| 李莉,王靖,鲁颖,王玫.强化干预与视频监测NICU医务人员手卫生依从性的管理探索[J].上海护理,2019,19(S1): |
| 强化干预与视频监测NICU医务人员手卫生依从性的管理探索 |
| Management exploration by strengthening hand hygiene and video monitoring in Neonatal Intensive Care Unit |
| DOI： |
| 中文关键词: 新生儿重症监护病房 手卫生依从性 医务人员 医院管理 |
| 英文关键词:neonatal intensive care unit hand hygiene compliance heath care workers hospital management |
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| 中文摘要: |
| 目的 探索在新生儿重症监护室(NICU)实施手卫生管理的方法和意义。方法 根据2009年WHO颁布的手卫生指南中“5个手卫生时机”,2017年2月-2017年7月为干预前,采用院感专职人员暗访的形式进行手卫生监测,作为干预前的基线水平；2017年8月-2018 年1月采取强化干预结合视频监测的方法进行手卫生依从性管理,作为干预后。比较干预前后NICU手卫生依从率及医院感染率。结果 NICU医务人员手卫生依从率由干预前的23.50%提高到干预后的71.32%,同时医院感染率也显著下降,前后比较均具有统计学差异(均P＜0.05)。医生、护士、医技、保洁的手卫生依从率经干预后均显著提高(均P＜0.05),其中护士提高幅度最大,由28.23%提高至82.11%。医技和保洁人员手卫生依从性不高,干预后分别为44.44%和48.57%,其中戴手套进行手消毒是主要问题。结论 强化干预结合视频监测可以显著提高NICU手卫生依从性,良好的手卫生策略是降低NICU医院感染的重要手段。 |
| 英文摘要: |
| OBJECTIVE To explore the effectiveness of hand hygiene management in the neonatal intensive care unit(NICU)and find out the right way. METHODS From February 1, 2017 to July 31, 2017 that was pre-intervention stage, the hand hygiene(HH) compliance among heath care workers (HCWs)was observed and recorded by undercover investigation method in NICU as baseline compliance, based on the “Five Monment” of WHO hand hygiene guideline 2009. Intensified intervention and video monitoring of HH compliance were conducted at post-intervention stage that was from August 1, 2017 to January 31, 2018. Post-intervention data were compared with pre-intervention data. RESULTS HH compliance rates of HCWs in NICU before and after intervention were 23.5% and 71.32% respectively, the rate of nosocomial infection was declined dramatically at the same time(both P＜0.05). HH compliance rates of doctors, nurses, medical technician and cleaners were all significantly improved(all P＜0.05), and the nurses did the best which increased from 28.23% before intervention to 71.32% after intervention. HH compliance rates of medical technician and cleaners were not good, which was 44.44% and 48.57% respectively after intervention, disinfection of gloved hands was the first question. CONCLUSION Intensified intervention and video monitoring can significantly improve HH compliance, HH has been singled out as the most important measure in preventing nosocomial infection in NICU. |
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