中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2011年
11期
1139-1142
,共4页
韩轲%窦丰满%张丽杰%朱保平
韓軻%竇豐滿%張麗傑%硃保平
한가%두봉만%장려걸%주보평
手卫生%医院感染
手衛生%醫院感染
수위생%의원감염
Hand-hygiene%Hospital infection
目的 了解成都市二级以上综合性医院医务人员手卫生执行状况及影响因素.方法 现场观察医务人员手卫生执行情况和手卫生设施,调查医务人员手卫生知识.结果 医务人员手卫生执行率为17.8％(接触患者前执行率为12.8％、接触患者周围物品及环境后执行率为21.0％、接触患者后执行率为27.3％,脱手套后执行率为31.5％)；2.2％的医疗室有脚踏或感应式水龙头、24.5％有洗手产品,6.3％有干手物品；92.8％的医务人员知道六步洗手法,对手掌、手背、手指和指背等洗手部位的认知率均在90.0％以上,仅22.8％的人知道搓手时间为≥15s.副主任以上医师(14.6％)、主治医师(9.2％)和医师(15.6％)以及主管以上护师(25.0％)、护师(26.3％)和护士(20.5％)之间手卫生执行率差异均无统计学意义(P＞0.05).副主任以上医师平均知识得分(12.4±3.2)、主治医师(13.6±3.3)和医师(13.4±2.9)以及主管以上护师(15.2±2.0)、护师(14.8±2.1)和护士(14.3±2.6)之间差异亦无统计学意义(P＞0.05).护士的手卫生执行率(22.7％)明显高于医生(13.6％)；≥50岁者(7.4％)明显低于＜50岁各年龄组(17.1％～25.0％)；女性(19.5％)显著高于男性(13.8％)；差异均有统计学意义(P＜0.05).护士的平均知识得分( 14.7±2.3)显著高于医生(13.2±3.1);50～ 59岁年龄组平均知识得分(12.2±3.8)显著低于20～29岁(14.0±2.6)、30～39岁(14.3±2.9)和40～ 49岁(13.8±2.7)组；女性(14.5±2.5)得分显著高于男性(12.7±3.2)；差异均有统计学意义(P＜0.05).结论 成都市二级以上综合性医院医务人员手卫生知识水平相对较高,但手卫生执行率偏低,医院手卫生设施不完善.应通过进一步加强培训,改善手卫生设施,以进一步提高手卫生执行率.
目的 瞭解成都市二級以上綜閤性醫院醫務人員手衛生執行狀況及影響因素.方法 現場觀察醫務人員手衛生執行情況和手衛生設施,調查醫務人員手衛生知識.結果 醫務人員手衛生執行率為17.8％(接觸患者前執行率為12.8％、接觸患者週圍物品及環境後執行率為21.0％、接觸患者後執行率為27.3％,脫手套後執行率為31.5％)；2.2％的醫療室有腳踏或感應式水龍頭、24.5％有洗手產品,6.3％有榦手物品；92.8％的醫務人員知道六步洗手法,對手掌、手揹、手指和指揹等洗手部位的認知率均在90.0％以上,僅22.8％的人知道搓手時間為≥15s.副主任以上醫師(14.6％)、主治醫師(9.2％)和醫師(15.6％)以及主管以上護師(25.0％)、護師(26.3％)和護士(20.5％)之間手衛生執行率差異均無統計學意義(P＞0.05).副主任以上醫師平均知識得分(12.4±3.2)、主治醫師(13.6±3.3)和醫師(13.4±2.9)以及主管以上護師(15.2±2.0)、護師(14.8±2.1)和護士(14.3±2.6)之間差異亦無統計學意義(P＞0.05).護士的手衛生執行率(22.7％)明顯高于醫生(13.6％)；≥50歲者(7.4％)明顯低于＜50歲各年齡組(17.1％～25.0％)；女性(19.5％)顯著高于男性(13.8％)；差異均有統計學意義(P＜0.05).護士的平均知識得分( 14.7±2.3)顯著高于醫生(13.2±3.1);50～ 59歲年齡組平均知識得分(12.2±3.8)顯著低于20～29歲(14.0±2.6)、30～39歲(14.3±2.9)和40～ 49歲(13.8±2.7)組；女性(14.5±2.5)得分顯著高于男性(12.7±3.2)；差異均有統計學意義(P＜0.05).結論 成都市二級以上綜閤性醫院醫務人員手衛生知識水平相對較高,但手衛生執行率偏低,醫院手衛生設施不完善.應通過進一步加彊培訓,改善手衛生設施,以進一步提高手衛生執行率.
목적 료해성도시이급이상종합성의원의무인원수위생집행상황급영향인소.방법 현장관찰의무인원수위생집행정황화수위생설시,조사의무인원수위생지식.결과 의무인원수위생집행솔위17.8％(접촉환자전집행솔위12.8％、접촉환자주위물품급배경후집행솔위21.0％、접촉환자후집행솔위27.3％,탈수투후집행솔위31.5％)；2.2％적의료실유각답혹감응식수룡두、24.5％유세수산품,6.3％유간수물품；92.8％적의무인원지도륙보세수법,대수장、수배、수지화지배등세수부위적인지솔균재90.0％이상,부22.8％적인지도차수시간위≥15s.부주임이상의사(14.6％)、주치의사(9.2％)화의사(15.6％)이급주관이상호사(25.0％)、호사(26.3％)화호사(20.5％)지간수위생집행솔차이균무통계학의의(P＞0.05).부주임이상의사평균지식득분(12.4±3.2)、주치의사(13.6±3.3)화의사(13.4±2.9)이급주관이상호사(15.2±2.0)、호사(14.8±2.1)화호사(14.3±2.6)지간차이역무통계학의의(P＞0.05).호사적수위생집행솔(22.7％)명현고우의생(13.6％)；≥50세자(7.4％)명현저우＜50세각년령조(17.1％～25.0％)；녀성(19.5％)현저고우남성(13.8％)；차이균유통계학의의(P＜0.05).호사적평균지식득분( 14.7±2.3)현저고우의생(13.2±3.1);50～ 59세년령조평균지식득분(12.2±3.8)현저저우20～29세(14.0±2.6)、30～39세(14.3±2.9)화40～ 49세(13.8±2.7)조；녀성(14.5±2.5)득분현저고우남성(12.7±3.2)；차이균유통계학의의(P＜0.05).결론 성도시이급이상종합성의원의무인원수위생지식수평상대교고,단수위생집행솔편저,의원수위생설시불완선.응통과진일보가강배훈,개선수위생설시,이진일보제고수위생집행솔.
Objective To evaluate the compliance on hand-hygiene and related factors among healthcare providers working at secondary and tertiary hospitals in Chengdu.Methods On-site observations regarding hand-hygiene compliance and facilities were conducted in 6 hospitals in Chengdu.Doctors and nurses were asked and recorded about their knowledge regarding hand hygiene.Results Of 1535 activities where hand-hygiene was deemed necessary,under observating healthcare providers would perform hand-hygiene procedures 17.8％ of the time (12.8％ of the time before touching a patient,21.0％ of the time before touching objects around a patient,27.3％ of the time after touching a patient,and 31.5％ of the time after removing gloves).Only 2.2％ of the treating rooms were equipped with foot-operated or automatic faucets; of these only 24.5％ had soap or alcohol-based hand-sanitizer,and 6.3％ had paper towel or other hand-drying equipments.92.8％ of the healthcare providers knew of the six-step method on hand-washing.More than 90.0％ of the healthcare providers knew that both palm and back of the hands as well as the front and back of the fingers should be washed.However,only 22.8％ knew that the hand-washing procedure should last ≥15 seconds.Rates on hand hygiene among chief or more senior physicians (14.6％),attending physicians (9.2％) and junior doctors (15.6％),nurses in chief (25.0％),senior nurses (26.3％) and junior nurses (20.5％) showed no significant differences (P＞0.05).Similarly,scores on related knowledge between chief or senior physicians (12.4 ± 3.2),attending physicians (13.6 ± 3.3) and junior doctors ( 13.4 ± 2.9),nurses in charge ( 15.2 ± 2.0),senior nurses ( 14.8 ± 2.1 ) and junior nurses (14.3 ± 2.6) also showed no significant differences (P＞0.05).Rate on hand hygiene among nurses (22.7％) was significantly higher than that of the doctors ( 13.6％ ).Rate of hand hygiene among 50-59 years old healthcare providers (7.4％) was significantly lower than those of all the other age groups ( 17.1％-25.0％ ) ; rate of female health care providers ( 19.5％ ) was significantly higher than that of males ( 13.8％ ).Similarly,the nurse' s knowledge score ( 14.7 ± 2.3) was significantly higher than that of the doctors ( 13.2 ± 3.1 ).Among 50-59 years old healthcare providers,the rate was ( 12.2 ± 3.8) significantly lower than that of 20-29 ( 14.0 ± 2.6),30-39 ( 14.3 ± 2.9) and 40-49 year olds ( 13.8 ± 2.7).Again,the knowledge score of females ( 14.5 ± 2.5 ) was significantly higher than that of males (12.7 ± 3.2) (P＜0.05).Conclusion The high-level knowledge on hand-hygiene among healthcare providers in this area did not translate into good practices.Also,most of the hospitals had poor hand-hygiene equipments.We recommend that training and periodic monitoring be conducted,and hand-hygiene equipment be improved to facilitate hand-hygiene practices among healthcare providers.
