外科重症监护室医务人员手部接触行为观察与分析

目的了解ICU医务人员手部与患者及其周围物表接触行为,为加强院感防控工作提供参考。方法将IPad分布于外科ICU不同方位,通过视频拍摄采集医务人员手部与患者及其周围物表接触行为的发生及目的等信息。结果拍摄视频15份,共计19.02h,每份(1.27±0.18)h。采集接触行为292人次,平均15.35人次/h。接触总频次463次,其中物表接触286次,发生率61.77%,平均15.03次/h;患者接触177次,发生率38.23%,平均9.31次/h。在各类人员中,护士接触人次最多(150人次),其他依次为助理护士(92人次)、医生(42人次)及其他人员(8人次);非必要接触行为共发生144人次,医生、护士、助理护士及其他人员分别为15人次、85人次、41人次和3人次,各类人群之间必要与非必要接触比例比较,差异有统计学意义(P<0.05)。结论应加强医务人员对接触行为的重视,尽量降低与患者的接触频率,减少医院感染的发生。

Observation and analysis of hand contact behaviors by various staff members in the surgical ICU

Objective To comprehend the hand contact behaviors by various staff members in the ICU,and to provide reference for prevention and control of nosocomial infection.Methods Several IPads were distributed across the surgical ICU to video film the hand contact behaviors by various staff members in the ICU.Then,occurrence and purpose of hand contact behaviors were summed up from the videos.Results A total of 15 videos were filmed,totaling 19.02 hours,with an averaged filming length of(1.27±0.18)hours.A total of 292 person contacts were collected,with an average of 15.35 person contacts/hour.A total of 463 contacts were observed,among which,286(61.77%)were object-surface related contacts,with an average of 15.03 contacts/hour,and 177(38.23%)were patient related contacts,with an average of 9.31 contacts/hour.When hand contacts were sorted by the types of workers,nurses contributed to the highest number of person contacts(150),followed by nurse aids(92),doctors(42),and other personnel(8).There were 144 unnecessary person contacts,respectively contributed by doctors(15),nurses(85),nurse aides(41)and other personnel(3).There was significant difference in the proportions of unnecessary and necessary person contacts by the 4 types of workers(P<0.05).Conclusion Attention should be paid to medical staff' s hand contact behaviors,and measures should be taken minimize unnecessary contacts with patients to reduce the incidence of nosocomial infections.