手卫生综合干预对儿科医院感染发病率的影响

目的探索利用5M1E质量分析工具为基础的手卫生综合干预措施对儿科医院感染的影响。方法监测某院儿科29名医务人员手卫生情况,2015年4—6月为手卫生本底调查时间,采用5M1E质量分析工具,查找影响儿科手卫生依从率的各方面因素,2015年6月开始采取干预措施,与2015年7月—2016年3月手卫生情况进行比较。并分析比较2014年7月—2015年3月与2015年7月—2016年3月医院感染发病情况。结果医务人员手卫生依从率2015年4—6月为30.86%,2016年1—3月上升至81.94%;手卫生正确率则从68.14%上升至93.75%;医务人员手卫生依从率及正确率均呈逐渐上升趋势(χ~2值分别为2 608.626、630.798,均P0.001)。手卫生采样合格率由2015年4—6月的20.69%上升至2016年1—3月的89.66%(χ~2=31.957,P0.001)。医院感染发病率由2014年7月—2015年3月的7.74%下降至2015年7月—2016年3月的3.62%(χ~2=46.717,P0.001)。结论采用5M1E质量分析工具对儿科医务人员手卫生情况进行分析调查和综合干预,提升了医务人员手卫生依从率,降低了儿科患者医院感染发病率。

Effect of hand hygiene comprehensive intervention on incidence of pediatric healthcare associated infection

ObjectiveTo explore the effect of 5M1E quality analysis tool based hand hygiene(HH) comprehensive intervention measures on pediatric healthcare associated infection(HAI).MethodsHH status of 29 health care workers(HCWs) in the pediatric department of a hospital was monitored, April June 2015 was baseline survey stage, 5M1E quality analysis tool was adopted to analyze various factors affecting the compliance rate of pediatric HH, intervention measures began to be taken in June 2015, and compared with HH in July 2015 March 2016. The occurrence of HAI between July 2014 March 2015 and July 2015 March 2016 was compared.ResultsHH compliance rate of HCWs increased from 30.86% in April June 2015 to 81.94% in January March 2016; HH correct rate increased from 68.14% to 93.75%; HH compliance rate and correct rate of HCWs gradually increased（χ2=2 608.626, 630.798，respectively, both P＜0.001）. Qualified rate of detection of HCWs’ HH sampling increased from 20.69% in April June 2015 to 89.66% in January March 2016（χ2=31.957，P＜0.001）. Incidence of HAI decreased from 7.74% in July 2014 March 2015 to 3.62% in July 2015 March 2016（χ2=46.717，P＜0.001）.ConclusionApplication of 5M1E quality analysis tool in the investigation, analysis, and comprehensive intervention in HCWs’ HH in pediatric department has greatly enhanced HCWs’ HH compliance rate, and reduced the incidence of HAI in pediatric patients.