探讨医院手卫生管理对手术切口感染率的影响
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摘要
目的探讨医院手卫生管理对手术切口感染率的影响价值。方法选择自2018年1—12月收治的已实施医院手卫生管理干预措施的26例手术治疗患者纳入研究,另选择自2017年1—12月收治的未实施医院手卫生管理干预措施的26例手术治疗患者纳入研究;比较分析医院手卫生管理实施前后的手术切口感染情况、护理满意度、手卫生基础知识评分、手卫生专业技能评分。结果实施医院手卫生管理后的手术切口感染率为3.85%,与实施医院手卫生管理前比较,差异显著(χ~2=4.127 0,P <0.05);实施医院手卫生管理后的护理满意度为96.15%,与实施医院手卫生管理前比较,差异显著(χ~2=4.127 0, P <0.05);实施医院手卫生管理后的手卫生和洗手的定义评分为(9.35±1.00)分,手卫生规范评分为(9.25±0.95)分,最新文献报道评分为(8.95±0.95)分,手卫生指征评分为(9.45±1.15)分,快速手消毒液使用指征评分为(9.75±1.05)分,相关应急预案评分为(9.00±1.05)分,与实施医院手卫生管理前比较,差异显著(t=4.743 8,3.292 3,2.373 1,3.347 3,4.984 7,3.869 3,P <0.05);实施医院手卫生管理后的6步洗手法正确步骤评分为(9.75±1.05)分,快速手消毒液合理使用评分为(9.65±1.15)分,正确适宜佩戴手套评分为(9.35±1.15)分,无菌操作技术规范评分为(9.55±1.25)分,与实施医院手卫生管理前比较,差异显著(t=3.115 4,6.025 6,3.080 9,3.356 6,P <0.05)。结论实施医院手卫生管理干预措施,可以明显降低对手术切口感染率,提高护理满意度,提高医护人员的手卫生基础知识及手卫生专业技能。
Objective To explore the effect of hand hygiene management on surgical incision infection rate. Methods Twenty-six patients with hospital hand hygiene management intervention from January to December 2018 were included in the study, and 26 patients without hospital hand hygiene management intervention from January to December 2017 were included in the study. The infection of surgical incision and full nursing before and after the implementation of hospital hand hygiene management were compared and analyzed. Intention, score of basic knowledge of hand hygiene and score of professional skills of hand hygiene were analyzed. Results The infection rate of surgical incision after the implementation of hospital hand hygiene management was 3.85%. Compared with that before the implementation of hospital hand hygiene management, the difference was significant(χ~2=4.127 0, P < 0.05).After the implementation of hospital hand hygiene management, the nursing satisfaction rate was 96.15%,which was significantly different from that before the implementation of hospital hand hygiene management(χ~2=4.127 0, P < 0.05).The definition score of hand hygiene and hand washing after the implementation of hospital hand hygiene management was(9.35±1.00), hand hygiene standard score was(9.25±0.95), latest literature report score was(8.95±0.95), hand hygiene indication score was(9.45 ±1.15), rapid hand disinfectant use indication score was(9.75±1.05), and emergency plan score was(9.00±1.05), which was practical. There were significant differences before hand hygiene management(t =4.743 8, 3.292 3,2.373 1, 3.347 3, 4.984 7, 3.869 3, P < 0.05).After the implementation of hospital hand hygiene management, the correct step score of 6-step washing method was(9.75±1.05), the rational use score of quick hand disinfectant was(9.65±1.15), the correct and suitable gloves score was(9.35±1.15), and the technical standard score of aseptic operation was(9.55±1.25). Compared with the pre-implementation of hospital hand hygiene management, the difference was significant(t =3.115 4, 6.025 6,3.080 9, 3.356 6, P < 0.05). Conclusion The implementation of hand hygiene management interventions in hospitals can significantly reduce the infection rate of surgical incision, improve nursing satisfaction, and improve the basic knowledge and professional skills of hand hygiene of medical staff.
Objective To explore the effect of hand hygiene management on surgical incision infection rate. Methods Twenty-six patients with hospital hand hygiene management intervention from January to December 2018 were included in the study, and 26 patients without hospital hand hygiene management intervention from January to December 2017 were included in the study. The infection of surgical incision and full nursing before and after the implementation of hospital hand hygiene management were compared and analyzed. Intention, score of basic knowledge of hand hygiene and score of professional skills of hand hygiene were analyzed. Results The infection rate of surgical incision after the implementation of hospital hand hygiene management was 3.85%. Compared with that before the implementation of hospital hand hygiene management, the difference was significant(χ~2=4.127 0, P < 0.05).After the implementation of hospital hand hygiene management, the nursing satisfaction rate was 96.15%,which was significantly different from that before the implementation of hospital hand hygiene management(χ~2=4.127 0, P < 0.05).The definition score of hand hygiene and hand washing after the implementation of hospital hand hygiene management was(9.35±1.00), hand hygiene standard score was(9.25±0.95), latest literature report score was(8.95±0.95), hand hygiene indication score was(9.45 ±1.15), rapid hand disinfectant use indication score was(9.75±1.05), and emergency plan score was(9.00±1.05), which was practical. There were significant differences before hand hygiene management(t =4.743 8, 3.292 3,2.373 1, 3.347 3, 4.984 7, 3.869 3, P < 0.05).After the implementation of hospital hand hygiene management, the correct step score of 6-step washing method was(9.75±1.05), the rational use score of quick hand disinfectant was(9.65±1.15), the correct and suitable gloves score was(9.35±1.15), and the technical standard score of aseptic operation was(9.55±1.25). Compared with the pre-implementation of hospital hand hygiene management, the difference was significant(t =3.115 4, 6.025 6,3.080 9, 3.356 6, P < 0.05). Conclusion The implementation of hand hygiene management interventions in hospitals can significantly reduce the infection rate of surgical incision, improve nursing satisfaction, and improve the basic knowledge and professional skills of hand hygiene of medical staff.
引文
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[14]柴艳红,王志存,田革新,等.加强麻醉人员手卫生管理降低全麻患者术后肺部感染[J].中华医院感染学杂志,2016,26(2):470-472.
[15]张秀梅.多角度强化手卫生管理对手术科室院内感染发生情况的影响探究[J].心理医生,2016,22(34):274-275.
[2]王瑞芬,周保利,薛文英,等.清洁切口预防使用抗菌药物管理效果评价[J].中国消毒学杂志,2015,32(1):32-34.
[3]廖丽,余华容.烧伤科医护人员实施手卫生管理后的洗手依从性和医院感染率分析[J].哈尔滨医药,2018,38(5):457-458.
[4]刘云红,张付华.骨科聚集性深部切口感染病例的调查分析及干预控制[J].世界临床医学,2017,11(20):194,197.
[5]董嘉,杨雪松,袁晓宁,等.脊柱手术围手术期抗菌药物预防应用干预效果评价[J].中国医院管理,2016,36(4):49-51.
[6]许彩娣,袁妃燕,倪晶贞,等.保洁员手卫生管理对住院患者金黄色葡萄球菌感染的影响[J].中华现代护理杂志,2017,23(35):4486-4489.
[7]董芸.医务人员手卫生管理在ICU医院感染干预中的应用[J].齐鲁护理杂志,2018,24(5):73-75.
[8]唐媛玲.多角度强化手卫生管理对降低儿科病房交叉感染率的影响[J].护理实践与研究,2016,13(23):91-93.
[9]万玉英,韩小建.PDCA循环加强ICU医务人员手卫生管理对控制MRSA医院感染的影响[J].重庆医学,2015,44(34):4777-4779.
[10]孙淑君.基于PDCA循环法手卫生管理在手术室护理工作中的应用[J].齐鲁护理杂志,2018,24(8):50-52.
[11]易艳斌,吴英,古丽芳,等.手卫生管理对烧伤科工作人员洗手依从性和感染率的影响[J].中华现代护理杂志,2016,22(14):1933-1934,1935.
[12]朱霞,肖烨,张绍伟,等.遵义市口腔医疗机构医务人员手卫生管理现状调查[J].中国感染控制杂志,2016,15(8):570-572.
[13]段丽,杨艳芳.某医院手卫生管理对Ⅱ类手术切口感染率的影响[J].现代预防医学,2018,45(21):4029-4032.
[14]柴艳红,王志存,田革新,等.加强麻醉人员手卫生管理降低全麻患者术后肺部感染[J].中华医院感染学杂志,2016,26(2):470-472.
[15]张秀梅.多角度强化手卫生管理对手术科室院内感染发生情况的影响探究[J].心理医生,2016,22(34):274-275.