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目的调查综合性重症医学科医务人员手卫生现状,分析影响手卫生依从性的因素。方法采用随机抽样和现场查看方法,对本医院重症监护病房医务人员手卫生执行情况进行了调查。结果平均每ICU床日需要手卫生236次,其中直接接触占38.98%(92次),间接接触占61.02%(144次),平均执行率为38.98%。直接接触执行率为57.61%,明显高于间接接触的27.08%(P<0.01);日班执行率为47.54%,明显高于夜班(29.82%,P<0.01)。ICU内医生执行率最高52.78%,高于其他岗位(P<0.01)。随着病情严重度增加,需要手卫生次数也相应增加,但执行率却随之下降,差异有显著性(P<0.01)。结论 ICU医务人员需要频繁进行手卫生,总体依从性较低。应合理分配工作量,配置足够的工作人员,加强教育培训,进一步提高ICU医务人员手卫生依从性。
Objective To investigate the status of hand hygiene in medical staff of comprehensive critical medicine and to analyze the factors influencing hand hygiene compliance. Methods Random sampling and on-site inspection methods were used to investigate the implementation of hand hygiene of medical personnel in intensive care unit of the hospital. Results An average of 236 hand hygiene was required per ICU bed day, of which direct contact accounted for 38.98% (92), indirect contact accounted for 61.02% (144) and average execution rate was 38.98%. The implementation rate of direct contact was 57.61%, which was significantly higher than that of indirect contact (27.08%, P <0.01). The implementation rate of daily work was 47.54%, which was significantly higher than that of night work (29.82%, P <0.01). The highest implementation rate of physicians in ICU was 52.78%, higher than other posts (P <0.01). As the severity of the illness increased, the number of hand hygiene needs also increased accordingly, but the rate of implementation decreased with a significant difference (P <0.01). Conclusion ICU medical staff need frequent hand hygiene and overall compliance is low. The workload should be rationally allocated, adequate staffing should be provided, education and training should be strengthened, and hand hygiene compliance of medical staff in ICU should be further improved.