“手卫生观察员”培训方法在提高医务人员手卫生依从性中的应用研究

Application of "hand hygiene observer" training method in improving hand hygiene compliance in medical staff

  • 摘要:
    背景 医务人员的手在日常工作中受到污染的概率极高,易成为传播病原体的重要媒介。手卫生一直是医疗机构感染预防的基本组成部分,是预防医院感染最重要、最经济、最有效的措施之一,而医务人员手卫生依从性难以有效提升是一个亟待解决的现实性问题。
    目的 探讨“手卫生观察员”培训方法在医院手卫生管理中的作用,为提高医务人员手卫生依从性提供对策。
    方法 对空军军医大学第一附属医院各科室(临床科室、ICU、门急诊、辅诊科室)感染监控员进行“手卫生观察员”培训。所培训的手卫生观察员在2014 - 2018年多次对该院97个科室医务人员手卫生状况进行现场观察,分析培训前后手卫生依从率的变化。
    结果 共培训手卫生观察员515名。经过培训,全院医务人员手卫生依从率从56.20%提升至79.53%(χ2=856.944,P<0.001),合格率从71.98%提升至84.63%(χ2=191.018,P<0.001),差异有统计学意义。医师、护士、护工、保洁人员的手卫生依从率和合格率与活动前相比均有提高,差异均有统计学意义(P<0.001)。WHO五个手卫生指征的手卫生依从率和合格率与培训前相比也均有提升,差异有统计学意义(P<0.01)。
    结论 “手卫生观察员”培训方法可有效改善医务人员的手卫生执行情况,是一项有效提升手卫生依从率和合格率的管理举措。

     

    Abstract:
    Background The probability of contamination of the hands of medical personnel in daily work is extremely high, making them an important medium for transmitting pathogens. Hand hygiene (HH) has always been a fundamental component of infection prevention in medical institutions, and is one of the most important, economical, and effective measures to prevent hospital infections. However, the difficulty in effectively improving hand hygiene compliance among medical personnel is a practical problem that needs to be urgently addressed.
    Objective  To analyze the effect of “HH observers training” on improvement of accuracy of hand hygiene, so as to provide strategies for improving hand hygiene compliance among medical personnel.
    Methods For the full effect of the infective monitor, we organized a series of activities of "HH observers qualification training and certification" in the First Affiliated Hospital of Air Force Military Medical University. A cross-sectional study was conducted by direct observation method, HCWs from 97 units (clinical department, ICU, out-patient department and auxiliary diagnosis department) were observed with the help of WHO HH Observation Form by the HH observers from 2014 to 2018.
    Results A total of 515 HH observers were trained, the rate of hand hygiene compliance and the qualified of assessment of hand hygiene increased from 56.20%, 71.98% before the training activities to79.53%, 84.63% after the training activities, with statistically significant difference (χ2=856.944, P<0.001; χ2=191.018, P<0.001); the compliance of HH of doctors, nurses, nursing workers, cleaners was significantly higher after the training activities (P<0.001), so did the compliance of the “five opportunity of HH” (P<0.01).
    Conclusion “HH observers training” can remarkably raise the accuracy of hand hygiene, which is an effective way to improve the compliance and accuracy rate of hand hygiene.

     

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