荧光标记在民族地区医疗机构环境清洁依从性调查中的应用

目的 评价荧光标记法在民族地区医疗机构高频接触环境清洁依从性调查中的应用效果。方法 选择某民族地区县医院外科、妇产科病区高频接触区域进行荧光标记，待保洁人员实施清洁处理后，同时采用视频监控、荧光标记法调查清洁依从性：在待投入使用的病区门把手捏手中间及手不易接触的门锁前面板分别做荧光标记，观察志愿者频繁开关门、频繁接触对荧光标记的影响。结果 对病区高频接触区域202个点位荧光标记法调查清洁依从率为66.83%。荧光标记法调查环境清洁依从性的灵敏度、特异度分别为94.96%、73.49%：荧光标记区手直接接触8次后荧光标记清除率达93.94%，门把手区域不同接触频次的荧光标记清除率比较，差异有统计学意义（χ²=49.622，P<0.05），经两两比较，荧光标记清除率随着手直接接触频次的增加而升高。结论 荧光标记法适用于基层医疗机构中对高频接触区域环境清洁依从性的调查，但标记时应避开门把手、电梯按键等人员直接频繁接触的区域。对门把手、电梯按键等人员直接接触高频区域标记方法有待于进一步研究。

Application of fluorescence labeling in survey of compliance to environmental cleaning of medical institutions in ethnic minority areas

Objective To evaluate application effect of fluorescence labeling method on survey of compliance to high-frequency touched environmental cleaning in medical institutions in ethnic minority areas. Methods High-frequency touched areas of surgical and obstetric and gynecological wards of a county hospital were selected for fluorescence labeling, after cleaned by cleaners, video monitoring and fluorescence labeling were performed to survey compliance to cleaning, fluorescence was labeled in the middle of door handle of wards to be put into use and in the front panel of door locks which were not easy to be touched by hand, effect of volunteers' frequent opening and frequent touch on fluorescence labeling was observed. Results Fluorescence labeling on 202 points showed that compliance rate to cleaning in high-frequency touched area was 66.83%. The sensitivity and specificity of fluorescence labeling for surveying environmental cleaning were 94.96% and 73.49% respectively; after 8 times of direct touch by hands, the removal rate of fluorescence labeling was 93.94%, there was a significant difference in the removal rate of fluorescence labeling between door handle with different touch frequencies(χ²=49.622,P<0.05). Pairwise comparison showed that the removal rate of fluorescent labeling increased with the increase of frequency of direct hand touch. Conclusion Fluorescent labeling method is applicable to the survey of compliance to environmental cleaning of high frequency-touched area in primary medical institutions, but it should avoid the area where the door handle, elevator button and other personnel directly frequently touched area when fluorescence was labeled. It is necessary to further study the method of labeling on high-frequency touched area when people directly touch the door handle, elevator button an so on.