集束照护策略对提高NICU医护人员手卫生依从性的作用

目的 探讨集束照护策略对提高新生儿重症监护病房(NICU)医护人员手卫生依从性的作用.方法 通过开展品质罔活动,实施医护人员手卫生的集束照护策略(care bundle),即:(1)加强培训和管理,增强手卫牛意识,强化手卫牛观念;(2)进行环境改造和流程再造,创建手卫生的氛围和方便的洗手设施;(3)加强监督,医护人员共同参与,保证洗手的正确性.对实施集束照护策略前后NICU医护人员入室及接触患儿前手卫生的落实情况进行比较分析. 结果NICU医护人员入室、接触患儿前手卫生实施率分别由集束照护策略实施前的32.1%、92.0%上升至实施后的97.4%、99.3%;新生儿院内感染的发生率由实施前的2.22%下降到实施后的1.38%.结论 集束照护策略能有效提高医护人员手卫生的依从性,预防医院内感染发生.

Effect of care bundle in improving the hand hygiene compliance of neonatal intensive care unit staffs

Objective To evaluate the effect of care bundle in improving the hand hygiene compliance of neonatal intensive care unit staffs. Methods We implemented care bundle strategy through QCC activity: strengthening training and management to improve the hand hygiene awareness of the medical staffs, environmental and workflow reform,improving the hand washing method and facilities and creating hand hygiene atmosphere, all staffs participated and supervised each other to ensure right way of washing hands. The hand hygiene compliance rate of medical staff after entering the neonatal intensive care unit (NICU) and before touching the neonates before and after the intervention were compared. Results After care bundle intervention, the hand hygiene compliance rate of medical staff after entering the NICU and before touching the neonates raised obviously from 32.1% to 97.4% and from 92.0% to 99.3%. The occurrence of nosocomial infection reduced from 2.22% to 1.38%. Conclusions Care bundle can significantly improve the hand hygiene compliance of medical staff, and prevent nosocomial infection.