孙小南;柴文昭;孙建华;张媛媛;马鸿鸣;苏龙翔;陆相云;
SUN Xiao-nan;CHAI Wen-zhao;SUN Jian-hua;ZHANG Yuan-yuan;MA Hong-ming;SU Long-xiang;LU Xiang-yun;Department of Urology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Infection Control,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical Colleg

• 1:中国医学科学院北京协和医学院北京协和医院泌尿外科
• 2:中国医学科学院北京协和医学院北京协和医院医院感染管理处
• 3:中国医学科学院北京协和医学院北京协和医院重症医学科

摘要(Abstract)：

目的调查北京协和医院ICU医务人员手卫生依从性现状,并分析其存在差异的深层次原因。方法采用单盲、便利抽样法,对2019年1月至12月北京协和医院经手卫生多维度培训后的ICU医务人员进行手卫生现状调查,计算手卫生依从率,并比较不同手卫生时刻及不同类别/来源的医务人员手卫生依从率的差异。结果共285名符合纳入和排除标准的ICU医务人员入选本研究。其中医生85名、护士171名、护理员21名、保洁员8名;本院医护人员104名、进修医护人员152名。共观察手卫生指征总数23 661次、手卫生执行总数21 360次,总体手卫生依从率为90.28%(21 360/23 661)。世界卫生组织规定的5个手卫生时刻依从率由高至低依次为接触患者体液后(95.63%,765/800)、无菌操作前(94.39%,2121/2247)、接触患者后(91.59%,7916/8643)、接触患者周围环境后(88.91%,4026/4528)、接触患者前(87.76%,6532/7443),差异有统计学意义(P<0.001);不同类别人员的手卫生依从率由高至低分别为护士(94.52%,11 186/11 834)、护理员(93.49%,1665/1781)、医生(84.78%,8427/9940)、保洁员(77.36%,82/106),差异有统计学意义(P<0.001)。本院医护人员的手卫生依从率(93.45%,7844/8394)高于进修医护人员(87.96%,11 769/13 380),差异有统计学意义(P<0.001)。结论北京协和医院ICU医务人员手卫生依从性总体较好,但不同手卫生时刻及不同类别人员之间仍存在一定差异,可能与医务人员的手卫生防护意识、科室对不同类别医务人员的培训和监督力度不同有关。
Objective To investigate the hand-hygiene compliance of ICU medical staff in Peking Union Medical College Hospital(PUMCH) and analyze the reasons for the differences.Methods A single-blind and convenient sampling-method was used to investigate the status of hand hygiene of the ICU medical staff who received hand-hygiene training in PUMCH from January to December 2019. The rate of hand-hygiene compliance was calculated, and the differences in the rate of hand-hygiene compliance of different time and personnel typeswere compared. Results A total of 285 ICU medical staff who met the inclusion and exclusion criteria were enrolled in this study. There were 85 doctors, 171 nurses, 21 nurse-assistants, 8 cleaners; 104 doctors and nurses of our hospital and 152 refresher doctors and nurses. The total number of hand-hygiene indications was 23 661, and the total number of hand-hygiene implementation was 21 360. The overall rate of hand-hygiene compliance was 90.28%(21 360/23 661). The compliance rates of the five hand-hygiene moments stipulated by the World Health Organization were 95.63%(765/800) after contacting the body fluid of the patients, 94.39%(2121/2247) before aseptic operation, 91.59%(7916/8643) after contacting the patients, 88.91%(4026/4528) after contacting the surrounding environment of the patients, and 87.76%(6532/7443) before contacting the patients, with statistically significant differences(P<0.05). The compliance rates of nurses, nurse-assistants doctors, and cleaners were 94.52%(11 186/11 834), 93.49%(1665/1781),84.78%(8427/9940), and 77.36%(82/106), respectively, with statistical significance(P<0.05). The rate of hand-hygiene compliance of the medical staff of our hospital was 93.45%(7844/8394), which was higher than that of the refresher medical staff(87.96%,11 769/13 380), and the difference was statistically significant(P<0.05). ConclusionsThe hand-hygiene compliance of the ICU medical staff in PUMCH is good, but there are still some differences in the hand-hygiene time and personnel types, which may be related to the awareness of hand-hygiene protection of the medical staff and the difference in training and supervision of different departments for different types of medical staff.

关键词(KeyWords)： 手卫生;依从性;院内感染
hand hygiene;compliance;nosocomial infection

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 孙小南;柴文昭;孙建华;张媛媛;马鸿鸣;苏龙翔;陆相云;
SUN Xiao-nan;CHAI Wen-zhao;SUN Jian-hua;ZHANG Yuan-yuan;MA Hong-ming;SU Long-xiang;LU Xiang-yun;Department of Urology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Infection Control,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical Colleg

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