2010—2012年综合性医院医务人员手卫生依从率的系统综述

目的对2010-2012年我国综合性医院医务人员手卫生依从率进行系统分析。方法检索中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、万方数据库（Wan Fang）、维普信息资源系统（VIP）及PubMed数据库，收集2010-2012年我国综合性医院医务人员手卫生依从率的文献，使用Comprehensive Meta Analysis V2软件和Stata12.0软件进行Meta分析。结果共纳入文献90篇，各文献间存在异质性（Q=48 118.32，P＜0.01），采用随机效应模型。医务人员合并手卫生依从率为47.83%（95%CI：43.27%～52.42%）；不同职业类别分层，医生合并手卫生依从率为40.36%（95%CI：35.42%～45.49%），护士为46.70%（95%CI：41.81%～51.65%），未进行职业分类的医务人员为40.72%（95%CI：27.75%～55.13%）。亚组分析，医生合并手卫生依从率与护士比较，差异无统计学意义（Q=3.12，P＞0.05）；接触患者后医务人员合并手卫生依从率为54.33%（95%CI：44.76%～63.59%），高于接触患者前的20.21%（95%CI：14.12%～28.06%）（Q=32.59，P＜0.01）；现场观察医院人员合并手卫生依从率为70.91%(95%CI：70.71%～71.10%)，高于隐蔽观察的41.20%（95%CI：37.55%～44.94%）（Q=247.66，P＜0.01）。结论2010-2012年我国综合性医院医务人员总体手卫生依从率低，医院应提高手卫生依从性，降低医院感染风险。

Hand hygiene compliance rates of health care workers in general hospitals from 2010 to 2012—A system review

ObjectiveTo assess the  prevalence of hand hygiene compliance rates of health care workers (HCWs) at general hospitals in China in 2010-2012.  MethodsLiteratures  about  hand hygiene compliance  of  HCWs from 2010 to 2012 were retrieved from  China Biology Medicine disc (CBM）, China National Knowledge Infrastructure（CNKI）,Wan Fang database, VIP ，and PubMed database , Comprehensive Meta Analysis V2 software and Stata12.0 software were adopted to conduct statistical analysis . ResultsNinety literatures  were selected with heterogeneity（Q=48 118.32，P＜0.01）, random effect model was used. The  overall  hand hygiene compliance rate of HCWs  was 47.83%（95%CI：43.27%-52.42%）; When stratified by occupation group， the overall compliance rate of doctors，nurses, and unclassified HCWs was 40.36%（95%CI：35.42%-45.49%）, 46.70%（95%CI：41.81%-51.65%）, and 40.72%（95%CI：27.75%-55.13%） respectively. According to subgroup analysis， there was no statistical difference in compliance rate between doctors and nurses（Q=3.12，P＞0.05）; the compliance rate after patient contact was higher than before patient contact （54.33% ［95%CI : 44.76%-63.59%］ vs 20.21%［ 95%CI: 14.12%-28.06%］）（Q=32.59，P＜0.01）; hand compliance rate from field observation was higher than from covert observation （70.91% ［95%CI ：70.71%- 71.10%］ vs  41.20%［95%CI ：37.55% -44.94%］）（Q=247.66，P＜0.01）.ConclusionThe overall hand hygiene compliance rate of HCWs in 2010-2012 was low,  in order to reduce the risk of healthcare associated infection, hand hygiene compliance of HCWs need to be increased .