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目的了解感染性疾病中心医务人员洗手依从性情况并进行分析。方法根据世界卫生组织2009年颁布的《手卫生技术参考手册》中手卫生的5个时刻(接触患者前、无菌操作前、体液暴露后、接触患者后和接触患者周围环境后),自行设计洗手依从性执行情况观察表,应用隐蔽观察法,由经过专业培训的医院感染护士,对洗手依从性进行调查,观察应洗手和实际洗手情况,每个观察对象连续观察20 min以上,记录其洗手情况。结果传染科医务人员洗手依从性有待提高,其中医生、护士均在接触血液、体液后的洗手依从率较高(医生为92.31%,护士为97.22%),两者比较差异无统计学意义(P>0.05);接触环境后最低(医生为41.67%,护士为70.37%),两者比较差异有统计学意义(P<0.05)。在接触患者前、无菌操作前、接触环境后的观察中,护士的洗手依从率均高于医生,差异有统计学意义(P<0.05);虽然接触患者后,护士洗手依从率高于医生,但两者比较差异无统计学意义(P>0.05)。在调查的73名医务人员的洗手正确率中,副主任医生、主治医生和主管护士均为100.00%,护师为91.67%,护士为77.22%,住院医生为66.67%,实习医生为58.33%,实习护士为50.00%。结论医务人员洗手依从性较低,在临床工作中,应加强各级医务人员手卫生相关知识培训,提高洗手依从性及正确性;同时加强管理,端正态度,提高意识,培养慎独精神,从而有效地切断传播途径,最终降低医院感染的发生。
Objective To understand and analyze the compliance status of medical staff in infectious diseases center. Methods According to the World Health Organization’s 2009 Handbook of Hand Hygiene Technical Handbook of five times (before the patient, before aseptic operation, body fluid exposure, after contact with patients and the patient’s surroundings), self-designed Compliance with the implementation of the hand-washing observation table, the application of covert observation method, the hospital trained nurses, hand-washing compliance survey to observe the situation should be hand-washing and actual hand-washing, observation of each observation for more than 20 minutes, record their hands Happening. Results The compliance of washing staff in infectious department needs to be improved. Among them, doctors and nurses are in contact with the blood and have high rate of hand-washing after body fluid (92.31% for doctors and 97.22% for nurses), and there is no significant difference between the two > 0.05), the lowest after exposure to the environment (41.67% for doctors and 70.37% for nurses), the difference was statistically significant (P <0.05). Before the contact with patients, before the aseptic operation and after contact with the environment, the compliance rate of the nurses was higher than that of the doctors (P <0.05). Although the contact rate of the nurses was higher than that of the doctors , But there was no significant difference between the two (P> 0.05). Among the 73 medical staff surveyed, 100.00% of deputy chief physicians, chief physicians and nurses were nurses, 91.67% were nurses, 77.22% were nurses, 66.67% were resident doctors, 58.33% were interns, Internship nurse is 50.00%. Conclusions Medical staffs have low degree of compliance with hand-washing. In clinical work, they should strengthen hand hygiene training at all levels of medical personnel to improve their compliance and correctness of hand-washing. At the same time, they should strengthen management, correct attitude, raise awareness and develop prudential spirit so as to be effective Cut off the route of transmission, and ultimately reduce the incidence of nosocomial infections.