摘要
目的探讨手卫生依从性干预对泌尿外科手术患者耐甲氧西林金黄色葡萄球菌(MRSA)感染的影响。方法纳入泌尿外科14名护理人员,采用现场观察法和问卷调查法收集2015年4月—2017年4月护理人员手卫生执行情况,收集同期泌尿外科手术患者MRSA感染情况,分析护理人员手卫生执行依从性与患者MRSA感染的关系,探讨影响护理人员手卫生执行依从性的因素,自2016年4月开始实施手卫生依从性干预方案,比较干预前后护理人员手卫生依从性变化情况及患者MRSA感染率。结果研究期间1名护士离职,1名护士转科,被剔除。干预后护理人员主观规范、知觉行为控制及手卫生依从性较干预前明显提高(P<0.05),直线线性分析显示,护理人员手卫生依从性与其主观规范和知觉行为控制得分呈显著正相关性(R2=0.724,0.396,P<0.05)。干预前后MRSA感染率分别为11.0%和3.9%,经卡方检验,干预前后差异有统计学意义(P<0.05)。手卫生依从率与院内MRSA感染呈显著负相关性(r=-0.742,P=<0.05)。多元回归分析显示,主观规范和知觉行为控制是影响手卫生依从性的独立因素。结论护理人员手卫生依从性与泌尿外科手术患者术后MRSA感染率具有显著相关性,提高护理人员主观规范和知觉行为控制情况能显著改善手卫生依从性,进而降低泌尿外科手术患者术后MRSA感染率。
Objective To investigate the effect of hand hygiene compliance on methicillin-resistant Staphylococcus aureus（MRSA） infection in patients undergoing urological surgery. Methods A total of 14 nurses in urology department were enrolled in this study. The situation of hand hygiene performed by nursing staff from April 2015 to April 2017 was collected by on-the-spot observation and questionnaire survey. The MRSA infection status of urological surgery patients during the same period was collected. Compliance and patient MRSA infection to explore the factors that affect the hand hygiene compliance of nursing staff. Since April 2016, hand hygiene compliance intervention program has been implemented, and the change of hand hygiene compliance and the MRSA infection of nursing staff before and after intervention rate. Results During the study, a nurse resigned, a nurse transferred to the department, was removed. After intervention, nurses＇ subjective norms, behavior control and hand hygiene compliance were significantly higher than those before intervention（P〈0.05）. Linear analysis showed that there was a significant positive correlation between nursing hand hygiene compliance and subjective norms and perceived behavioral control scores（R2= 0.724,0.396, P〈0.05）. The infection rates of MRSA before and after intervention were 11.0% and 3.9%, respectively. After chi-square test, the difference was statistically significant before and after intervention（P〈0.05）. There was a significant negative correlation between hand hygiene compliance and hospital infection of MRSA（r =-0.742, P = 0.05）. Multiple regression analysis showed that subjective norms and perceptual behavior control were independent factors affecting hand hygiene compliance. Conclusions There is a significant correlation between hand hygiene compliance and MRSA infection rate among nursing staffs. Improving subjective norm and perceptual behavi or control of nursing staff can significantly improve hand hygiene compliance and reduce posto
作者
徐华丽
张倩
曾世超
XU Hua-li;ZHANG Qian;ZENG Shi-chao(Neijiang Second People＇s Hospital,Neijiang 641000 China)
出处
《工业卫生与职业病》
CAS
2018年第5期330-333,共4页
Industrial Health and Occupational Diseases
