“3步揉搓法”在新冠隔离病区医护人员脱摘防护用品过程中的效果评价  

Effect of “3-step rubbing method” adopted by health care workers during the process of removing protective equipment in COVID -19 isolation ward

作　　者：胡正翠 李奕 张伟 薛倩 陈怡 HU Zheng-cui;LI Yi;ZHANG Wei;XUE Qian;CHEN Yi(Department of Infection,The First Affilia-ted Hospital of Naval Medical University,Shanghai 200433,China;Department of Infection Control,The First Affilia-ted Hospital of Naval Medical University,Shanghai 200433,China;Department of Respiratory Diseases,The First Affilia-ted Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院感染科,上海200433 [2]海军军医大学第一附属医院感控科,上海200433 [3]海军军医大学第一附属医院呼吸科,上海200433

出　　处：《中国感染控制杂志》2023年第6期707-711,共5页Chinese Journal of Infection Control

基　　金：军队护理创新与培育专项计划项目(培育)(2021HL029);海军军医大学第一附属医院集智科研攻关重点项目(COVID-ZD-003)。

摘　　要：目的 探讨“3步揉搓法”在新冠隔离病区医护人员脱摘防护用品过程中的效果。方法 选取2022年4—6月参加上海市某三级甲等医院隔离病房支援的临床一线医护人员35人,在脱摘防护用品前,每名医护人员分别进行“3步揉搓法”、“6步揉搓法”两种卫生手消毒法各1次,比较两种方法卫生手消毒前后最外层手套正面、背面、指缝3处标本新型冠状病毒核酸检测结果。结果 两种卫生手消毒法消毒前后的最外层手套表面新型冠状病毒核酸检测结果比较,差异有统计学意义(均P<0.05)。“6步揉搓法”卫生手消毒后最外层手套表面新型冠状病毒核酸检测阳性率为4.76%(5/105),“3步揉搓法”卫生手消毒后最外层手套表面新型冠状病毒核酸检测阳性率为5.71%(6/105),两组比较差异无统计学意义(P>0.05)。使用“3步揉搓法”时的手卫生规范率(91.43%)高于使用“6步揉搓法”时的手卫生规范率(77.14%),差异有统计学意义(P=0.02)。结论 “3步揉搓法”与“6步揉搓法”在新冠隔离病区医护人员脱摘防护用品过程中的消毒效果一致,但实施“3步揉搓法”时医护人员手卫生操作规范率高,因此,“3步揉搓法”有助于保障医护人员的职业安全,在临床工作中易于推广和接受。Objective To explore the effect of“3-step rubbing method”adopted by health care workers(HCWs)during the process of removing protective equipment in COVID-19 isolation ward.Methods 35 front-line clinical HCWs who supported the isolation ward of a tertiary first-class hospital in Shanghai from April to June 2022 were selected.Before removing protective equipment,each HCW conducted hygienic hand disinfection with the“3-step rubbing method”and the“6-step rubbing method”once,respectively.SARS-CoV-2 nucleic acid test results of the front,back and finger side of the outermost gloves before and after conducting two hygienic hand disinfection me-thods were compared.Results SARS-CoV-2 nucleic acid test results of the surface of outermost glove before and after disinfected by two hygienic hand disinfection methods were statistically different(both P<0.05).Positive rate of SARS-CoV-2 nucleic acid test of the surface of the outermost gloves after“6-step rubbing method”and“3-step rubbing method”hygienic hand disinfection were 4.76%(5/105)and 5.71%(6/105),respectively,with no statistically significant difference between the two groups(P>0.05).Standard rate of hand hygiene was higher when using the“3-step rubbing method”than the“6-step rubbing method”(91.43%vs 77.14%,P=0.02).Conclusion The“3-step rubbing method”can achieve the same disinfection effect as the“6-step rubbing method”during the process of HCWs’removing protective equipment in COVID-19 isolation ward,but the standard rate of“3-step rubbing method”for hand hygiene of HCWs is higher,therefore,the“3-step rubbing method”is helpful for ensuring the occupational safety of HCWs,and is easy to be promoted and accepted in clinical practice.

关 键 词：手卫生 卫生手消毒法 3步揉搓法 6步揉搓法 新型冠状病毒核酸检测 规范率 

分 类 号：R181.32[医药卫生—流行病学] R187[医药卫生—公共卫生与预防医学]