影响重症监护病房医护人员主动洗手因素探析.doc

影响重症监护病房医护人员主动洗手因素探析 　［摘要］ 目的 探讨ICU医护人员对洗手的认识及采用相应的方式进行干预的效果。方法 通过设计问卷调查，并随机观察医护人员实际洗手状况及手部细菌培养，然后通过培训六步洗手法进行干预并再次调查，对干预前后结果进行比较。结果 干预前后护士问卷平均得分为30.23分和39.87分，医生平均得分为22.4分和33.18分；六步洗手法的掌握情况医生和护士均有明显提高（培训前后比较，Plt;0.05）；同时手卫生监测结果亦有改善。结论 正确洗手能有效地改善手部卫生，从而减少医院感染机会。正确的洗手有效提高了洗手的合格率，而便捷的设施以及高效、迅速、使用方便的手卫生产品是保持有效洗手的必要条件。 ［关键词］ 重症监护病房；洗手；医院感染；细菌培养 Assessment of factors affecting the active hand-washing of medical and nursing staff of ICU ［Abstract］ Objective To assess the factors which affect active hand-washing of both medical and nursing staff of ICU，and to improve the compliance of hand hygiene of medical personnel and take effective measures to reduce hospital acquired infection.Methods Using questionnaire and direct hand hygiene testing，49 medical and nursing staff were selected and asked to fill out questionnaire on their knowledge about hand-washing.And monitoring outcomes were compared after “six steps of hand washing”education.Results All of 49 medical and nursing staff had inadequate knowledge about hand-washing.The rate of eligible hand hygiene practices of doctor and nurse was increased by 18.18% （54.55% to 72.73%，χ2=1.57，Pgt;0.05） and 24.68% （76.32% to 100％，χ2=20.42，Plt;0.05） over the “six steps of hand washing” education.Hands washing of doctors was less standard than that of nurses.Hand-washing effect of doctors was poorer than that of nurses.Conclusion Problems existed in the course of hand-washing in medical staff were related not only with that they do not pay more attention to but also with that management is not standard at all.It is necessary to take action to improve hand hygiene practices in ICU. ［Key words］ intensive care unit；hand-washing；hospital acquired infection；germiculture 外源性医院感染中，医务人员的手卫生意义相当重要。ICU是医院的重要科室，经手引起的直接和间接感染占首位。多项研究证明，正确地洗手能有效降低医院感染率，加强医护人员洗手，可降低50%感染率，所以医护人员对洗手不可忽视［1～3］。本文就ICU日常医务人员洗手时遇到的几个问题进行探讨，了解广州市第一人民医院ICU医护人员手卫生情况、影响手卫生的因素，并制订相应的工作制度及采取有效的措施，探讨提高ICU医护人员手清洗、消毒的依从性，促进手卫生行为，降低医院感染率的方法。 1 资料与方法 1.1 一般资料 广州市第一