医护人员手卫生依从行为及其影响因素

目的了解医护人员手卫生依从行为及其影响因素。方法采用调查问卷自评的方法，于2014年11月-2015年2月对某院15个临床科室医护人员手卫生执行情况进行调查，采用多因素logistic回归分析医护人员手卫生执行目的对手卫生行为的影响。结果共调查医护人员364名，其中手卫生行为执行较好者245名（占67.31%）。单因素分析结果显示，不同岗位、教育程度、手卫生目的医护人员手卫生执行情况比较，差异具有统计学意义（均P＜0.05）。将单因素分析具有统计学差异的因素引入多因素logistic回归分析结果显示，手卫生目的与手卫生行为执行情况比较，差异具有统计学意义（P=0.042）；与以“保护自己”为目的进行手卫生的医护人员相比，以“防止交叉感染”为手卫生目的的医护人员手卫生行为执行得更好(OR=2.17,95%CI: 1.29～3.65)。影响医护人员手卫生行为居前5位的客观因素分别为冬天无温水洗手（占70.73%），工作量大、太忙没时间（占61.38%），手消毒剂及洗手液会引起皮肤粗糙/干燥（占54.88%），未配备干手用具（占47.56%），一次性手套的使用（占45.12%）。结论在完善手卫生硬件设施的基础上，改变医护人员只偏重“保护自己”的手卫生意识，可能是提高医护人员手卫生行为的另一种方式。

Hand hygiene compliance and influencing factors among health care workers

ObjectiveTo investigate compliance and influencing factors of hand hygiene (HH) among health care workers(HCWs).MethodsFrom November 2014 to February 2015, implementation of HH among HCWs in 15 clinical departments in a hospital was investigated through questionnaires, the effect of HH purpose on HH behavior of HCWs was analyzed with multivariate logistic regression method.ResultsA total of 364 HCWs were investigated, 245 (67.31%）of whom implemented HH well. Univariate analysis revealed that implementation of HH among HCWs of different occupations, education levels, and HH purpose were all significantly different (all P<0.05). Multivariate logistic regression analysis showed that HH purpose as well as HH compliance were both significantly different (P=0.042）. Compared with HH purpose of self protection among HCWs, HCWs with HH purpose of cross infection prevention had better HH behavior (OR,2.17［95%CI, 1.29-3.65］).The top five objective factors influencing HCWs’ HH implementation were as follows: lack of warm water in winter (70.73%), heavy workload,had no time (61.38%), skin irritation caused by disinfectant or hand sanitizer (54.88%), without hand dryer (47.56%), and use disposable gloves (45.12%).ConclusionOn the basis of improving HH facilities, changing HCWs’ awareness of HH only for self protection may be an another way to improve HH compliance among HCWs.