多模式干预措施提高手卫生依从率的效果评价

Multimodal intervention measures to improve efficacy of hand hygiene compliance rate

摘要:

目的探讨切实可行的手卫生干预方法，提高医务人员手卫生依从性，降低医院感染率。方法选择某院外科作为干预科室，2013年1—2月对干预科室进行基线调查，2013年3月—2014年4月对干预科室采取多模式干预措施，2014年5—6月采用与基线调查相同的方法进行干预后调查，比较干预前后医务人员手卫生依从性和医院感染情况。结果经过干预，直接接触患者前后医务人员手卫生依从性均明显升高；医务人员手卫生依从率由干预前的53.32%上升至干预后的69.27%，差异有统计学意义(χ2=26.19, P＜0.001)。直接接触患者前医务人员的手卫生方式：干预前以皂液+流动水为主（67.02%），干预后以速干手消毒剂为主（61.08%）；直接接触患者后医务人员的手卫生方式：干预前后均以皂液+流动水为主（分别为86.40%和70.41%）。干预前，医务人员直接接触患者前后的手卫生干手方式均以工作服擦干为主,干预后，均以干手纸巾干手为主。干预科室的医院感染率由干预前的3.08%下降至干预后的2.00%，差异有统计学意义（χ2=7.76,P=0.005）。结论对干预科室采取多模式干预措施可有效提高医务人员手卫生依从率。

Abstract:

ObjectiveTo evaluate the feasible hand hygiene intervention methods to improve health care workers’ (HCWs) hand hygiene compliance, and reduce healthcareassociated infection(HAI) rate.MethodsThe surgical department in a hospital was selected as intervention department, intervention department was conducted baseline investigation in JanuaryFebruary 2013, multimodel intervention measures were conducted  between  March  2013 and April 2014, postintervention survey was performed by the same method as baseline survey in MayJune 2014, hand hygiene of HCWs as well as  occurrence of HAI between before  and after intervention was compared respectively. ResultsAfter intervention, HCWs’ hand hygiene compliance  before and after patient contact both enhanced significantly; HCWs’ hand hygiene compliance rate increased from 53.32% before intervention to 69.27% after intervention, the difference was significant(χ2=26.19, P<0.001). HCWs’ hand hygiene modes before patient contact: liquid soap plus running water before intervention(67.02%), alcoholbased hand rub after intervention (61.08%); HCWs’ hand hygiene modes after patient contact : both liquid soap plus running water before and after intervention (86.40% and 70.41% respectively). Before intervention， hand dry method of  HCWs before and after patient contact was by wiping with uniforms， after intervention was by wiping with paper towel. HAI in intervention department decreased from 3.08% before intervention to 2.00% after intervention, the difference was significant(χ2=7.76, P=0.005).ConclusionMultimodel intervention measures in intervention department can effectively improve HCWs’ hand hygiene compliance rate.