健康信念模式改善医务人员手卫生依从性研究  

Study on health belief model for the improvement of hand hygiene compliance of medical staff

作　　者：张静[1] 纪灏[1] 窦颖[1] 李光辉[2] 

机构地区：[1]上海交通大学附属胸科医院医院感染管理办公室,上海200030 [2]复旦大学附属华山医院医院感染管理办公室,上海200040

出　　处：《中华医院感染学杂志》2016年第24期5754-5756,共3页Chinese Journal of Nosocomiology

基　　金：中华医院感染控制研究基金(ZHYY2015-0008)

摘　　要：目的探讨应用健康信念模式改善医务人员手卫生依从性的效果评价,为提高医务人员手卫生依从性提供参考依据。方法选取2015年10-12月ICU医务人员90名及300例患者为干预前,2016年1月采用健康信念模式干预其手卫生,比较干预前、后手卫生依从性认知情况改善程度及医院感染率,数据采用SPSS 17.0软件进行统计分析。结果干预后医务人员手卫生基础知识得分为(30.64±6.08)分、手卫生专业知识得分为(27.40±4.61)分,均高于干预前;医务人员手卫生依从性从干预前的66.67%上升到干预后的94.44%;干预前医务人员手菌落数为(19.10±5.08)CFU,显著高于干预后的(3.87±0.67)CFU;300例患者医院感染发生率由干预前的5.00%减少至干预后的2.33%,干预前、后比较,差异均有统计学意义(P<0.05)。结论应用健康信念模式可以有效改善医务人员手卫生依从性,间接成本的获益,使医疗质量得到提高,获得经济效益和社会效益的双赢。OBJECTIVE To evaluate the effect of applying health belief model on hand hygiene compliance of medical staff, so as to provide references for the improvement of hand hygiene compliance of medical staff. METHODS A total of 90 cases of ICU medical staff and 300 cases of patients from Oct. 2015 to Dec. 2015 were selected, and health belief model was used to intervene their hand hygiene in Jan. 2016. the control group followed the routine hand hygiene standard, and the control group was not intervened. The improvement of hand hygiene compliance and the nosocomial infection rates of the two groups of medical staff were compared before and after the intervention, and the data were analyzed by SPSS 17.0 software. RESULTS The hand hygiene basic knowledge score and professional knowledge score of medical staff were （30.64±6.08） points and （27.40±4.61） points after the intervention, which were all higher than those before the intervention. The hand hygiene compliance of medical staff increased from 66.67% before the intervention to 94.44% after the intervention. The number of colonies of medical staff was （19.10±5.08）CFU before the intervention, which was significantly higher than （3.87±0.67）CFU after the intervention. The nosocomial infection rate of 300 cases of patients was reduced from 5.00% before the intervention to 2.33% after the intervention, which had significant differences （P〈0.05）. CONCLUSION Application of the health belief model can effectively improve the hand hygiene compliance of medical staff, benefit of indirect costs, improve the quality of medical care, and obtain a win-win situation of economic and social benefits.

关 键 词：手卫生依从性 健康信念模式 成本效益分析 ICU 

分 类 号：R192[医药卫生—卫生事业管理]