医院工作人员呼吸道防护能力的评价研究

Assessment of respiratory protection competency of staff in healthcare facilities

摘要:

目的 了解医院工作人员呼吸道防护能力。 方法 选取北京市6所不同级别、性质的医院不同风险级别的工作人员, 包括医生、护士、医技、工勤人员进行呼吸道防护能力知识测评。根据呼吸道传染病暴露风险, 以实际案例及日常工作场景出发, 从呼吸道传染病的识别、呼吸道传染病的传播途径与相应防护要求和口罩的正确选择与使用三个方面设计呼吸道防护能力测评内容, 分别包括6、6、8个知识点, 共20个知识点, 均为选择题。多选题全选对为满分, 部分选正确且无错误选项为部分得分, 有错误选项不得分。根据经典测评理论对每个知识点题目进行难度、区分度分析。 结果 对6所医院326名不同风险级别的工作人员呼吸道防护能力知识测评结果显示, 20个知识点中, 得满分比率在60%以上的有6个, 其他题目得满分比例较低, 其中空气传播疾病种类、飞沫传播疾病种类、呼吸道传染病医院感染防控常规措施、医用防护口罩的佩戴指征和医用外科口罩的佩戴指征5个知识点得满分比率在10%以下。在20道知识题中, 难度分析较为容易、难度中等和较难的题目分别有5、1、14道; 区分度在≥0.4、0.30~0.39、0.20~0.29、≤0.19的题目分别为6、1、4、9道。 结论 医院工作人员呼吸道防护能力还有很大提升空间, 尤其在不同传播途径疾病种类的认知和不同类型口罩佩戴指征的掌握方面。

Abstract:

Objective To understand the respiratory protection competency of staff in hospitals. Methods Staff from six hospitals of different levels and characteristics in Beijing were selected, including doctors, nurses, medical technicians, and servicers, to conduct knowledge assessment on respiratory protection competency. According to exposure risks of respiratory infectious diseases, based on actual cases and daily work scenarios, content of respiratory protection competency assessment was designed from three aspects: identification of respiratory infectious diseases, transmission routes and corresponding protection requirements, as well as correct selection and use of masks. The assessment included 6, 6, and 8 knowledge points respectively, with 20 knowledge points in total, all of which were choice questions. For multiple-choice questions, full marks, partial marks, and no mark were given respectively if all options were correct, partial options were correct and without incorrect options, and partial options were correct but with incorrect options. Difficulty and discrimination analyses on question of each knowledge point was conducted based on classical test theory. Results The respiratory protection competency knowledge assessment for 326 staff members at different risk levels in 6 hospitals showed that concerning the 20 knowledge points, more than 60% participants got full marks for 6 points, while the proportion of full marks for other questions was relatively low. Less than 10% participants got full marks for the following 5 knowledge points: types of airborne diseases, types of droplet-borne diseases, conventional measures for the prevention and control of healthcare-associated infection with respiratory infectious diseases, indications for wearing respirators, and indications for wearing medical protective masks. Among the 20 knowledge questions, 5, 1, and 14 questions were relatively easy, medium, and difficult, respectively; 6, 1, 4, and 9 questions were with discrimination levels of ≥0.4, 0.30-0.39, 0.20-0.29, and ≤0.19, respectively. Conclusion There is still much room for hospital staff to improve their respiratory protection competency, especially in the recognition of diseases with different transmission routes and the indications for wearing different types of masks.