CAJ | 학술논문

目的：：调查干预前后重症监护室医务人员手卫生依从性、知晓情况及医院感染发生率，了解手卫生现状及手卫生与医院感染之间的关系。方法：采用实验流行病学方法，从2013年5月至2014年5月分5个阶段进行手卫生干预，干预措施包括直接观察、手卫生培训、评估反馈等，观察干预前后手卫生执行情况，计算手卫生依从性。进行现场试卷考核，计算重症监护室人员手卫生知晓率。统计调查时段内医院感染发生例数，计算医院感染发生率。结果：医生手卫生执行依从性从干预前45.0％提高到再干预后的91.1％，护士手卫生依从性从干预前43.3％提高到再干预后的92.2％，差异均有统计学意义( P<0.01)。医生手卫生知晓考试成绩从培训前60.0分提高到培训后90.0分；护士成绩从培训前59.1分提高到培训后92.1分，差异均有统计学意义(P<0.01)。医院感染发生率从2013年5月的12.5％降低到再干预后的3.2％，但差异无统计学意义(P>0.05)。结论：采取有效的干预措施提高手卫生依从性和知晓率，可以有效降低医院感染的发生。
목적：：조사간예전후중증감호실의무인원수위생의종성、지효정황급의원감염발생솔，료해수위생현상급수위생여의원감염지간적관계。방법：채용실험류행병학방법，종2013년5월지2014년5월분5개계단진행수위생간예，간예조시포괄직접관찰、수위생배훈、평고반궤등，관찰간예전후수위생집행정황，계산수위생의종성。진행현장시권고핵，계산중증감호실인원수위생지효솔。통계조사시단내의원감염발생례수，계산의원감염발생솔。결과：의생수위생집행의종성종간예전45.0％제고도재간예후적91.1％，호사수위생의종성종간예전43.3％제고도재간예후적92.2％，차이균유통계학의의( P<0.01)。의생수위생지효고시성적종배훈전60.0분제고도배훈후90.0분；호사성적종배훈전59.1분제고도배훈후92.1분，차이균유통계학의의(P<0.01)。의원감염발생솔종2013년5월적12.5％강저도재간예후적3.2％，단차이무통계학의의(P>0.05)。결론：채취유효적간예조시제고수위생의종성화지효솔，가이유효강저의원감염적발생。
Objective:To investigate the hand hygiene compliance and awareness of medical staff in intensive care unit,incidence of nosocomial infection before and after the intervention, and know the status of hand hygiene, relationship between hand hygiene and nosocomial infection. Methods:The hand hygiene intervention in five stages were implemented using experimental epidemiology method from May 2013 to May 2014. The intervention measures included direct observing,hand hygiene training,assessment feedback,observing the implementation of hand hygiene before and after the intervention and calculating the compliance of hand hygiene. All people were examined on-site to calculate the awareness rate of hand hygiene. The number of cases with nosocomial infection was analyzed during the survey period to calculate the incidence of nosocomial infection. Results:The hand hygiene compliance in doctors and nurses before and after intervention were from 45. 0% to 91. 1% and from 43. 3% to 92. 2%, respectively, the difference of which was statistically significant(P<0. 01). The score of awareness rate of hand hygiene in doctors and nurses before and after training were from 60. 0 to 90. 0 and from 59. 1 to 92. 1,respectively,the difference of which was statistically significant(P<0. 01). The incidence of nosocomial infection reduced from 12. 5% to 3. 2%,the difference was not statistically significant(P >0. 05). Conclusions:Taking effective intervention measures can improve the compliance and awareness of hand hygiene, which can reduce the occurrence of nosocomial infection.