静脉穿刺皮肤消毒剂作用时间临床调查  

Clinical investigation of exposure time of skin disinfectant for vein puncture

作　　者：张静[1] 杨艳[1] 钟晓祝[1] 谭细兰[1] 尹雪如[1] 

机构地区：[1]南方医科大学珠江医院感染管理科,广东广州510282

出　　处：《中华医院感染学杂志》2016年第5期1186-1188,共3页Chinese Journal of Nosocomiology

基　　金：广东省省级科技计划基金资助项目(2013B021800155)

摘　　要：目的了解临床实际工作中静脉穿刺操作时皮肤消毒剂的作用时间,探讨皮肤消毒剂作用时间不足的原因与对策。方法随机调查2014年4月住院部病区、门诊部抽血室、门急诊输液室3个有代表性区域,观察护士在临床工作中对静脉穿刺部位进行皮肤消毒时消毒剂作用时间。结果共观察926例患者,住院部病区、门诊部抽血室、门急诊输液室静脉穿刺消毒剂作用时间分别为(21.25±4.11)(11.38±3.23)s和(15.93±4.93)s,均低于所使用的皮肤消毒剂说明书规定的消毒作用时间(1min),差异有统计学意义(P<0.05),住院部病区静脉输液消毒剂作用时间较门诊部抽血室、门急诊输液室的长,差异有统计学意义(P<0.05)。结论在临床实际工作中,静脉穿刺皮肤消毒剂作用时间均低于目前卫计委批准的皮肤消毒剂说明书的最短消毒时间(30s),难以达到预期的消毒效果;需加强静脉穿刺操作的规范化培训,强化消毒理念,充分达到消毒剂作用的时间;还可优化和改进静脉穿刺操作流程,在流程设计上给消毒剂留有足够的作用时间,提高依从性;此外在消毒剂的选择方面,可优选消毒作用时间短的速效消毒剂。OBJECTIVE To investigate the exposure time of skin disinfectant for vein puncture in routine practice and discuss the causes and countermeasures of insufficient skin disinfectant effect time.METHODS The exposure time of skin disinfectant for vein puncture（from cotton swabs to intravenous needles into the skin）was randomly investigated at the inpatient ward,the outpatient clinic,and the ER infusion room respectively.RESULTS Altogether 926 cases of puncture were observed,the exposure time of skin disinfectant for vein puncture was calculated as（21.25±4.11）s at the inpatient ward,（11.38±3.23）s at outpatient clinic and（15.93±4.93）s at the ER infusion room respectively,which were all shorter than the minimum time（1min）specified in the instructions.And there was a significant difference（P〈0.05）.The exposure time of skin disinfectant for vein puncture at the inpatient ward was significantly longer than that at both ER infusion room and the outpatient clinic（P〈0.05）.CONCLUSIONIn routine practice,the exposure time of skin disinfectant for vein puncture is shorter than the minimum time（0.5minute）that is needed to ensure the disinfection effect.There are some suggestions that should be followed.Intensive normalized training of vein puncture procedure is needed.The concept of disinfection should be emphasized.Optimization and improvement of the process of vein puncture procedure may help promoting nurse compliance of effective skin disinfectant exposure time.In the use of disinfectants,the best choice was a fast disinfectant.

关 键 词：皮肤消毒剂 静脉穿刺 作用时间 

分 类 号：R184[医药卫生—流行病学]