基层医院医务人员手卫生依从性调查

目的:了解基层医院医务人员洗手行为的依从性,探讨相应的管理对策。方法:采用自行设计的调查问卷并结合现场观察洗手过程的方法,调查不同科室医务人员洗手知识的知晓情况及其洗手执行率。结果:医务人员的手卫生依从性不容乐观,接触患者前为58.4%,戴手套前仅为47.5%,儿科手卫生依从性最高,为78.8%,急诊科最低,为47.3%,护士的手卫生依从性高于医生。结论:实施灵活多变的培训方式及措施;及时、实事求是地反馈医院感染监测结果;进行医务人员手卫生依从性的调查;完善、改造和配备洗手设施;提供"伸手可得"的速干手消毒剂,规范洗手行为,确保洗手到位,有效降低医院感染的发生。     

医务人员手的消毒方法探讨

医务人员手的消毒方法探讨５６２４００贵州黔西南州人民医院罗碧秀，田景锦医务人员的手是医院内感染传播的主要媒介之一。如何清洁消毒医务人员的手，使之符合卫生部要求的卫生学标准，以减少经手传播的医院内感染，乃是医院感染监控中的重要课题。为此，我们进行了探索...     

消毒擦手纸巾对护理员手消毒效果的观察

医务人员的手是直接或间接污染物品或病人的最重要方式,医务人员有效的洗手或手消毒是防止医院内感染的重要措施。调查发现,到消毒供应室交换物品的护理员手的细菌培养总数不合格,用传统的潮湿肥皂洗手效果不理想。我们以消毒擦手纸巾用于护理员手消毒,经细菌培养监测,效果满意,现报告如下。用氯已定、乙醇溶液浸渍的无菌水刺布(简称消毒擦手纸巾)仔细擦拭双手2 m in,擦拭前后用浸湿灭菌生理盐水的棉拭子,涂抹双手指屈面从指根到指末来回2次,再放入装有10 m l采样液的试管内,作活菌计数,以细菌总数<10cfu/cm2,并不得检出金黄色葡萄球菌和大…     

PICU医务人员手消毒依从性情况调查及对策

[目的]调查儿科监护室医护人员对医院感染及手卫生的认知、洗手的依从性情况,分析影响手部卫生依从性的因素及手卫生和院内感染的关系。[方法]随机抽样调查儿科监护室的40名医护人员。[结果]大多数医护人员已经具备了医院感染的基本知识,在工作中积极进行预防和控制,一些医护人员对医院感染发生及控制工作有错误认识;个别医务人员对手卫生操作的依从率较低,影响手卫生低依从率的因素包括：手卫生设施不够便利、护理优先权（即对患儿的护理需要优先于手卫生）、缺少个人责任感等。[结论]儿科监护室医院感染疾病的发生与流行与儿科监护室医护人员的手部带茵状况密切相关,儿科监护室医护人员应重视手部卫生,提高洗手的依从性。     

PICU医务人员手消毒依从性情况调查及对策

[目的]调查儿科监护室医护人员对医院感染及手卫生的认知、洗手的依从性情况,分析影响手部卫生依从性的因素及手卫生和院内感染的关系.[方法]随机抽样调查儿科监护室的40名医护人员.[结果]大多数医护人员已经具备了医院感染的基本知识,在工作中积极进行预防和控制,一些医护人员对医院感染发生及控制工作有错误认识;个别医务人员对手卫生操作的依从率较低,影响手卫生低依从率的因素包括:手卫生设施不够便利、护理优先权(即对患儿的护理需要优先于手卫生)、缺少个人责任感等.[结论]儿科监护室医院感染疾病的发生与流行与儿科监护室医护人员的手部带菌状况密切相关,儿科监护室医护人员应重视手部卫生,提高洗手的依从性.     

三氯生醇消毒凝胶对医务人员手消毒效果

目的了解三氯生醇消毒凝胶对医务人员手消毒效果。方法用现场试验方法,对消毒凝胶消毒医务人员手的效果进行了观察。结果用该凝胶消毒剂对医护人员手擦拭消毒作用1 m in,可使医护人员手平均菌数由大于73.93 cfu/cm2下降到<5 cfu/cm2;平均杀灭率为93.55%。结论三氯生醇消毒凝胶对医务人员手消毒效果较好,满足消毒指标要求,应注意消毒后等待手干燥再从事诊疗操作。     

医务人员手消毒的现状及对策

在医院感染传播途径中，医务人员的手是造成医院内感染的重要原因。目前，由于医务人员主观上洗手意识淡化，以及医院客观条件的限制，手现状令人不满，分析存在的原因有：洗手设施不合理，手部消毒液配制不合格；洗手习惯不良。认为应从以下几方面进行改进，强化洗手意识；强调正确的洗手方法，配备合格的洗手装置及洗剂，优化手部消毒液的配方并严格管理，洗手后烘干处理。     

医务人员手卫生消毒状况调查

目的了解传染病医院医务人员手卫生消毒状况,加强手卫生管理。方法现场采样检测方法对医院Ⅰ~Ⅲ类环境的医务人员手消毒效果进行了监测。结果共检测1185人份,总合格率为84.47%。Ⅰ~Ⅲ类环境人员合格率依次为93.75%、80.11%、84.22%;临床医生、护士和医技人员合格率范围为83.16%~87.20%。结论传染病医院医务人员手消毒合格率较高,医护人员之间无明显差异。     

传染病医院医务人员手卫生消毒效果分析

[目的]了解医务人员手卫生消毒效果。[方法]定期对各科室医务人员手进行细菌监测，并将结果填入设计好的表格中进行回顾性统计分析。[结果]2005—2008年共监测医务人员手1723例次，合格率为88．28％，2008年的合格率已达到96．06％；医务人员洗手合格率有逐年上升趋势；其中手术室、中心供应室洗手合格率较高。[结论]快速手消改善了医务人员手部卫生的依从性，是行之有效的手卫生消毒方法。     

Hand Hygiene Compliance Among Health Care Staff and Student Nurses in a Mental Health Setting

Hand hygiene practice among health care workers is considered to be the single most effective method of preventing nosocomial infection in hospital settings. Infection control practices in psychiatric facilities are particularly challenging as hand hygiene protocols are specific to acute care facilities, areas where hands are visibly soiled, and when procedures are completed that may involve body fluid exposure. The inability to motivate and change the hand washing practices of health care workers suggests that hand washing behaviour is complex, involving individual beliefs and attitudes and institutional commitment and rigor.     

结合社区联动的延续护理对提高高血压患者服药依从性和健康行为的影响

【】目的：探讨结合社区联动的延续护理对提高高血压患者服药依从性和健康行为。方法：选取我院自2016年8月~2017年4月收治的120例原发性高血压患者作为研究对象,随即分为对照组和观察组,各60例。对照组患者实行常规护理模式,观察组患者在常规护理的基础上进行结合社区联动的延续性护理。随访问卷调查分别在患者就诊时、诊疗后1月、3月、6月进行,指标包括高血压防治知识,服药依从性和健康行为情况。结果：观察组患者高血压防治知识、服药依从性和健康行为均明显优于对照组治疗。且差异均有统计学意义(P＜0.05)。结论：结合社区联动的延续护理能提高高血压患者高血压防治知识和服药依从性,促进健康行为,提高治疗效果。     

Improving Health Promotion and Disease Prevention in NP-Delivered Primary Care

Health promotion and disease prevention are critical to primary care nurse practitioner (NP) practice. However, studies regarding NP-delivered health promotion and disease prevention suggest room for improvement. Many health promotion and disease prevention interventions designed and delivered by NPs focus on educating patients about evidence-based lifestyle recommendations without incorporating behavioral theories and techniques. The purpose of this article is to describe the importance of behavioral theories to NP-delivered primary care, to discuss strategies for the implementation of behavioral theories and techniques into practice, and to present a case study example of an approach to implementation.     

COVID-19 in Health Care Personnel: Significance of Health Care Role,Contact History,and Symptoms in Those Who Test Positive for SARS-CoV-2 Infection

ObjectiveTo identify significant factors that help predict whether health care personnel (HCP) will test positive for severe acute respiratory coronavirus 2 (SARS-CoV-2).Patients and MethodsWe conducted a prospective cohort study among 7015 symptomatic HCP from March 25, 2020, through November 11, 2020. We analyzed the associations between health care role, contact history, symptoms, and a positive nasopharyngeal swab SARS-CoV-2 polymerase chain reaction test results, using univariate and multivariable modelling.ResultsOf the symptomatic HCP, 624 (8.9%) were positive over the study period. On multivariable analysis, having a health care role other than physician or advanced practice provider, contact with family or community member with known or suspected coronavirus disease 2019 (COVID-19), and seven individual symptoms (cough, anosmia, ageusia, fever, myalgia, chills, and headache) were significantly associated with higher adjusted odds ratios for testing positive for SARS-CoV-2. For each increase in symptom number, the odds of testing positive nearly doubled (odds ratio, 1.93; 95% CI, 1.82 to 2.07, P<.001).ConclusionSymptomatic HCP have higher adjusted odds of testing positive for SARS-CoV-2 based on three distinct factors: (1) nonphysician/advanced practice provider role, (2) contact with a family or community member with suspected or known COVID-19, and (3) specific symptoms and symptom number. Differences among health care roles, which persisted after controlling for contacts, may reflect the influence of social determinants. Contacts with COVID-19–positive patients and/or HCP were not associated with higher odds of testing positive, supporting current infection control efforts. Targeted symptom and contact questionnaires may streamline symptomatic HCP testing for COVID-19.     

静脉输液护士手卫生依从性的质性研究

目的深入探讨影响静脉输液护士手卫生依从性的原因,为卫生管理决策提供依据。方法采用目的抽样法选取北京市3所三级甲等医院的注册护士10名,均为女性,目前从事临床一线护理工作,具备静脉输液操作资质,现场考核均能准确完成手卫生"六步洗手法"。通过半结构式深度访谈法收集资料,采用持续比较的方式对资料进行比较、归类,形成主题。结果静脉输液护士手卫生依从性的影响因素包括3个一级主题、8个次主题。护士主观因素包括从众心理、自我保护和侥幸心理;洗手设施和物品因素包括舒适度、便捷性和可及性;工作因素包括时间因素和情境因素。结论改革手卫生培训内容、改善手卫生设施的状况、改进手卫生监控方式等有助于提高静脉输液护士的手卫生依从性。