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目的了解甘肃省各级医院医务人员手卫生现状,发现手卫生中存在的问题,为完善相关制度,提出改进措施提供依据。方法采用横断面调查的方式,于2015年12月随机抽取全省131所医院,调查医院感染管理、手卫生制度制定和手卫生落实的现状;通过EpiData建立数据库录入问卷数据,用SPSS20.0软件进行统计分析。结果 131所医院均建立了较完善的医院感染管理制度,但仍有3所医院(2.29%)未制定手卫生相关制度;14所医院手卫生设施配备不合格,主要表现是未配备流动水洗手设施或未配备洗手液,其中三级医院2所占1.53%,二级医院12所占10.69%;126所占96.18%医院粘贴了六步洗手法,41所占31.30%粘贴了手卫生指征,粘贴手卫生指征的三级医院比例高于二级医院,差异有统计学意义(P<0.05);现场观察手卫生依从性,共观察1 300个手卫生时机,实施手卫生681次,手卫生依从率52.38%,其中三级机构手卫生依从率高于二级机构,护士的依从率高于医师。结论甘肃省各所医院已基本建立了较完善的医院感染管理和手卫生相关制度,并基本落实了手卫生工作,但手卫生依从性非常低,需要采取措施进一步加强。
Objective To understand the status quo of hand hygiene of medical staff at all levels of hospitals in Gansu Province and to find out the problems existing in hand hygiene so as to provide evidence for perfecting the related systems and proposing improvement measures. Methods By means of cross-sectional survey, 131 hospitals in the province were randomly selected in December 2015 to investigate the status of nosocomial infection management, hand hygiene system establishment and hand hygiene implementation. Data entry questionnaire was established by EpiData and SPSS20.0 software conduct statistical analysis. Results In all 131 hospitals, a well-established management system for nosocomial infections was established. However, there were still 3 hospitals (2.29%) that did not have a hand hygiene system. Fourteen hospital hand sanitation facilities were unqualified, mainly because they were not equipped with mobile handwashing Facilities or not equipped with hand sanitizer, of which two hospitals accounted for 1.53% 1.53%, two hospitals accounted for 10.69%; 126 accounted for 96.18% of hospitals pasted six steps washing method, 41 accounted for 31.30% paste hand hygiene indications (P <0.05). The compliance of hand hygiene was observed on site. A total of 1 300 hand hygiene opportunities were observed and hand hygiene was implemented for 681 times. Hand hygiene compliance rate was 52.38%, of which the hand hygiene compliance rate of tertiary institutions was higher than that of secondary agencies, and the compliance rate of nurses was higher than that of physicians. Conclusion All hospitals in Gansu Province have basically established a relatively complete system for management of nosocomial infections and hand hygiene and basically implemented hand hygiene. However, hand hygiene compliance is very low and measures need to be taken to further strengthen the system.