2014—2022年手卫生干预对医院感染例次发病率的影响  

Effect of hand hygiene intervention on healthcare-associated case infection incidence from 2014 to 2022

作　　者：丁佳燕 沈瑞红[1] 周文琴[1] 袁雅赟 黄妹[1] 杨亚 蔡冰超 班海群 傅小芳[1] DING Jia-yan;SHEN Rui-hong;ZHOU Wen-qin;YUAN Ya-yun;HUANG Mei;YANG Ya;CAI Bing-chao;BAN Hai-qun;FU Xiao-fang(Department of Infection Management,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院感染管理办公室,上海200127

出　　处：《中国感染控制杂志》2024年第2期208-213,共6页Chinese Journal of Infection Control

基　　金：上海市浦江人才计划项目(22PJD041);市级医院诊疗技术推广及优化管理项目(SHDC22023235);上海市医院协会管理研究基金项目(X2023170)。

摘　　要：目的 观察多模式手卫生干预对手卫生依从性的影响,以及手卫生依从性与医院感染例次发病率之间的关系。方法 2014—2022年,某三甲医院感染控制团队对全院医务人员实施多模式手卫生干预,回顾性分析手卫生监测数据的变化趋势、手卫生依从率与医院感染例次发病率的相关性。结果 病房手卫生用品消耗量呈稳定上升趋势;手卫生依从率从2014年64.98%提高到2022年85.01%(P<0.001),医院感染例次发病率从1.21%下降至0.83%(P<0.05),手卫生依从率与医院感染例次发病率之间存在负相关(r=-0.369,P=0.027)。各季度不同区域及不同岗位的手卫生依从率均有所提高(P<0.001)。各季度5个时刻手卫生依从率中,无菌操作前与接触患者后的手卫生依从率小幅波动;接触患者周围环境后的手卫生依从率呈上升趋势;接触患者前与接触患者体液后的手卫生依从率在2020年之后有所下降(P<0.001)。结论 多模式手卫生干预能提高医务人员的手卫生依从性,提高医务人员手卫生意识有利于降低医院感染例次发病率。Objective To observe the effect of multi-modal hand hygiene(HH)intervention on HH compliance,as well as the relationship between HH compliance and the healthcare-associated(HA)case infection incidence.Methods From 2014 to 2022,the infection control team in a tertiary first-class hospital implemented multi-modal HH intervention for health care workers(HCWs).The changing trend of HH monitoring data,the correlation between HH compliance rate and HA case infection incidence were analyzed retrospectively.Results The consumption of HH products in the wards showed a stable upward trend;HH compliance rate increased from 64.98%in 2014 to 85.01%in 2022(P<0.001),and HA case infection incidence decreased from 1.21%to 0.83%(P<0.05).HH compliance rate was negatively correlated with HA case infection incidence(r=-0.369,P=0.027).HH compliance rates in different regions and job posts in each quarter were increased(P<0.001).For 5 different HH moments in each quarter,HH compliance rate fluctuated slightly before sterile manipulation and after touching patient;presented rising trend after touching surroundings around patient,and decreased before touching patient and after touching patient’s body fluid since 2020(P<0.001).Conclusion Multi-modal HH intervention can improve the HH compliance of HCWs,improving their HH awareness is conducive to reducing HA case infection incidence.

关 键 词：手卫生 依从性 医务人员 医院感染发病率 干预 

分 类 号：R197.323.4[医药卫生—卫生事业管理]