视频监控纳入绩效考核对ICU护理人员手卫生依从性的影响  

Influence of video surveillance in perfomance assessment on the hand hygiene compliance of ICU nurses

作　　者：田金凤 李媛[2] 黄成 朱梅 陈君[3] 李耀胜 TIAN Jin-feng;LI Yuan;HUANG Cheng;ZHU Mei;CHEN Jun;LI Yao-sheng(Feicheng Mining Center Hospital,Feicheng,Shandong 271608,China;不详)

机构地区：[1]肥城矿业中心医院重症医学科,山东肥城271608 [2]山东科技大学校医院,山东青岛266590 [3]泰山学院物理与电子工程学院,山东泰安271021

出　　处：《中华医院感染学杂志》2020年第3期473-476,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金青年基金资助项目(61605139)。

摘　　要：目的通过视频监控方式了解重症医学科护理人员手卫生情况,验证该方法的效果。方法启用视频监控设备记录肥城矿业中心医院重症医学科护理人员2018年1-11月手卫生情况,进行规范培训并制定考核办法,随机截取实施前视频记录的960人次手卫生情况,再截取实施监控后1100人次手卫生情况,按照该办法统计分析,比较实施前后护理人员手卫生依从率变化。结果启用后手卫生依从率为92.00%(1012/1100)高于启用前的61.98%(595/960)(P<0.001);在接触患者前、清洁/无菌操作前、接触患者后及接触患者物品后4个时刻的手卫生依从率升高,差异有统计学意义(P均<0.001);白班和中班护理人员手卫生依从率较高(均为91.67%),夜班的当班护理人员手卫生依从率较低(88.00%),差异具有统计学意义(P<0.001);大拇指、指尖步骤合格率最低,分别为56.25%(45/80)、57.50%(46/80),实施后分别提升到98.75%(79/80)、96.25%(77/80),差异有统计学意义(P<0.001),开启监控后ICU护理人员的手卫生合格率显著提高。结论视频监控纳入绩效考核可客观记录手卫生情况,起到良好监督作用,手卫生绩效考核能有效提高ICU护理人员手卫生依从率。OBJETIVE To investigate the hand hygiene of nurses in intensive care unit by video surveillance,and to verify the effectiveness of this method.METHODS The video surveillance equipment was used to record the hand hygiene of nurses in ICU of Feicheng Mining Center Hospital from Jan.to Nov.2018.Standard training was conducted during the period and assessment methods were formulated.Before implementation,the hand hygiene records of 960 people by video before implementation were selected randomly,and the hand hygiene records of 1100 people after implementation of surveillance were intercepted again.According to this method,the changes of hand hygiene compliance rate of nursing staff before and after implementation were analyzed.RESULTS The compliance rate of hand hygiene after implementation was 92.00%(1012/1100),significantly higher than 61.98%(595/960)before implementation(P<0.001).The compliance rate of hand hygiene increased significantly(P<0.001)before contact with patients and cleaning/aseptic operation,as well as after contact with patients and contact with patients’articles.The hand hygiene compliance rate of day shift and middle shift nurses was significantly higher(all are 91.67%)than that of night shift nurses(88.00%)(P<0.001).The pass rate of thumb and fingertip steps was the lowest,which was 56.25%(45/80)and 57.50%(46/80)respectively.After implementation,the pass rate was increased to 98.75%(79/80)and 96.25%(77/80)respectively.The difference was significant(P<0.001).The pass rate of hand hygiene of ICU nurses increased remarkably after the implementation of video surveillance.CONCLUSION The inclusion of video surveillance in performance assessment can objectively record the hand hygiene situation and play a good supervisory role.Hand hygiene performance assessment can effectively improve the hand hygiene compliance rate of ICU nurses.

关 键 词：手卫生 视频监控 绩效考核 护理人员 依从率 

分 类 号：R183[医药卫生—流行病学]