标准示范与情景演示法改善医护人员手卫生

目的通过采取标准示范与情景演示法对医护人员进行手卫生教育培训,提高神经外科医护人员手卫生依从率与正确率。方法选取某院神经外科全体医护人员为研究对象,依据美国Dreyfus健康基金会项目的方法,首先分析2015年1月—2016年11月的手卫生监测结果并确立问题,制定预期目标。2016年12月—2017年9月,采取标准示范与情景演示法分阶段对医护人员进行手卫生教育培训,采用明查法和盲查法调查医护人员培训前后手卫生情况并进行比较。结果培训前神经外科医护人员手卫生依从率为31.51%,培训后手卫生依从率盲查为45.21%,明查为80.79%;三组手卫生依从率比较,差异有统计学意义(χ~2=363.46,P0.001)。培训前神经外科医护人员手卫生正确率为69.26%,培训后手卫生正确率盲查为79.20%,明查为84.41%;三组手卫生正确率比较,差异有统计学意义(χ~2=24.62,P0.001)。神经外科医护人员洗手皂液与速干手消毒剂日平均消耗量培训前为5.06 mL/床日,培训后为10.06 mL/床日。结论通过采取标准示范与情景演示法对医护人员进行手卫生教育培训,可提升医护人员手卫生依从性与正确性。采用明查与盲查相结合的调查方法,可有效摒除人为趋从因素的存在。

Standard demonstration and scenario demonstration to improve hand hygiene of health care workers

Objective To perform hand hygiene(HH) education and training for health care workers(HCWs) by adopting standard demonstration and scenario demonstration method, improve compliance rate and correct rate of HH of HCWs in department of neurosurgery. Methods All HCWs in department of neurosurgery in a hospital were selected as the studied object, according to the method of Dreyfus Health Foundation Project of America, HH surveillance results from January 2015 to November 2016 were analyzed, problems were identified, and the expected goals were formulated. From December 2016 to September 2017, standard demonstration and scenario demonstration method were adopted to performe HH education and training for HCWs, HH of HCWs before and after training was investigated by direct investigation method and concealed investigation method, result was compared. Results HH compliance rate of HCWs in department of neurosurgery before training was 31.51%, compliance rate of HH revealed by concealed investigation method and direct investigation method after training were 45.21% and 80.79% respectively, there was significant difference in compliance rate of HH among three groups (χ²=363.46,P<0.001). HH correct rate was 69.26% before training, correct rate of HH revealed by concealed investigation method and direct investigation method after training were 79.20% and 84.41% respectively; there was significant difference in the correct rate of HH among three groups (χ²=24.62,P<0.001). The average daily comsumption of liquid soap and alcohol-based hand rub for HCWs in department of neurosurgery before and after training were 5.06 mL/bed-day and 10.06 mL/bed-day respectively. Conclusion By adopting standard demonstration and scenario demonstration methods for HCWs' HH training and education, compliance and correctness of HCWs' HH can be improved. The combination of direct investigation method and concealed investigation method can effectively eliminate the existence of human tendency factors.