第三方调查的绩效考核对改进医务人员手卫生依从性的效果

目的了解医务人员手卫生执行的真实情况,为改进手卫生管理提供依据。方法某院2016年度实行手卫生绩效考核,同时邀请第三方(外院医院感染专职人员)对全院医务人员手卫生进行4次匿名调查,并比较医务人员手卫生依从率的变化。结果第三方调查的医务人员手卫生依从率为60.68%,其中上半年和下半年的手卫生依从率分别为52.72%、68.62%,差异有统计学意义(P0.001)。重点科室(各重症监护病房、新生儿科)的手卫生依从率(87.44%)高于外科科室(64.71%)和内科科室(53.74%),差异均有统计学意义(均P0.05)。医务人员在接触患者前、接触患者后以及接触患者周围环境后的手卫生依从率较低(分别为53.59%、58.07%、43.97%)。结论第三方手卫生调查能有效降低手卫生观察过程中的霍桑效应。手卫生绩效考核有助于改进医务人员手卫生依从性。

Effect of performance appraisal through third party survey on improving the compliance of hand hygiene among health care workers

ObjectiveTo understand the actual implementation of hand hygiene(HH) of health care workers(HCWs), and provide evidence for improving HH management. MethodsHH performance appraisal began to implement in a hospital in 2016, at the same time, third party (healthcare associated infection management professionals in other hospitals) was invited to carry out 4 times of anonymous survey on HH among HCWs in the hospital, change in HH compliance rate among HCWs was compared. ResultsHH compliance of HCWs surveyed by the third party was 60.68%, HH rates in the first half and second half year were 52.72% and 68.62% respectively, difference was statistically significant (P< 0.001). Compliance rate of HH in key departments (intensive care unit and neonatal department, 87.44%) was higher than surgical departments (64.71%) and internal medicine departments (53.74%), difference was statistically significant (both P<0.05). HH compliance rates of HCWs before and after contact with patients and after contact with the surrounding environment of patients were all low (53.59%, 58.07%, 43.97%, respectively). ConclusionHH surveyed by the third party can effectively reduce the Hawthorne effect during the observation process. HH performance appraisal can significantly improve the compliance of HH among HCWs.