多元化培训在ICU规培医生感染防控中的应用

目的　探讨多元化培训对重症监护病房（ICU）规培医生进行医院感染防控培训的应用效果。方法　选择2019年10月至2020年5月在广东省中医院ICU轮科3个月或以上的规培医生60人,按照进入ICU的时间分组,2019年10月至2020年1月30人为对照组,2020年2月至5月入ICU的30人为试验组。对照组采用常规培训方法;试验组采用多元化培训模式,由科室感控护士主导培训过程,通过手卫生流程图、穿脱隔离衣视频、自制感控宣传微电影、微信公众号感控专栏、感控工作坊、理论与操作考核、实时反馈等分阶段进行培训。培训完后对比评价两组手卫生依从性、医院感染知识的掌握水平以及医院感染率。不符合正态分布的计量资料组间比较采用秩和检验,计数资料组间比较采用χ²检验。结果　试验组规培医生实际手卫生执行率明显高于对照组［93.3%（56/60）比80.0%（48/60）］,两组比较差异有统计学意义（χ²=4.615,P=0.032）。对照组规培医生的医院感染知识得分为80.0（75.0,85.0）分,试验组为90.0（80.0,95.0）分,两组比较差异有统计学意义（Z=-3.219,P=0.001）。试验组的医院感染率低于对照组［6.7%（22/331）比12.8%（47/367）］,差异有统计学意义（χ²=7.413,P=0.006）。结论　运用多元化方法培训医院感染防控,有助于ICU规培医生系统、全面地掌握针对性的医院感染防控知识,提高手卫生依从性,降低医院感染率,对提高ICU规培医生临床工作中预防控制医院感染的意识和行为具有重要意义。

Application of diversified training in infection prevention and control training for regular training doctors at ICU

Objective　To explore the effectapplying diversified training in nosocomial infection prevention and controltraining for regular training doctors at ICU. Methods　Sixty regular trainingdoctors who had been working at ICU of Guangdong Provincial Hospital ofTraditional Chinese Medicine for three months or more from October 2019 to May2020 were selected. According time they started to work at ICU, the 30 onesfrom October 2019 to January 2020 were set as a control group, and the 30 onesfrom February to May 2020 were set as an experimental group. The control grouptook conventional training methods. The experimental group took diversifiedtraining, and the department nurses took the lead in the training process; thetraining was conducted by hand hygiene flow chart, wearing and taking offisolation gown video, self-made micro-films for propaganda of sensory control,WeChat official account column for sensory control, sensory control workshop,theoretical and operational assessment, and real-time feedback. After thetraining, the hand hygiene compliances, mastery levels of nosocomial infectionknowledge and nosocomial infection rates of the two groups were compared and evaluated.The measurement data were compared between these two groups byindependent-sample t test, and theenumeration data by χ² test. Results　The hand hygiene compliance and the score of nosocomial infectionknowledge in the experimental group were higher than those in the control group[93.3% (56/60) vs. 80.0% (48/60) and 80.0 (75.0, 85.0) vs. 90.0 (80.0, 95.0)],with statistical differences (χ²=4.615, P=0.032; Z=-3.219, P=0.001). Thehospital infection rate of the experimental group was lower than that of thecontrol group [6.65% (22/331) vs. 12.8% (47/367)], with a statisticaldifference (χ²=7.413, P=0.006). Conclusions  The use ofdiversified training to train regular training doctors at ICU on hospitalinfection prevention and control can help them systematically andcomprehensively master targeted hospital infection prevention and controlknowledge, improve their hand hygiene compliance, and reduce the hospitalinfection rate. It is of great significance to improve the awareness andbehaviors of preventing and controlling hospital infections in clinical work.