摘要
目的 研究某三级甲等医院重症监护病房(ICU)工作人员手卫生依从性及正确性,为手卫生干预提供理论基础。方法 2023年4月,专职感染监控人员对该院17个ICU的工作人员进行现场调查,填写手卫生依从性和正确性监测表。结果 使用隐蔽观察法共观察874次手卫生时机,执行手卫生时机501次,依从率57.32%,正确执行273次,正确率54.49%。不同ICU工作人员手卫生依从率及正确率差异较大。不同岗位工作人员手卫生依从率和正确率比较差异有统计学意义,保洁员的手卫生依从率(31.97%)低于护士(63.83%)、医生(58.77%)和其他人员(58.14%);保洁员的手卫生正确率(30.77%)低于护士(58.17%)。不同岗位人员及不同手卫生时刻未执行手卫生的原因差异有统计学意义:接触患者后未执行任何手卫生措施的比率(84.75%)高于接触患者前(41.27%)、清洁无菌操作前(30.00%)、接触血液体液后(45.45%);接触患者周围环境后未执行任何手卫生措施的比率(66.67%)高于接触患者前和清洁无菌操作前。不同岗位工作人员手卫生步骤不全的比率及时间不够的比率比较差异有统计学意义,其他人员的手卫生步骤不全的比率(82.35%)高于医生(52.63%);医生(82.46%)及护士(78.18%)手卫生时间不够的比率高于保洁员(51.85%)。结论 在ICU,不同职业的人群、不同时刻手卫生执行情况存在明显差异,需要综合其特点进行干预。
Objective To study the compliance and correctness of hand hygiene(HH)of staff in intensive care units(ICUs)of a tertiary first-class hospital,and provide theoretical basis for HH intervention.Methods In April 2023,staff in 17 ICUs of this hospital were performed on-site survey by infection control staff,and monitoring forms about HH compliance and correctness were filled out.Results A total of 874 HH opportunities were observed with the concealed observation method,501 HH opportunities were implemented,the compliance rate was 57.32%,273 HH opportunities were correctly implemented,with an correct rate of 54.49%.The compliance and correct rate of HH among staff in different ICUs varied significantly.Compliance and correct rates of HH among staff with different jobs were statistically different:HH compliance rate of cleaners(31.97%)was lower than that of nurses(63.83%),doctors(58.77%)and other personnel(58.14%);HH correct rate of cleaners(30.77%)was lower than that of nurses(58.17%).The causes for not implementing HH among staff with different jobs and at different HH opportunities were statistically different:the rate of not implementing any HH measures after contact with patients(84.75%)was higher than before contact with patients(41.27%),before clean and sterile manipulation(30.00%),as well as after contact with blood and body fluid(45.45%).The rate of not implementing any HH measures after contact with the patient’s surrounding environment(66.67%)was higher than before contact with patient as well as before clean and sterile manipulation.The rates of incomplete HH steps and insufficient HH time among staff with different jobs were statistically different:The rates of incomplete HH steps of other personnel(82.35%)was higher than that of doctors(52.63%).The rates of insufficient HH time of doctors(82.46%)and nurses(78.18%)were higher than that of cleaners(51.85%).Conclusion The implementation of HH among different occupational groups and at different HH implementation opportunities in ICU is significantly differ
作者
邹明君
谭莉
徐敏
许川
谭昆
王骁
ZOU Ming-jun;TAN Li;XU Min;XU Chuan;TAN Kun;WANG Xiao(Department of Infection Management,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Obstetrics and Gynecology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2024年第3期298-304,共7页
Chinese Journal of Infection Control
基金
湖北省自然科学基金项目(2023AFB132)
同济医院科研基金项目(2022B27)。
关键词
重症监护病房
医务人员
手卫生
依从率
正确率
intensive care unit
health care worker
hand hygiene
compliance rate
correct rate
