic review of studies on compliance with hand hygiene guidelines in hospital care[J].Infect Control Hosp Epidemiol,2010,31(3):281-294.
[14]刘秀梅.医务人员手卫生依从性及改进措施研究[J].临床医药文献电子杂志,2014,1(8):1292-1294.
[15]宋丽红,贾会学,贾建侠,等.医务人员手卫生影响因素的调查与分析[J].中华医院感染学杂志,2009,19(1):35-37.
[16]贾彩霞.洗手前后细菌监测提高护士手卫生依从性研究[J].医学信息,2015,28(7):116.
[17]邢娟,桂斯卿.医护人员手卫生研究进展[J].护理学杂志,2010,25(6):91-93.
[18]林金香,陈妙霞,周小香.医护人员手卫生依从性与医院感染的相关研究[J].中华医院感染学杂志,2009,19(2):185-187.