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目的了解深圳市福田区医务人员手卫生知、行现状及手卫生工作管理情况。方法选取深圳市福田区辖区内25家医院和40家诊所,问卷调查65家医疗机构的手卫生工作管理与手卫生设施配置情况。根据医疗机构级别(市、区、私营、诊所)分层随机抽取600名医务人员,问卷调查手卫生知识掌握情况和手卫生执行的影响因素;分层随机抽取205名医务人员,现场观察手卫生执行情况。结果调查的585名医务人员手卫生知识平均得分为(19.15±1.73)分(满分21分);不同性别、医疗机构级别和职称的医务人员手卫生知识得分差异均有统计学意义(均P<0.01)。观察202名医务人员2 020次洗手指征,平均手卫生依从率为48.1%(971/2 020),手卫生执行正确率为24.3%(490/2 020);不同科室、职务、手卫生指征、医疗机构级别的医务人员手卫生依从率的差异均有统计学意义(均P<0.01)。仅有24.0%(6/25)的医院设置了独立的医院感染管理科室,12.5%(5/40)的诊所指定了专(兼)职人员负责医院感染管理工作。43.1%(28/65)的医疗机构开展过手卫生知识培训。70.1%(410/585)的医务人员认为“工作太忙没有足够的时间”是影响手卫生执行的主要因素。结论深圳市福田区医务人员手卫生知识掌握较好,但执行情况较差,医务人员手卫生管理工作有待加强,医疗机构手卫生设施配置有待完善。
Objective To understand the status of hand hygiene and management of medical staff in Futian District, Shenzhen and the status of hand hygiene management. Methods A total of 25 hospitals and 40 clinics in the Futian district of Shenzhen were selected to survey the hand hygiene management and hand hygiene facilities in 65 medical institutions. According to the level of medical institutions (municipal, district, private, clinics) stratified random selection of 600 medical staff, questionnaire survey of hand hygiene knowledge and hand hygiene implementation of the factors; stratified random extraction of 205 medical staff, hand observation of hand hygiene Implementation. Results The average score of hand hygiene knowledge of 585 medical staff surveyed was (19.15 ± 1.73) points (out of 21 points). The differences of hand hygiene knowledge scores among medical staff of different gender, medical institution level and professional title were statistically significant (all P < 0.01). 202 medical staffs were observed for 2,202 hand-washing indications, the average hand hygiene compliance rate was 48.1% (971/2 020), hand hygiene implementation accuracy rate was 24.3% (490/2 020); different departments, positions, hand hygiene index Medical staff at the medical institution level had significantly lower rates of hand hygiene compliance (both P <0.01). Only 24.0% (6/25) of the hospitals had independent nosocomial infection control departments, and 12.5% (5/40) of the clinics appointed their own (nos.) Staffs to manage nosocomial infections. 43.1% (28/65) of the medical institutions conducted hand hygiene knowledge training. 70.1% (410/585) of medical staff considered that “too much work time did not have enough time” is the main factor affecting the implementation of hand hygiene. Conclusion The hand hygiene knowledge of medical staff in Futian District, Shenzhen is better, but the implementation is not so good. The hand hygiene management of medical staff needs to be strengthened, and the configuration of hand hygiene facilities in medical institutions needs further improvement.