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目的分析不同级别医疗机构医务人员手卫生效果的影响因素,提高手卫生依从性,保证医疗质量。方法通过隐蔽现场观察法,对不同级别医疗机构医务人员手卫生的执行情况进行调查,并分析影响因素。结果调查37家不同级别医疗机构10个科室118名医务人员,三级医疗机构手卫生合格率(87.72%)高于二级医疗机构(73.08%)和民营医疗机构(45.71%);护士手卫生合格率(72.94%)高于医生手卫生合格率(57.58%);使用免洗速干手消毒液,手卫生效果最好,与流水、肥皂、洗手液等手卫生方式比较差异有统计学意义(χ~2=49.51,P<0.01);手触式洗手设施对手卫生效果有影响;通过比较不同干手方式,公用毛巾干手方式对手卫生效果较差,与其他方式相比,差异有统计学意义(χ~2=12.43,P<0.01),自然晾干或烘干、一次性纸巾是比较合适的干手方式。结论加强民营医疗机构医务人员手卫生培训与管理,配备完善的手卫生设施,有效提高手卫生依从性,保证医疗护理安全,提高医疗的质量。
Objective To analyze the influencing factors of hand hygiene effect of medical personnel in different levels of medical institutions, to improve hand hygiene compliance and to ensure medical quality. Methods Through the concealed field observation method, the implementation of hand hygiene of medical staff at different levels of medical institutions was investigated and the influencing factors were analyzed. Results A total of 118 medical personnel in 10 departments and departments of 37 medical institutions of different levels were investigated. The pass rate of hand hygiene in tertiary medical institutions was 87.72% higher than that of secondary medical institutions (73.08%) and 45.71% in private medical institutions. The pass rate (72.94%) was higher than that of the doctor’s hand hygiene (57.58%). The hand-sanitizing effect was the best when using the hands-free hand sanitizer solution, which was significantly different from the hand hygiene methods such as running water, soap and hand sanitizer (χ ~ 2 = 49.51, P <0.01). The impact of hand-touch hand hygiene facilities on the hand hygiene was poor. By comparing different hand-drying methods, public hand towel hand hygiene had less effect on hand hygiene. Compared with other methods, the difference was statistically significant Significance of learning (χ ~ 2 = 12.43, P <0.01), natural drying or drying, disposable paper towels is more appropriate way of hand. Conclusion The hand hygiene training and management of medical personnel in private medical institutions should be strengthened, and hand hand hygiene facilities should be provided to improve hand hygiene compliance, ensure the safety of medical care and improve the quality of medical treatment.