CAJ | 학술논문

目的：对某院重症监护病房（ICU）医护人员手卫生进行干预，评估医护人员手卫生依从性及其影响因素。方法选取某三级甲等教学医院 ICU 37名医护人员作为调查对象，采用直接与间接法对其干预前后的手卫生情况进行观察、分析。结果手卫生监测第一阶段中，基线调查期手卫生依从率（46．96％）和干预后观察期（63．30％）比较，差异有统计学意义（χ2＝7．344，P ＝0．007）；手卫生监测第二阶段中 ICU 手卫生依从率从57．85％上升至88．58％。手卫生依从率与平均每床日手卫生用品消耗量呈正相关（r＝0．725，P ＜0．001），与医院感染发病率、例次发病率均呈负相关关系（r 值分别为－0．983、－0．990，均 P ＜0．001），使用含乙醇免洗手消毒剂手卫生依从率与平均每床日手卫生用品消耗量呈正相关（r＝0．391，P ＜0．001）。结论手卫生依从性监测和干预需要长期连续性进行，直接观察法与间接手卫生产品消耗评估法相结合，可以对医护人员手卫生依从性进行有效的监测和干预。
목적：대모원중증감호병방（ICU）의호인원수위생진행간예，평고의호인원수위생의종성급기영향인소。방법선취모삼급갑등교학의원 ICU 37명의호인원작위조사대상，채용직접여간접법대기간예전후적수위생정황진행관찰、분석。결과수위생감측제일계단중，기선조사기수위생의종솔（46．96％）화간예후관찰기（63．30％）비교，차이유통계학의의（χ2＝7．344，P ＝0．007）；수위생감측제이계단중 ICU 수위생의종솔종57．85％상승지88．58％。수위생의종솔여평균매상일수위생용품소모량정정상관（r＝0．725，P ＜0．001），여의원감염발병솔、례차발병솔균정부상관관계（r 치분별위－0．983、－0．990，균 P ＜0．001），사용함을순면세수소독제수위생의종솔여평균매상일수위생용품소모량정정상관（r＝0．391，P ＜0．001）。결론수위생의종성감측화간예수요장기련속성진행，직접관찰법여간접수위생산품소모평고법상결합，가이대의호인원수위생의종성진행유효적감측화간예。
Objective To intervene hand hygiene(HH)of health care workers (HCWs)in an intensive care unit(ICU)of a hospital,and evaluate HH compliance of HCWs and influencing factors.Methods 37 HCWs from an ICU of a teaching hospital were chosen as studied subjects,HH status before and after intervention was observed and analyzed by direct and indirect methods.Results In the first monitoring stage,HH rate in baseline and post-intervention survey stage was signifi-cantly different (46.96% vs 63.30%,χ2 =7.344,P =0.007);in the second monitoring stage,HH compliance rate in-creased from 57.85% to 88.58%.HH compliance rate was positively correlated with consumption of HH product per bed-day(r=0.725,P <0.001),but negatively correlated with incidence of healthcare-associated infection(HAI)and case rate of HAI(r=-0.983,-0.990,respectively,both P <0.001),HH rate to alcohol-based hand sanitizers was positively correlated with consumption of HH product per bed-day (r=0.391,P <0.001 ).Conclusion Long-term monitoring and intervention of HH compliance is necessary,combination of direct observation and indirect assessment of HH product con-sumption is helpful for effective monitoring and intervention of HH compliance among HCWs.