2019年全国医疗机构医务人员诊疗过程手卫生监测报告  

Hand hygiene surveillance report of health care workers during diagnosis and treatment in medical institutions in China in 2019

作　　者：文细毛[1,2] 黄勋[1] 曾烂漫[1,2] 陈修文[3] 战榕[4] 孟庆兰[5] 熊薇 李宝珍[7] 方旭[8] 李卫光 李福琴[10] 刘丁 侯铁英[12] 吴佳玉 逄崇杰[14] 鲜于舒铭[15] 杨怀[16] 孙丽萍[17] 张浩军[18] 姚新宝[19] 何文英[20] 姜亦红 杜龙敏[22] 任南[1] 吴安华[1] WEN Xiao-mao;HUANG Xun;ZENG Lan-man;CHEN Xiu-wen;ZHAN Rong;MENG Qing-lan;XIONG Wei;LI Bao-zhen;FANG Xu;LI Wei-guang;LI Fu-qin;LIU Ding;HOU Tie-ying;WU Jia-yu;PANG Chong-jie;XIANYU Shu-ming;YANG Huai;SUN Li-ping;ZHANG Hao-jun;YAO Xin-bao;HE Wen-ying;JIANG Yi-hong;DU Long-min;REN Nan;WU An-hua(Center for Healthcare-associated Infection Control,Xiangya Hospital,Central South University,Changsha 410008,China;Teaching and Research Section of Clinical Nursing,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Infection Control-Public Health,Jiangxi Provincial Children’s Hospital,Nanchang 330006,China;Department of Healthcare-associated Infection Management,Fujian Medical University Union Hospital,Fuzhou 350001,China;Department of Healthcare-associated Infection Management,Inner Mongolia People’s Hospital,Hohhot 010017,China;Department of Healthcare-associated Infection Management,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;Department of Medical Affairs,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Healthcare-associated Infection Management,The First People’s Hospital of Yunnan Province,Kunming 650032,China;Office of Healthcare-associated Infection Management,Shandong Provincial Hospital,Shandong First Medical University,Jinan 250021,China;Department of Healthcare-associated Infection Management,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Disease Control and Prevention,Army Characteristic Medical Center,Chongqing 400042,China;Department of Laboratory Medicine,Guangdong Provincial People’s Hospital,Guangzhou 510080,China;Center for Healthcare-associated Infection Control,Sichuan Academy of Medical Sciences,Sichuan Provincial People’s Hospital,Chengdu 610072,China;Department of Infection Management,Tianjin Medical University General Hospital,Tianjin 300052,China;Office of Healthcare-associated Infection Management,Hainan General

机构地区：[1]中南大学湘雅医院医院感染控制中心,湖南长沙410008 [2]中南大学湘雅医院临床护理学教研室,湖南长沙410008 [3]江西省儿童医院感染控制-公共卫生科,江西南昌330006 [4]福建医科大学附属协和医院医院感染管理科,福建福州350001 [5]内蒙古医科大学附属医院医院感染管理部,内蒙呼和浩特010017 [6]华中科技大学同济医学院附属同济医院医院感染管理科,湖北武汉430030 [7]西安交通大学第一附属医院医务部,陕西西安710061 [8]云南省第一人民医院感染管理科,云南昆明650032 [9]山东第一医科大学附属省立医院医院感染管理办公室,山东济南250021 [10]郑州大学第一附属医院医院感染管理科,河南郑州450052 [11]陆军特色医学中心疾病预防控制科,重庆400042 [12]广东省人民医院检验科,广东广州510080 [13]四川省医学科学院四川省人民医院医院感染控制中心,四川成都610072 [14]天津医科大学总医院感染科,天津300052 [15]海南省人民医院医院感染管理办公室,海南570311 [16]贵州省人民医院医院感染管理科,贵州贵阳550002 [17]吉林大学第二医院医院感染管理部,吉林长春130041 [18]甘肃省人民医院公共卫生与医院感染管理处,甘肃兰州730000 [19]新疆维吾尔自治区人民医院医务部院感科,新疆乌鲁木齐830001 [20]石河子大学医学院第一附属医院院内感染控制办公室,新疆石河子832008 [21]南京鼓楼医院医院感染管理办公室,江苏南京210008 [22]银川市第一人民医院院感保健部,宁夏银川750001

出　　处：《中国感染控制杂志》2021年第5期389-396,共8页Chinese Journal of Infection Control

摘　　要：目的建立医务人员诊疗过程手卫生监测数据的评价体系。方法2019年9月1—30日采用手卫生观察员现场调查方法获取综合重症监护病房(ICU)、呼吸内科病区、骨科病区、感染科病区、儿科门急诊、血液透析室医生和护士手卫生执行情况,并统计同期调查科室工作量、手卫生用品消耗量以及医疗机构实际开放床位数,计算手卫生依从率和手卫生用品床日消耗量。结果共有1480所医疗机构手卫生调查资料审核合格,应执行手卫生1353531次,执行手卫生1076639次,正确执行手卫生891185次,手卫生依从率为79.54%,手卫生执行正确率为82.77%。不同规模医疗机构手卫生依从率为76.26%~82.84%,以实际开放床位数600~899张者手卫生依从率最低;手卫生正确率为81.87%~84.01%,以实际开放床位数≥900张者手卫生正确率最低。调查科室手卫生依从率为76.80%~84.44%,以儿科门急诊手卫生依从率最低;手卫生正确率为81.19%~84.98%,以骨科手卫生正确率最低。五个手卫生时机手卫生依从率为67.59%~89.84%,以接触患者周围环境后手卫生依从率最低;手卫生执行正确率为81.51%~86.76%,以接触患者周围环境后手卫生执行正确率最低。综合ICU、呼吸内科、骨科、感染科手卫生用品消耗量分别为56.62、10.76、9.50、14.54 mL/床日,儿科门急诊、血液透析室手卫生用品消耗量分别为2.02、9.06 mL/人次。不同规模医疗机构中,综合ICU以实际开放床位数600~899张者手卫生用品消耗量最多(61.15 mL/床日),呼吸内科、骨科、感染科均以实际开放床位数>900张者手卫生用品消耗量最多(分别为13.61、10.96、16.55 mL/床日),儿科门急诊、血液透析室均以实际开放床位数300~599张者手卫生用品消耗量最多(分别为2.53、10.76 mL/人次)。结论此次调查获取的不同规模医疗机构手卫生依从率及手卫生用品床日消耗量可作为标杆,为各医院机构提供手卫生执行�Objective To establish an evaluation system for hand hygiene(HH)surveillance data of heath care workers(HCWs)during diagnosis and treatment.Methods In September 1-30,2019,information about the implementation of HH of doctors and nurses in general intensive care unit(ICU),departments of respiratory diseases,orthopedics,infectious diseases,pediatric outpatient and emergency,and hemodialysis room was obtained through on-site investigation by HH observers.The workload of surveyed departments,consumption of HH products and actual number of opened beds of medical institutions were investigated,compliance rates of HH and daily consumption of HH products were calculated.Results The examination and verification of HH survey data in 1480 medical institutions were qualified,HH should be implemented 1353531 times,HH were actually implemented 1076639 times,implementation of correct HH was 891185 times,compliance rate of HH was 79.54%,correct HH implementation rate was 82.77%.Compliance rates of HH in different scales of medical institutions were 76.26%-82.84%,which was lowest in those with 600-899 actual opened beds,correct rates of HH were 81.87%-84.01%,which was lowest in those with≥900 actual opened beds.Compliance rates of HH in surveyed department were 76.80%-84.44%,which was lowest in departments of pediatric outpatient and emergency,correct rates of HH were 81.19%-84.98%,which was lowest in department of orthopedics.HH compliance rates at five HH moments were 67.59%-89.84%,which was lowest after touching patient surroundings,correct rates of HH implementation were 81.51%-86.76%,which was lowest after touching patient surroundings.Consumption of HH products in general ICU,departments of respiratory diseases,orthopedics,and infectious diseases were 56.62,10.76,9.50,and 14.54 mL/bed-days respectively,consumption of HH products in department of pediatric outpatient and emergency as well as hemodialysis room was 2.02 and 9.06 mL/person-time respectively.Among different scales of medical institutions,consumption of HH prod

关 键 词：医疗机构 医务人员 手卫生 手卫生用品消耗量 监测 医院感染 

分 类 号：R181.3+2[医药卫生—流行病学]