2014—2022年手卫生干预对医院感染例次发病率的影响

目的 观察多模式手卫生干预对手卫生依从性的影响，以及手卫生依从性与医院感染例次发病率之间的关系。方法 2014—2022年，某三甲医院感染控制团队对全院医务人员实施多模式手卫生干预，回顾性分析手卫生监测数据的变化趋势、手卫生依从率与医院感染例次发病率的相关性。结果 病房手卫生用品消耗量呈稳定上升趋势；手卫生依从率从2014年64.98%提高到2022年85.01%(P<0.001),医院感染例次发病率从1.21%下降至0.83%(P<0.05),手卫生依从率与医院感染例次发病率之间存在负相关(r=-0.369,P=0.027)。各季度不同区域及不同岗位的手卫生依从率均有所提高(P<0.001)。各季度5个时刻手卫生依从率中，无菌操作前与接触患者后的手卫生依从率小幅波动；接触患者周围环境后的手卫生依从率呈上升趋势；接触患者前与接触患者体液后的手卫生依从率在2020年之后有所下降(P<0.001)。结论 多模式手卫生干预能提高医务人员的手卫生依从性，提高医务人员手卫生意识有利于降低医院感染例次发病率。

Effect of hand hygiene intervention on healthcare-associated case infection incidence from 2014 to 2022

Objective To observe the effect of multi-modal hand hygiene (HH) intervention on HH compliance, as well as the relationship between HH compliance and the healthcare-associated (HA) case infection incidence. Methods From 2014 to 2022, the infection control team in a tertiary first-class hospital implemented multi-modal HH intervention for health care workers (HCWs). The changing trend of HH monitoring data, the correlation between HH compliance rate and HA case infection incidence were analyzed retrospectively. Results The consumption of HH products in the wards showed a stable upward trend; HH compliance rate increased from 64.98% in 2014 to 85.01% in 2022 (P<0.001), and HA case infection incidence decreased from 1.21% to 0.83% (P<0.05). HH compliance rate was negatively correlated with HA case infection incidence (r=-0.369, P=0.027). HH compliance rates in different regions and job posts in each quarter were increased (P<0.001). For 5 different HH moments in each quarter, HH compliance rate fluctuated slightly before sterile manipulation and after touching patient; presented rising trend after touching surroundings around patient, and decreased before touching patient and after touching patient''s body fluid since 2020 (P<0.001). Conclusion Multi-modal HH intervention can improve the HH compliance of HCWs, improving their HH awareness is conducive to reducing HA case infection incidence.