多重耐药菌感染患者陪护人员手部接触行为的调查研究

Hand contact behaviors among caregivers of patients with multidrug-resistant organism infection

摘要:

目的 了解多重耐药菌（MDRO）感染患者陪护人员手部与患者、环境表面及陪护人员自身的接触行为。 方法 2019年3月-2020年7月对2所大学附属医院收治的MDRO感染患者的陪护人员进行直接观察。由训练有素的观察员使用自行设计的观察量表记录陪护人员手部与患者、环境表面及其自身的接触情况和频次。 结果 陪护人员最常接触的为患者（89.82%），其次为近患者区（88.94%）。陪护人员频繁接触的环境表面包括床栏（80.09%）和床面（68.58%）。陪护人员自我接触时触摸口罩和躯干的比率分别为46.02%、36.73%。陪护人员手部与环境表面总接触频次在不同科室存在差异，内科的接触频次高于外科（P < 0.05）。陪护人员手部与患者接触频次在不同陪护时段有差异，治疗护理高峰期、探访时段的患者接触频次高于晨晚间护理时段（P < 0.05）。 结论 陪护人员在为MDRO感染患者提供照护时，频繁与患者、环境表面及自身接触，可能导致MDRO感染的传播。

Abstract:

Objective To understand the contact behavior between the hands of caregivers of patients with multidrug-resistant organism (MDRO) infection, environmental surfaces and caregiver themselves. Methods Caregivers of MDRO-infected patients in two university affiliated hospitals were directly observed from March 2019 to July 2020, self-designed observation scale was used by trained observers to record the contact situation and frequency of caregivers' hands with patients, environmental surfaces and caregiver themselves. Results Patients were most frequently contacted by caregivers (89.82%), followed by areas adjacent to patients (88.94%). The frequently contacted environmental surface by caregivers included bed-rail (80.09%) and bed surface (68.58%). 46.02% and 36.73% of the caregivers touched the mask and trunk during self-contact respectively. The total contact frequency between caregivers' hands and environmental surface was different in different departments, and the contact frequency of internal medicine was higher than that of surgery (P < 0.05). The contact frequency between caregivers' hands and patients was different in different nursing periods, contact frequency with patients in peak period of treatment and nursing as well as visit period was higher than that in morning and evening nursing period (P < 0.05). Conclusion When caregivers provide care for MDRO-infected patients, frequent contact with patients, environmental surface and caregiver themselves may lead to the spread of MDRO infection.