实时监测干预重症医学科医务人员手卫生效果评价

目的评价应用信息化系统实时监测干预重症医学科(ICU)医务人员手卫生依从性效果。方法选择2017年11月-2019年5月武汉市中心医院综合ICU医护人员为观察对象,在ICU安装手卫生信息化管理系统,实时监测、记录医务人员手卫生指征和手卫生行为。观察、比较安装前后医务人员手卫生依从率和各项医院感染管理指标的变化规律。结果信息化系统安装后ICU医务人员手卫生依从率从77.23%上升到96.22%,差异有统计学意义(P<0.001);不同岗位医务人员包括医生、护士和其他人员手卫生依从率均提高(P<0.001);手卫生用品消耗量上升,从每床日(40.57±4.62)ml提高到每床日(51.59±5.12)ml(P<0.001);信息化系统安装前后医院感染率、血管内导管相关血流感染发病率、呼吸机相关肺炎发病率、导尿管相关泌尿系感染发病率和多药耐药菌检出率比较,无统计学差异。结论实时反馈信息化系统对医务人员手卫生行为有良好的干预效果,能够显著提高医务人员的手卫生依从性。

Effect of real-time monitoring intervention on hand hygiene of health care workers of intensive care unit

OBJECTIVE To evaluate the effect of information system for real-time monitoring intervention on hand hygiene compliance of the health care workers of intensive care unit(ICU).METHODS From Nov 2017 to May 2019,the health care workers of intensive care units of the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology were recruited as the study subjects,a hand hygiene information system was installed in the ICUs,the system could be performed for real-time monitoring,and record of hand hygiene indications and hand hygiene behaviors.The hand hygiene compliance rates and infection control indexes were observed and compared before and after the system was installed.RESULTS The hand hygiene compliance rate of the ICU health care workers was increased from 77.23%to 96.22%after the information system was installed,and there was significant difference(P<0.001).The hand hygiene compliance rates of the health care workers in different positions such as doctors,nurses and other personnel were increased significantly(P<0.001).The consumption of hand hygiene supplies was increased significantly from(40.57±4.62)ml per patient-day to(51.59±5.12)ml per patient-day(P<0.001).There were no significant differences in the incidence of nosocomial infection,incidence of intravascular catheter-related bloodstream infection,incidence of ventilator-associated pneumonia,incidence of urinary catheter-related urinary tract infection and isolation rate of multidrug-resistant organisms before and after the information system was installed.CONCLUSION The real-time feedback information system has favorable intervention effect on the hand hygiene behaviors of the health care workers and can remarkably improve the hand hygiene compliance.