医疗机构保洁人员“一前五后”手卫生干预效果研究  

Efficacy of“one before and five after”hand hygiene intervention among cleaning staff in medical institutions

作　　者：李妍 何文斌 冯毕龙[2,3] 陈小艳 程晓琳[2] 陈诺[4] 王莹 LI Yan;HE Wen-bin;FENG Bi-long;CHEN Xiao-yan;CHENG Xiao-lin;CHEN Nuo;WANG Ying(Department of Healthcare-associated Infection Management,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Nursing Department,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Hubei Engineering Research Center for Precise Prevention,Control,Diagnosis and Treatment of Infectious Diseases,Wuhan 430071,China;School of Public Administration,Hubei University of Medicine,Shiyan 442000,China)

机构地区：[1]武汉大学中南医院医院感染管理办公室,湖北武汉430071 [2]武汉大学中南医院护理部,湖北武汉430071 [3]感染性疾病精准防控与诊治湖北省工程研究中心,湖北武汉430071 [4]湖北医药学院公共卫生与健康学院,湖北十堰442000

出　　处：《中国感染控制杂志》2023年第5期591-596,共6页Chinese Journal of Infection Control

基　　金：武汉大学中南医院创新平台基金(ZNXKPY2022005);西部绿色建筑重点实验室开放基金(LSKF202104)。

摘　　要：目的 探索“一前五后”手卫生指征在医疗机构保洁人员手卫生管理中的应用效果。方法 2021年12月-2022年1月,采用便利抽样法选取某三甲医院保洁人员为研究对象,并随机分为三组(对照组、试验组Ⅰ、试验组Ⅱ)。对照组采用世界卫生组织(WHO)“两前三后”手卫生指征进行培训,试验组Ⅰ采用“一前五后”手卫生指征进行广泛培训,试验组Ⅱ采用“一前五后”手卫生指征进行精准化培训。比较三组保洁人员手卫生依从率、不同指征手卫生依从率和手卫生时刻分布趋势。结果 共调查保洁人员对照组26名,试验组Ⅰ24名,试验组Ⅱ18名。对照组、试验组Ⅰ和试验组Ⅱ培训前的手卫生依从率分别为31.30%、27.18%和30.30%;培训后的手卫生依从率分别为43.11%、59.26%和83.62%。培训后,试验组Ⅱ保洁人员的手卫生依从率较培训前明显上升,增加了53.32%,差异有统计学意义(P<0.05);培训后试验组Ⅱ的手卫生依从率最高,为83.62%。培训后,试验组Ⅰ保洁人员手卫生依从率最高时刻发生在脱卸个人防护用品后,为64.77%,最低时刻发生在清洁消毒前,为54.55%。除准备工具后,培训后试验组Ⅱ其他不同时刻的手卫生依从率均高于试验组Ⅰ,差异均有统计学意义(均P<0.05)。培训后试验组Ⅱ手卫生依从率最高时刻发生在处置医疗废物后,为90.72%,最低时刻发生在准备工具后,为78.33%。上午6点至上午9点和下午3点至下午4点是保洁人员进行手卫生行为的高频次时段。结论 “一前五后”比“两前三后”手卫生指征更适用于医疗机构内保洁人员的手卫生依从性监测和培训,“一前五后”手卫生精准化培训可有效提高医疗机构内保洁人员手卫生依从性。Objective To explore the application effect of the“one before and five after”hand hygiene(HH)indicators in HH management of cleaning staff in medical institutions.Methods From December 2021 to January 2022,cleaning staff from a tertiary hospital were selected as the research subjects through convenience sampling method and randomly divided into three groups(control group,experimental groupⅠ,and experimental groupⅡ).The control group received training according to the World Health Organization(WHO)“two before and three after”HH indicators,while the experimental groupⅠreceived extensive training according to the“one before and five after”HH indicators,and the experimental groupⅡreceived precision training according to the“one before and five after”HH indicators.HH compliance rate,HH compliance rates for different indicators,and the distribution trend of HH moments among three groups of cleaning staff were compared.Results A total of 26 cleaning staff in the control group,24 in the experimental groupⅠ,and 18 in the experimental groupⅡwere surveyed.HH compliance rates before training in the control group,experimental groupⅠ,and experimental groupⅡwere 31.30%,27.18%,and 30.30%,respectively;and those after training were 43.11%,59.26%,and 83.62%,respectively.After training,HH compliance rate of cleaning staff in experimental groupⅡsignificantly increased compared to before training,with a growth rate of 53.32%and statistically significant difference(P<0.05).After training,HH compliance rate in experimental groupⅡwas the highest(83.62%).The HH moment with the highest HH compliance rate of cleaning staff in experimental groupⅠwas after unloading personal protective equipment(64.77%),and the lowest was before cleaning and disinfection(54.55%).Except after preparing tools,HH compliance rates of experimental groupⅡat other different HH moments after training were all higher than experimental groupⅠ,differences were statistically significant(all P<0.05).After training,the HH moment wi

关 键 词：手卫生 手卫生依从性 保洁人员 医院感染 干预 

分 类 号：R197.323.4[医药卫生—卫生事业管理]