医护人员不同手卫生方法的效果评价

目的比较快速手消毒液与洗手液洗手的消毒效果,探讨适合的手卫生方法。方法选取本院100例医护人员,随机将其分为快速手消毒液组和洗手液组等两组,每组各50例。观察两组洗手前后的细菌总数。结果快速手消毒液组和洗手液组对手带菌量≥50cfu/cm2的洗手后细菌群落数均较洗手前减少,差异有统计学意义（t=54.97,P〈0.01;t=52.78,P〈0.01）;洗手后两组细菌群落数比较,差异有统计学意义（t=9.33,P〈0.01）;两组合格率比较,差异有统计学意义（χ2=8.90,P〈0.01）。快速手消毒液组和洗手液组对手带菌量〈50 cfu/cm2的洗手后细菌群落数均较洗手前减少,差异有统计学意义（t=38.98,P〈0.01;t=36.53,P〈0.01）;洗手后两组细菌群落数比较,差异无统计学意义（t=0.33,P〉0.05）;两组合格率比较,差异无统计学意义（χ2=0.10,P〉0.05）。结论两种手卫生方法均消毒效果显著,但手部污染明显（带菌量≥50cfu/cm2）时,用快速手消毒液处理的合格率低于洗手液,此时应选用洗手液加流动水洗手。     

净手消毒剂与肥皂洗手效果的对照研究

目的：探索洗手液的洗手效果,从而为减少医院感染提供依据。方法：分别对研究组40例医护人员用净手消毒剂洗手,对照组40例医护人员用肥皂洗手,两组人员洗手前后均进行手部自然菌检测。结果：两组洗涤剂均有较好的效果,洗手前后菌落数经t值检验,P〈0.05,有显著差异。在合格率方面存在显著差异,x^2=9.60,P〈0.05,净手消毒剂效果较好。结论：净手消毒剂洗手效果明显好于肥皂。建议临床推广应用。     

急诊护士两种洗手法的效果比较

目的 比较用肥皂洗手和用洗手液洗手的效果.方法 经现场试验,采用棉拭涂采样法和活菌计数法对两种洗手方法 进行了检测.结果 用肥皂按六步洗手法洗手的人员手合格率为98%,而用洗手液洗后的手的卫生合格率为100%,而肥皂的价格明显比洗手液低.结论 用肥皂洗手和洗手液洗手两组数据结果 在统计学上无显著差异,说明在工作中工作人员用肥皂按六步洗手法洗手可以达到手卫生质量要求而且节约成本.     

消毒供应室人员洗手效果的观察与分析

目的 探讨消毒供应室人员的洗手效果,进一步完善及制定手卫生管理措施.方法 将8名消毒供应室人员随机分为两组,分别采用蓝月亮洗手液和佳华抗菌洗手液洗手,抽取每人55次洗手后细菌监测效果进行对比分析.结果 蓝月亮洗手液细菌清除率为69.02%,佳华抗菌洗手液细菌消除率为92.46%,两者之间差异有统计学意义(P<0.05),佳华抗菌洗手液洗手组工作人员洗手合格率明显高于蓝月亮洗手液洗手组(P<0.05).结论 佳华抗菌洗手液能有效抑制细菌生长,并有润肤作用,适合于消毒供应室人员洗手,因而能提高洗手的依从性.     

687例肥皂洗手结果分析

目的:通过对医生、护士洗手后的监测,提高医护人员控制医院感染的意识.方法:将医院医护人员分成三个组:门诊、大内科、大外科医护人员共687人次,用肥皂流动水洗手后进行微生物学监测.结果:肥皂洗手后合格率为91.27%,其中医生合格率为87.19%,护士合格率为92.98%,医护之间洗手效果有显著差别.结论:医护人员掌握正确的洗手方式、洗手时间、洗手频度,能有效的防止因手传播引发的医院感染.     

基层医院医务人员手卫生目视管理效果分析

目的:研究目视管理在基层医院医务人员手卫生中的应用效果。方法:抽取南朗医院2017年5月1日-2018年4月30日内、外、妇、儿科四个科室的医务人员共80名作为研究对象,采用随机抽签对照试验进行分组,每组各40名。对照组医务人员实施传统方法管理,观察组医务人员应用目视管理法进行管理。研究期间抽取符合标准的患者100例,并随机分为对照组与研究组,每组各50例。将两组医务人员的手卫生知识掌握情况、洗手依从性情况、手卫生合格率以及患者医源性感染发生率、患者对医务人员满意度进行比对,并统计科室洗手液和速干手消毒液的使用数量。结果:观察组医务人员经过管理后手卫生知识掌握合格率分别为洗手步骤(92.50%)、洗手时间(100%)、洗手次数(92.50%)、洗手范围(95.00%)均高于对照组,两组比较差异均有统计学意义(x~2=7.813、10.141、6.646、7.440,P=0.005、0.001、0.010、0.006)。观察组医务人员洗手依从性分别为接触患者前后(97.50%、100%)、无菌清洁操作前后(97.50%、100%)、接触患者体液或污染物后(95.00%、97.50%)、接触患者周围环境或物品后(97.50%)、处理药物及配餐前(100%),手卫生合格率为92.50%,均高于对照组,两组比较差异均有统计学意义(P0.05)。四个科室中洗手液和速干手消毒液的使用数量最多的为儿科,且管理后的使用数量多于管理前。观察组患者的医源性感染发生率为0低于对照组13.00%,差异有统计学意义(x~2=7.527,P=0.006);患者总满意率为96.00%高于对照组76.00%,差异有统计学意义(x~2=8.306,P=0.004)。结论:目视管理应用在基层医院医务人员中可促进其手卫生知识掌握合格率的提高,进而可提高医务人员的洗手依从率和手卫生合格率,减少患者医源性感染的发生,有助于患者对医务人员满意度的提升。     

急诊护士手卫生方法探讨

目的:了解三种手卫生方法的使用情况及效果,探讨改进急诊护士手卫生现状的措施。方法:随机抽取急诊科护士20人,观察记录他们在护理操作项目中使用的手卫生方法、标准洗手次数和实际洗手次数,并对其手部进行消毒效果监测。结果:采用快速手消毒液洗手、洗手液洗手和固体肥皂洗手这三种手卫生方法的洗手合格率分别为98.2%、90.5%和79.5%,除菌率分别为95.0%、80.0%和65.0%,在各护理操作前后的平均实际洗手率为56.6%,结果均具有统计学意义(P<0.05)。结论:快速手消毒液洗手方法效果优于洗手液洗手和固体肥皂洗手方法,建议广泛使用,通过加强手卫生知识的教育培训、配置完善的洗手用品和设施、建立手卫生的监管机制可以改进目前急诊护士的手卫生情况。     

一种自制速干手消毒剂的临床研究

目的探讨甘油乙醇免洗手消毒剂的临床实验效果,为产品推广提供依据。方法通过临床医务人员采用普通肥皂洗手和3种速干手消毒剂(甘油乙醇免洗手消毒剂、3M公司爱护佳免洗手消毒液、洗得宝牌手消毒凝胶)进行卫生手消毒,并比较4种方法的效果。结果采用普通肥皂洗手法及3种速干手消毒剂处理前、后手部细菌菌落数比较,差异有统计学意义(P<0.01);甘油乙醇免洗手消毒液的消毒效果优于其他3种方法,其余3种方法效果均能达到卫生部相应标准,其合格率差异无统计学意义(P>0.05)。结论甘油乙醇免洗手消毒剂杀菌效果好,价格低廉,有润肤作用,是一种值得推广的速干手消毒剂。     

健康促进对医护人员手卫生依从性的影响研 究简

目的 对包头某医院医护人员进行健康促进,以评价其对医护人员手卫生的影响.方法 2012年11月～2013年10月对某院临床各科室医护人员进行手卫生知识调查,并进行健康促进,评价项目实施前、实施中和实施后医护人员手卫生知识知晓率、卫生洗手正确率和手卫生依从性,并对卫生用品领取量进行分析.结果 项目实施前医护人员手卫生知识知晓率均较低,项目实施中和实施后,医护人员手卫生知识知晓率均明显上升（P＜0.05）;项目实施前医护人员手卫生洗手正确率均较低,项目实施中和实施后,医护人员洗手正确率均明显上升（P＜0.05）;项目实施前医师、护士手卫生依从率差异有统计学意义（P＜0.05）,项目实施中、实施后两组依从性均明显提高,与实施前比较差异有统计学意义（P＜0.05）,但医护之间差异仍有统计学意义（P＜0.05）;项目实施中及实施后,肥皂、洗手液和手消液领取量与实施前相比均明显增加,差异有统计学意义（P＜0.05）.结论 健康促进项目能够培养医护人员手卫生意识,提高医护人员手卫生知识知晓率、卫生洗手正确率和手卫生依从性.     

急诊护士手卫生方法探讨

目的：对比以皮肤消毒液擦拭手与传统的用肥皂洗手两种手卫生方法,探讨两者效果。方法：选取本院70例急诊护理工作人员,随机将其分为观察组和对照组,每组各35例。对照组护理人员采取常规的手卫生方法,即用肥皂洗手;观察组用皮肤消毒液进行手部擦拭,观察两组护理人员洗手前后的细菌情况。结果：观察组洗手后细菌群落总数为（1．74±0．63）cfu／cm2,对照组洗手后细菌群落总数为（1．82±0．81）cfu／cm2,两组细菌群落总数比较,差异有统计学意义（t=3．241,P〈0．01）;观察组35例护理工作人员中,洗手后有34例合格,合格率为97．14％,对照组35例中,有33例合格,合格率为94．29％,两组合格率比较,差异无统计学意义（P〉0．05）。结论：两种手卫生方法均能实现洗手目的。     

诺如病毒在手上的存活力及消毒剂对其杀灭效果的研究

目的:研究探讨诺如病毒(NoV)在手上的存活力以及常用手消毒剂对其杀灭的效果。方法:将NoV接种于志愿者手上,在不同时间点上进行洗脱,并对洗脱液进行荧光定量RT-PCR检测。在上述NV接种的基础上,用速干手消毒剂和液体香皂分别回收病毒,并进行荧光定量RT-PCR检测。结果:志愿者在15min后平均NV和SMV数量稍减少,病毒量仅下降0.15~0.20Log10 GEP,而在随后的30min、1h、和2h观察时间点病毒数量无明显变化。对NV杀灭效果最好的是液体香皂,平均降低NV0.94Log10 GEP,水洗平均降低NV0.75Log10 GEP,而速干手消毒剂效果最差,平均降低NV 0.14Log10 GEP。结论:NoV在手上的存活力强,液体香皂对NV的杀灭效果优于速干手消毒剂,但效果亦有限。     

The pH of commercially available rinse-off products in Sri Lanka and their effect on skin pH

INTRODUCTION: Initially linked to antimicrobial function, the acidic skin pH plays a key role in permeability barrier homeostasis and integrity of the stratum corneum. Barrier recovery is delayed when acutely perturbed skin sites are exposed to a neutral pH. OBJECTIVE: To evaluate the pH of commercially available rinse-off products in Sri Lanka, and the effect of detergent rinses on skin pH and its recovery rate. METHODS: The pH of 18 rinse-off products was determined using pH indicator paper and a pH meter. The effect of an alkaline (pH 9) and an acid (pH 5.5) rinse-off product on the hand skin pH was compared in 48 healthy volunteers after single and multiple applications. The skin pH of the dorsum of hands was measured in nurses before (n = 131) and during (n = 40) a duty shift that involved frequent hand washing using alkaline soap. RESULTS: Soaps available in Sri Lanka have a pH of 9.1-10.5. The pH of syndets and cleansers range from 5.5-7.0. Five minutes after hand washing, the mean skin pH increased by 1.7 +/- SD 0.5 pH units with alkaline soap, and by 0.8 +/- SD 0.4 pH units with acidic cleanser (p < 0.0001). Recovery of pH was slower when alkaline soap was used. The increase in skin pH was significantly greater when hands were repetitively washed with alkaline soap (p < 0.0001). The mean skin pH values of nurses before (4.9 +/- SD 0.4) and during (5.7 +/- SD 0.7) the work shift were significantly different (p < 0.0001). CONCLUSIONS: Alkalinisation with rinse-off products increases the skin pH with potential functional and clinical implications.     

医院护工手污染情况和肥皂洗手前后的效果比较

目的了解护工手污染情况以及肥皂洗手后的微生物学监测情况。方法随机抽取护工50人,比较肥皂洗手前后的菌落总数和带菌情况。结果规范的卫生洗手后能明显的降低手的菌落总数和细菌。结论护工的手卫生意识较差,自我防护的意识也比较弱,应加强护工卫生洗手法的培训,有效的控制病原体的传播。     

医务人员手卫生监测结果分析

目的：了解医务人员的洗手情况,便于针对性的对医务人员进行手卫生监督及监测,提高医务人员手卫生依从性。方法：回顾性分析医院2006-2009年手卫生监测资料。结果：我院医务人员手卫生监测合格率逐年提高,总合格率为83.5%;高年资医务人员洗手合格率高于低年资医务人员,肥皂组洗手后菌落数明显超标,与洗手液组和速干手消毒剂组比较,有统计学意义。结论：及时监测与反馈医务人员手的微生物学检测结果,有助于医务人员行为的改变,可强化其手卫生观念,提高手卫生依从性。     

Role of the Coronavirus Disease 2019 (COVID-19) pandemic in the upgrading of personal hygiene. A cross-sectional study in Saudi Arabia

Objectives:To assess the role of the Coronavirus Disease 2019 (COVID-19) pandemic in improving personal hygiene in Saudi Arabia.Methods:We administered a questionnaire distributed online between 19 and 28 May 2020 to determine alterations in personal hygiene practices during this pandemic compared to the pre-pandemic phase.Results:We included 211 respondents from the Kingdom of Saudi Arabia (KSA) in this study. Improvement at different levels was detected in all examined personal hygiene items compared to the pre-pandemic stage. The percentages of respondents who always washed their hands after coming back home (34.1%), used soap to wash their hands (58.8%), used a hand sanitizer outside (5.2%), wore a face masks while outside (1.4%) and washed their hands before preparing and/or eating food (74.9%) was increased before the pandemic to 89.6%, 90%, 63.5%, 59.2% and 89.1% during the pandemic, respectively. The percentage of respondents who never shake hands with people they know increased from 0% before the pandemic to 62.6% during the pandemic. The mean duration of washing hands with soap significantly increased from 13.31 seconds before the pandemic to 28.01 seconds during the pandemic (p<0.0001).Conclusion:The COVID-19 pandemic resulted in a noticeable improvement in the personal hygiene habits in Saudi Arabia mainly those related to COVID-19 prevention.     

医务人员的手使用肥皂清洗效果调查

目的了解肥皂对医务人员手的清洁效果,为进一步做好医务人员手部卫生工作提供依据。方法随机抽取28家医疗机构203名医务人员的双手。在其接触病人、从事医疗活动前、后(肥皂清洗后)对其双手指曲面进行涂抹采样,一只手涂抹面积约30cm2。结果肥皂加流动水对手部微生物平均清除率71.5%(t0.05/2,6=2.42,p<0.05)。结论医务人员手部微生物污染不可忽视,肥皂作为日常手部清洁用品方便、快捷、有效。     

Adherence to hand hygiene protocol by clinicians and medical students at Queen Elizabeth Central Hospital,Blantyre-Malawi

Background

While communicable diseases are the leading causes of morbidity and mortality in Malawi, the contribution of nosocomial or hospital-acquired infections (HAIs) is unknown but could be substantial. The single most important method of preventing nosocomial infections is hand hygiene. We report a study which was conducted in 2011 to investigate adherence to hand hygiene protocols by clinicians and medical students working at Queen Elizabeth Central Hospital in Blantyre, Malawi.

Methods

There were two parts to the study: a single blinded arm in which participants were observed without their knowledge by trained nurses; and a second arm which included self-completion of questionnaire after participant consent was obtained. The 2009 World Health Organization hand hygiene technique and recommendations which were adopted by Queen Elizabeth Central Hospital were used to define an opportunity for hand washing and effectiveness of hand washing. Hand hygiene effectiveness was defined as adherence to at least 6 out of 7 steps (80%) of the hand hygiene technique when using alcohol-based formulation or at least 8 out of 10 steps (80%) of the hand hygiene technique when using water and soap formulation before and after having direct contact with patients or their immediate surroundings.

Results

Clinicians were found to have disinfected their hands more than medical students (p<0.05) but effectiveness was similar and very low between the two groups (p=0.2). No association was also found between having a personal hand sanitizer and hand hygiene practice (p=0.3). Adherence to hand hygiene was found to be 23%. Most of the participants mentioned infection transmission prevention as a reason for disinfecting their hands. Other reasons mentioned included: a routine personal hand hygiene behaviour and discomfort if not washing hands. The top three reasons why they did not disinfect hands were forgetfulness, unavailability of sanitizers and negligence.

Conclusion

Adherence to hand hygiene practice was found to be low, with forgetfulness and negligence being the major contributing factors. A hospital-wide multifaceted program aiming at clinicians and students education, adoption of alcohol based hand rubs as a primary formulation, production of colored poster reminders and encouraging role modeling of junior practitioners by senior practitioners can help improve compliance to hand hygiene.     

医院洗手肥皂染菌状况调查与分析

目的:探讨使用中肥皂保存状态与污染情况的关系。方法:选择《医院消毒卫生标准》GB15982-1995中的采样与判定方法,对大连市23所医疗保健单位使用中肥皂进行随机抽采,统计与分析。结果:肥皂表面的污染情况很严重,细菌总数超标50倍以上的占19.32%,甚至有12.5%的表面细菌总数无法计数。结论:在保存不当的情况下,肥皂会成为病菌传播者,通过医疗操作前后必要的洗手过程污染医护人员的手,引起院内感染事故的发生,各医疗单位要加强对使用中肥皂染菌情况的管理。