摘要
[目的]本研究通过对南京地区三家甲等医院ICU医务人员手卫生知识的掌握情况和手卫生的执行现状进行调查和干预,探讨提高其手卫生依从性、手卫生质量的有效策略,从而提高临床医务人员手部卫生意识及手卫生依从性,强化ICU医务人员控制医院感染的意识,为医院感染的预防、控制、管理提供科学的依据,从而降低医院的感染率,在目前的形式下是非常迫切与重要的,有着显著的社会效益与经济效益。
[方法]采用定量研究的方法,首先在南京地区三家甲等医院ICU医务人员随机选取了90名医务人员作为研究对象,采用观察法和问卷法收集手卫生行为、手卫生知识掌握情况及影响手卫生依从性因素等。针对ICU医务人员手卫生现状和影响手卫生依从性的因素等,制定集束化行为干预措施。对ICU医务人员进行为期1个月集束化行为干预。随后对干预前的90名观察对象利用观察法收集手卫生行为,评价干预前后的效果。
[结果]TCU医务人员手卫生总依从率行为干预前、后分别为21.70%、53.20%。其中医生干预前、后手卫生依从率分别为17.86%、41.50%；护士干预前、后手卫生依从率分别为22.86%、56.40%；非固定人员干预前、后手卫生依从率分别为21.71%、53.17%。不同职称、工龄、学历、年龄行为干预前、后手卫生依从率均有显著差异。影响手卫生依从性的主要因素为工作太忙(58.1%)、盛放皂液的容器被污染(43.5%)、清洁剂或手消毒剂刺激皮肤,引起皮肤干燥(41.9%)等。
[结论]集束化行为干预能提高ICU医务人员的手卫生依从率,ICU医务人员手部卫生状况仍有待提高,执行手卫生行为及控制医院感染意识有待强化。
【Object】This paper discussed efficient strategy to improve hand hygiene compliance and quality through investigation and intervention on the present situation of ICU medical staff from three upper first-class hospitals in Nanjing and their mastering of hand hygiene knowledge, aiming to enhance the hand hygiene concept and compliance of ICU medical staff and to strengthen their concept of controlling nosocomial infection. This paper provides scientific evidence for the prevention, control and management of nosocomial infection, reduce nosocomial infection rate, which is very urgent and important with great social and economic effect.
【Methods】Use the investigative method of quantitative.Firstly,90 medical staff from three upper first-class hospitals in Nanjing were randomly chosen as subjects. Secondly, observation and questionnaire methods were adopted to collect their behavior and knowledge of hand hygiene as well as the facts that would affect hand hygiene compliance;and then behavior intervention was acted on the previous 90 subjects. One month later, observation method was used to collect hand hygiene behavior of 90 subjects to evaluate effects before and after intervention.
【Results】The hand hygiene rates of ICU staff before and after intervention were 21.70% and 53.20% respectively, of which the hand hygiene rates of ICU doctors before and after intervention were 17.86% and 41.50%; ICU nurses 22.86%and 56.40%; ICU non-regular staff 21.71% and 53.17%, The statistics suggested significant differences before and after intervention due to diversity in positional titles, working years, educational backgrounds and ages. Moreover, the facts that affected hand hygiene dependency were busyness with work (58.1%), infection containers of soap lye (43.5%) and dry skin caused by skin irritation from detergent and hand disinfector (41.9%).
[Conclusions] Bundle behavior intervention can enhance the hand hygiene dependent tare of ICU medical staff. Further improvement concerning hand hygiene situation of ICU medical staff and the exploration into strengthening regarding executing hand hygiene behavior and nosocomial infection control are expected.
引文
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