手卫生对医院感染成本效益的影响  

Effect of hand hygiene on cost-effectiveness of healthcare-associated infection

作　　者：周霞[1] 杨金霞[1] 刘新平[1] 王良俊[1] 

机构地区：[1]滨州市人民医院,山东滨州256610

出　　处：《中国感染控制杂志》2017年第4期318-321,共4页Chinese Journal of Infection Control

基　　金：中华医院感染控制研究基金(ZHYY2015-0031)

摘　　要：目的了解干预前后医务人员手卫生依从率及手术患者医院感染发生率,分析手卫生对医院感染成本效益的影响。方法以2012年12月—2014年6月某院神经外科78名医务人员作为手卫生依从性干预对象,进行颅脑清洁手术的325例患者作为医院感染调查对象,比较干预前后医务人员手卫生依从率、手术患者医院感染发病率、手卫生成本,以及手术患者住院费用等。结果干预前手卫生依从率为35.24%(216/613),干预后为73.75%(486/659);干预前医院感染发病率为31.85%(50/157),干预后为18.45%(31/168),干预前后比较,差异均有统计学意义(χ~2值分别为180.091、7.782,均P<0.001)。干预前患者平均住院费用为(89 524.90±38 856.70)元,干预后为(61 401.00±29 237.80)元;干预前患者平均住院日为36.70 d,干预后为26.90 d,差异均有统计学意义(t值分别为3.296、3.511,均P<0.01)。结论提高医务人员手卫生依从性,能降低医院感染发病率,减少患者的住院费用,缩短患者住院日。Objective To understand hand hygiene（HH） compliance among health care workers（HCWs） and incidence of healthcare-associated infection（HAI） in surgical patients before and after the intervention, analyze the effect of HH on cost-effectiveness of HAI.Methods From December 2012-June 2014, 78 HCWs in the department of neurosurgery of a hospital were as the intervention objects of HH compliance, 325 patients who underwent craniocerebral clean operation were as the surveyed objects, HH compliance among HCWs, incidence of HAI in surgical patients, cost of HH, and hospitalization expense before and after intervention were compared respectively.Results HH compliance among HCWs before and after intervention were 35.24% （216/613） and 73.75%（486/659）respectively （X2=180.091,P〈0.001）;incidence of HAI in surgical patients before and after intervention were 31.85%（50/157）and 18.45%（31/168）respectively（X2=7.782,P〈0.001）.Hospitalization expense before and after intervention were （89 524.90±38 856.70）￥ and （61 401.00±29 237.80）￥ respectively;average length of hospital stay before and after intervention were 36.70 days and 26.90 days respectively（t=3.296, 3.511,respectively, both P〈0.01）.Conclusion Improving HH compliance among HCWs can reduce the incidence of HAI and hospitalization cost, and shorten the average length of hospital stay of patients.

关 键 词：手卫生 医院感染 成本效益分析 

分 类 号：R181.32[医药卫生—流行病学]