手卫生情况调查问卷及现场观察评估

目的 了解临床各科室医护人员手卫生相关知识掌握及执行情况.方法 通过不计名当场回收问卷形式评估手卫生相关知识,并现场观察了解手卫生实际执行情况.结果 此次调查共发放问卷203份,实际回收203份.在接触病人前、无菌操作前医护人员自评洗手率分别为33.5%和52.7%,其中医护人员吃饭前、上厕所前后、下班前洗手率大于90%,接触病人后洗手率为70.4%,其中接触体液及血液后的洗手率为100%,明显高于未接触体液者.而实际现场观察到的总洗手率为58.8%,调查问卷及现场观察两者结果基本一致.接触患者后的手卫生执行率以医师最高,为85.7%(P=0.002),接触患者直接范围之后的手卫生执行率以护士为最高,为44.2%(P=0.009).不同科室间,接触病人前、无菌操作前及接触病人直接范围后的手卫生执行率均以血液科最高,分别为68.4%、72.7%及94.2%(P=0.000);接触病人后以内科监护室及血液科的手卫生执行率最高,为86.5%及82.9%(P=0.000).大部分被访者对手卫生院内感染相关知识认识不足,无人答全问卷中相关院内感染英文缩写的全称,只有3.4%的被访者表示严格按照六步洗手法洗手;1人(0.5%)表示每次洗手时间>30 s.结论 医护人员对于手卫生相关知识了解不足,理论上了解手卫生的重要性,实际洗手依从性有待增强;应加强相关指导,提高洗手依从性,减少院内感染,有效保护医护人员自身及病人安全,降低医疗成本.

Questionnaire of hand hygiene and field assessment of hand hygiene compliance in medical staffs

Objective To investigate the understanding of hand hygiene (HH) and to assess the status of hand hygiene compliance (HHC) in medical staffs of the hospital. Methods The non-registered questionnaires for HH was collected and the obersevation for HHC was undertaken on the spot. Results Two hundred and three sets of questionnaires were distributed and reclaimed. The rates of HHC "before patient contact" and "before an aseptic task" were 33.5% and 52.7%, respectively. The rates of HHC "before going to restroom"...