医务人员接触患者后手卫生执行情况的调查分析

目的了解医务人员接触患者后的手卫生执行情况及不同条件对医务人员手卫生执行率的影响。方法对北京、上海、广州3城市8所三级医院不同职务、不同科室的医务人员进行现场观察。结果医务人员接触患者后的手卫生执行率为56．5％，医生为61．0％、护士为53．8％。在提供手套时医务人员手卫生执行率为52．8％，不提供手套为82．0％，差异有统计学意义；在提供醇类快速手消毒剂、肥皂和洗手液时医务人员手卫生执行率（58．7％、61．3％）比不提供的手卫生执行率（51．2％、48．4％）高（P〈0．05、P〈0．01）。医务人员接触患者后使用肥皂（洗手液）和流动水洗手时间≥15s的占74．6％。结论我国大城市、大医院医务人员接触患者后的手卫生执行情况相对较好，洗手时间和流程较为规范，但仍存在手卫生意识薄弱、硬件设施不足等缺陷，尚需加强手卫生教育，采取干预措施，提高医院感染控制水平。

Investigation of hand hygiene compliance after patient contact

Objective To evaluate hand hygiene compliance (HHC) after patient contact and the influence of different factors on HHC in China. Methods HHC by different levels of medical workers from different departments were observed on 8 tertiary hospitals in Beijing, Shanghai and Guangzhou. Results The average HHC was 56. 5%( 61. 0% by the doctors and 53. 8% by the nurses). HHC was 52. 8% in the presence of gloves and 82. 0% in the absence of gloves; the difference was statistically significant. When alcohol-based hand rub or soap (hand sanitizer) was provided, HHC was respectively 58. 7% and 61. 3%; when they were not provided, it was respectively 51. 2% and 48. 4% (P<0. 05, P<0. 01). In addition, 74. 6% of the medical workers washed their hands for more than 15 s after patient contact with soap (hand sanitizer) and running water. Conclusion HHC by medical workers in the big hospitals in the big cities is relatively good and the time and procedure for hand washing are up to the standard. However, the awareness of hand hygiene is still weak and there is a shortage of relevant facilities. Training and education in hand hygiene should be strengthened and measures of intervention be adopted so as to better control hospital infection.