2016—2023年成都市某三甲医院医务人员手卫生依从性的差异性研究  

Study on the differences in hand hygiene compliance among medical staff in a tertiary hospital in Chengdu from 2016 to 2023

作　　者：肖冬梅 钟怀昌 黄琼华 XIAO Dongmei;ZHONG Huaichang;HUANG Qionghua(Department of Hospital Infection Management,The First People's Hospital in Shuangliu District of Chengdu(West China Airport Hospital of Sichuan University),Chengdu 610200,Sichuan Province,China)

机构地区：[1]成都市双流区第一人民医院(四川大学华西空港医院)医院感染管理科,成都610200

出　　处：《预防医学情报杂志》2025年第1期89-95,共7页Journal of Preventive Medicine Information

摘　　要：目的研究基于直接观察法和隐蔽式观察法调查医务人员手卫生依从性的差异,为提升医务人员手卫生依从率提供参考。方法回顾性分析基于直接观察法(2016—2019年)和隐蔽式观察法(2020—2023年)调查成都市双流区第一人民医院医务人员手卫生依从性及戴手套行为、洗手液及手消毒剂使用量、医院感染率的变化情况,应用Excel SPSS25.0软件进行统计学分析,采用t检验及χ^(2)检验比较调查方式改变前后上述指标变化情况,检验水准α=0.05。结果医务人员手卫生依从率及正确率由2016年的74.80%和72.70%下降至2023年的61.46%和63.66%,基于直接观察法与隐蔽式观察法调查的手卫生依从率及正确率均具有统计学差异(P均<0.05);从职业类别来看,护士、医生、医技和医辅人员的手卫生依从率均呈下降(P均<0.05);从手卫生指征来看,“接触病人前”、“无菌操作前”和“接触环境后”的手卫生依从率降低(P<0.05),“接触患者后”及“接触环境后”未执行手卫生中戴手套率分别由63.62%、29.87%上升至78.07%、48.90%(P<0.05);洗手液和手消毒剂床日消耗量由11.45 ml增加至17.66 ml,医院感染率由1.52%下降至0.58%,多重耐药菌医院感染率由0.42%下降至0.07%,差异均有统计学意义(P均<0.05)。结论基于隐蔽式观察法调查的医务人员手卫生依从率较直接观察法更低,排除了“霍桑效应”的影响,更能反映真实情况。Objective To investigate the differences in hand hygiene compliance among healthcare workers based on direct and indirect observation methods,to provide a reference for improving the hand hygiene compliance rate among healthcare workers.Methods Retrospective analysis based on direct observation method(2016-2019)and indirect observation method(2020-2023)were used to investigate the changes of hand hygiene compliance and glove-wearing behaviour,hand sanitizer and hand disinfectant usage,and the infection rate of hospital among the medical staff of the First People's Hospital of Shuangliu District,Chengdu City,SPSS 25.0 was used to perform the statistical analysis,and t-test andχ^(2)test was used to compare the changes of the above indicators before and after the change of the survey method,the test levelα=0.05.Results The hand hygiene compliance and correctness rates of medical staff decreased from 74.80%and 72.70%in2016 to 61.46%and 63.66%in 2023,and there was a statistically significant difference between the compliance and correctness rates of hand hygiene based on the direct and covert observation methods of investigation(all P<0.05);From the perspective of occupational categories,the rates of hand hygiene compliance of nurses,doctors,medical technicians and medical auxiliary personel were all decreased(All P<0.05).From the viewpoint of hand hygiene indications,the hand hygiene compliance rates of“before contact with the patient”,“before aseptic manipulation”and“after contact with the environment”decreased(P<0.05),“after contact with patients”and“after contact with the environment”did not perform hand hygiene in the rate of wearing gloves increased from 63.62%,29.87%to 78.07%,48.90%,respectively(P<0.05).Daily consumption of hand sanitizer and hand disinfectant per bed increased from 11.45 ml to 17.66 ml,the infection rate of hospital decreased from 1.52%to 0.58%,and multidrug-resistant bacteria hospital infection rate decreased from 0.42%to 0.07%,the differences were statistically signific

关 键 词：调查方式 手卫生依从性 霍桑效应 医院感染 

分 类 号：R197.323[医药卫生—卫生事业管理]