某三级甲等医院医务人员手卫生依从性现状调查

目的了解某三级甲等医院医务人员手卫生依从性现状，探讨提高手卫生依从性的有效措施。方法采用直接观察法，于2012年9-12月对该院23个临床科室医务人员的手卫生依从性及手卫生方式进行现场调查，并填写手卫生依从性监测表。结果共观察721次手卫生时刻，手卫生依从率为58.53%，其中选择速干手消毒剂擦手者占32.18%，流动水洗手者占26.35%，戴手套未采取其他手卫生措施者占19.42%。不同岗位医务人员以护士手卫生依从率（68.65%）最高，保洁员最低（39.25%）。“5个时刻”手卫生依从率以“接触患者体液后”最高（73.75%），其次是“接触患者后”（65.00%），“接触患者周围环境后”最低（47.85%）。结论该院医务人员手卫生依从性有待提高，应进一步加强手卫生管理，针对不同岗位人员采取相应的改进措施。
［关键词］手卫生； 洗手； 依从性； 医务人员； 手卫生时刻； 医院感染

Survey on hand hygiene compliance of health care workers in a tertiary hospital

Objective To investigate hand hygiene compliance of health care workers（HCWs）in a tertiary hospital,and to explore effective methods to improve hand hygiene compliance.Methods By direct observation method,hand hygiene compliance and practice among HCWs in 23 clinical departments were surveyed in September-December 2012,and hand hygiene compliance monitor forms were filled in.Results A total of 721 opportunities of hand hygiene were recorded,overall compliance rate of hand hygiene was 58.53%,32.18% used instant hand antiseptic,26.35%selected running water,and 19.42% wore gloves without taking hand hygiene measures.For different occupations,hand hygiene compliance among nurses was the highest（68.65%）,and cleaners was the lowest（39.25%）.Of the five moments for hand hygiene,hand hygiene compliance after body fluid exposure was the highest（73.75%）,followed by the moment after touching apatient（65.00%）,while the moment after touching patients＇ surroundings was the lowest（47.85%）.Conclusion Hand hygiene compliance of HCWs needs to be improved,and the management should be further strengthened,corresponding measures should be taken for different personnel.