医护人员手卫生依从行为及其影响因素

摘要

目的 了解医护人员手卫生依从行为及其影响因素.方法 采用调查问卷自评的方法,于2014年11月—2015年2月对某院15个临床科室医护人员手卫生执行情况进行调查,采用多因素logistic回归分析医护人员手卫生执行目的对手卫生行为的影响.结果 共调查医护人员364名,其中手卫生行为执行较好者245名(占67.31%).单因素分析结果显示,不同岗位、教育程度、手卫生目的医护人员手卫生执行情况比较,差异具有统计学意义(均P<0.05).将单因素分析具有统计学差异的因素引入多因素logistic回归分析结果显示,手卫生目的与手卫生行为执行情况比较,差异具有统计学意义(P=0.042);与以"保护自己"为目的进行手卫生的医护人员相比,以"防止交叉感染"为手卫生目的的医护人员手卫生行为执行得更好(OR=2.17,95%CI:1.29~3.65).影响医护人员手卫生行为居前5位的客观因素分别为冬天无温水洗手(占70.73%),工作量大、太忙没时间(占61.38%),手消毒剂及洗手液会引起皮肤粗糙/干燥(占54.88%),未配备干手用具(占47.56%),一次性手套的使用(占45.12%).结论 在完善手卫生硬件设施的基础上,改变医护人员只偏重"保护自己"的手卫生意识,可能是提高医护人员手卫生行为的另一种方式.%Objective To investigate compliance and influencing factors of hand hygiene (HH)among health care workers(HCWs).Methods From November 2014 to February 2015,implementation of HH among HCWs in 15 clinical departments in a hospital was investigated through questionnaires,the effect of HH purpose on HH behav-ior of HCWs was analyzed with multivariate logistic regression method.Results A total of 364 HCWs were investi-gated,245 (67.31% )of whom implemented HH well. Univariate analysis revealed that implementation of HH a-mong HCWs of different occupations,education levels,and HH purpose were all significantly different (all P<0. 05). Multivariate logistic regression analysis showed that HH purpose as well as HH compliance were both signifi-cantly different (P= 0.042). Compared with HH purpose of self-protection among HCWs,HCWs with HH pur-pose of cross-infection prevention had better HH behavior (OR,2.17[95% CI,1.29-3.65]).The top five objective factors influencing HCWs'HH implementation were as follows:lack of warm water in winter (70.73% ),heavy workload,had no time (61 .38% ),skin irritation caused by disinfectant or hand sanitizer (54.88% ),without hand dryer (47.56% ),and use disposable gloves (45.12% ).Conclusion On the basis of improving HH facilities,chan-ging HCWs'awareness of HH only for self-protection may be an another way to improve HH compliance among HCWs.