2016—2018年某儿童医院护理员手卫生知信行变化趋势及其影响因素  

Changing trend and influencing factors of hand hygiene knowledge,attitude and behavior among caregivers in a children’s hospital from 2016 to 2018

作　　者：熊亮[1] 印爱珍[2] 马乐龙[2] 李枝国[1] 丁川中[1] 魏选东 宋青青[4] XIONG Liang;YIN Ai-zhen;MA Le-long;LI Zhi-guo;DING Chuan-zhong;WEI Xuan-dong;SONG Qing-qing(Department of Nursing,Hunan Provincial Children’s Hospital,Changsha 410007,China;Office of Healthcare-associated Infection Control and Infectious Disease Management,Hunan Provincial Children’s Hospital,Changsha 410007,China;Editorial Department of Journal of Clinical Pediatric Surgery,Hunan Provincial Children’s Hospital,Changsha 410007,China;Department of Cardiovascular Medicine,Hunan Provincial Children’s Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院护理部,湖南长沙410007 [2]湖南省儿童医院院感控制与传染病管理办公室,湖南长沙410007 [3]湖南省儿童医院临床小儿外科杂志编辑部,湖南长沙410007 [4]湖南省儿童医院心血管内科,湖南长沙410007

出　　处：《中国感染控制杂志》2019年第10期942-947,共6页Chinese Journal of Infection Control

基　　金：湖南省卫健委科研项目(B2016033)

摘　　要：目的调查某三级甲等儿童专科医院护理员手卫生知信行现状,分析其知信行变化趋势及其影响因素。方法于2016年1月—2018年12月对该儿童医院护理员采用隐蔽性现场观察方法调查手卫生执行情况,同时进行手卫生细菌学监测,对手卫生知信行及其影响因素进行问卷调查。结果护理员手卫生依从率为71.10%,手卫生细菌学监测合格率为72.92%,三年间护理员手卫生依从率、合格率比较,差异均无统计学意义(均P>0.05)。2016年护理员手卫生的知识得分与信念得分具有相关性(P<0.05),但知识得分、信念得分与行为得分不相关(均P>0.05);2017—2018年护理员手卫生知识得分、信念得分与行为得分均相关(均P<0.05)。医院监督不够严格、认为快速手消毒剂刺激皮肤,以及周围护理员洗手意识薄弱是造成手卫生行为得分较低的主要影响因素。结论该儿童医院手卫生依从率总体较高,但仍有提升的空间,主管部门应制定可行的手卫生制度与规范,并做好落实监督工作,进一步提高护理员手卫生依从率及细菌学监测合格率。Objective To investigate the knowledge,attitude and behavior(KAB)of hand hygiene(HH)among caregivers in a tertiary first-class children’s hospital,and analyze the changing trend of KAB and its risk factors.Methods From January 2016 to December 2018,the implementation of HH among caregivers in a children’s hospital was investigated by concealed on-site observation,bacteriological surveillance on HH was conducted,KAB of HH and its influencing factors were performed questionnaire survey.Results Caregivers’HH compliance rate was 71.10%,qualified rate of bacteriological surveillance on HH was 72.92%,there were no significant differences in the compliance rate and qualified rate of HH among caregivers in three years(all P>0.05).In 2016,caregivers’HH knowledge score and attitude score was correlated(P<0.05),but knowledge score and attitude score were not correlated to behavior score(both P>0.05);in 2017-2018,caregivers’HH knowledge score and attitude score were both correlated to behavior score(both P<0.05).Insufficient supervision of hospital,considering the irritation of skin by alcohol-based hand rub and caregivers’weak consciousness of hand-washing were main factors for lower scores of HH behavior.Conclusion The overall HH compliance rate in this children’s hospital is relatively high,but there is still room for improvement,competent department should formulate feasible HH system and standards,and carry out the supervision on implementation,further improve HH compliance rate of caregivers and qualified rate of bacteriological surveillance.

关 键 词：护理员 手卫生 知信行 医院感染 影响因素 

分 类 号：R197.323[医药卫生—卫生事业管理]