ICU医务人员手卫生依从性差异的深层次原因分析

目的 调查北京协和医院ICU医务人员手卫生依从性现状,并分析其存在差异的深层次原因.方法 采用单盲、便利抽样法,对2019年1月至12月北京协和医院经手卫生多维度培训后的ICU医务人员进行手卫生现状调查,计算手卫生依从率,并比较不同手卫生时刻及不同类别/来源的医务人员手卫生依从率的差异.结果 共285名符合纳入和排除标...

Analysis of the Deep Reasons for the Differences of Hand-hygiene Compliance among the ICU Medical Staff

  Objective  To investigate the hand-hygiene compliance of ICU medical staff in Peking Union Medical College Hospital(PUMCH) and analyze the reasons for the differences.  Methods  A single-blind and convenient sampling-method was used to investigate the status of hand hygiene of the ICU medical staff who received hand-hygiene training in PUMCH from January to December 2019. The rate of hand-hygiene compliance was calculated, and the differences in the rate of hand-hygiene compliance of different time and personnel types were compared.  Results  A total of 285 ICU medical staff who met the inclusion and exclusion criteria were enrolled in this study. There were 85 doctors, 171 nurses, 21 nurse-assistants, 8 cleaners; 104 doctors and nurses of our hospital and 152 refresher doctors and nurses. The total number of hand-hygiene indications was 23 661, and the total number of hand-hygiene implementation was 21 360. The overall rate of hand-hygiene compliance was 90.28% (21 360/23 661). The compliance rates of the five hand-hygiene moments stipulated by the World Health Organization were 95.63% (765/800) after contacting the body fluid of the patients, 94.39% (2121/2247) before aseptic operation, 91.59% (7916/8643) after contacting the patients, 88.91% (4026/4528) after contacting the surrounding environment of the patients, and 87.76% (6532/7443) before contacting the patients, with statistically significant differences (P < 0.05). The compliance rates of nurses, nurse-assistants doctors, and cleaners were 94.52% (11 186/11 834), 93.49% (1665/1781), 84.78% (8427/9940), and 77.36% (82/106), respectively, with statistical significance (P < 0.05). The rate of hand-hygiene compliance of the medical staff of our hospital was 93.45% (7844/8394), which was higher than that of the refresher medical staff (87.96%, 11 769/13 380), and the difference was statistically significant (P < 0.05).  Conclusions  The hand-hygiene compliance of the ICU medical staff in PUMCH is good, but there are still some differences in the hand-hygiene time and personnel types, which may be related to the awareness of hand-hygiene protection of the medical staff and the difference in training and supervision of different departments for different types of medical staff.