Survey And The Intervention Experiment On Health Care Workers' Hand Hygiene In A General Hospital

ObjectiveThrough the study and investigation for current situation of microbial contamination on the health care workers (HCWs)hands,to enhance the HCWs' concept of handwashing and control the hospital infection. Research the effective intervention to improve the handwashing state;in increase the handwa-shing compliance and decrease the nosocomial infection rate. To provide the scientific evidence for the prevention,control and management of nosoco-mial infections.MethodUse the investigative method of qualitation and quantitation conjuncted, the study take 180 HCWs randomly from the medical and surgery department and intensive care unit(ICU)and clinical service and emergency of a grade-A comprehensiveness hospital of Taian as the observation objects. Observe the HCWs, handwashing rate as handwashing indicated appearancing and sampled the hands of HCWs after handwashing,to Progress bacterial culture and identification.Use observation method and questionnaire to collect and understand the informations of handwashing behavioral and basic knowledge of hand hygiene, to analyses the influential factor for compliance of hand hygiene.To aim at error handwashing behavioral, formulate management and intervention measure, choose two division whose basic condition are identical as the objects of confrontation test, evaluate the effect after the intervention test.Result1.The performed condition of hand hygiene:the average rate of compliance of hand hygiene of 180 HCWs are29.79±15.21, After each handwashing indicated appearancing, the higher rates of compliance of hand hygiene are after handle filth, before go to toilet, and after touch the blood and secretions of Patienis, the rates are 74.71±38.99%,63.85±41.93%,51.21±43.99% respect tively.Among the 20 factors to influence performance of hand hygiene, the most important factors are:①cleanser, antiseptics cause asteatosis cutis;②the work too busy;③Lack of individual priority for hand hygiene.2.The prehension of knowledge of hand hygiene:the average mark of knowledge of hand hygiene 21.37±1.50, among the total the average mark of knowledge of hand hygiene indicated 16.11±1.12,and the average mark of correlated knowledge of handhygiene5.27±0.75.The HCWs with different age, sex, occupation, educational background and professional title whose marks of knowledge of hand hygiene havn't significant difference(P>0.05),but HCWs of ICU whose marks higher than HCWs of the medical and urgery department and clinical service and emergeney(P<0.05).After statistically analysis these are of the health information of hand hygiene and the compliance of hand hygiene are not correlation(P>0.05).3.Aim at the current state of handwashing cognitive behavior and contaminate of handwashing installations, take intervention measure and run the controlled trial. Own control the samples of HCWs'hands after handwashing have significant difference:after intervention the qualified rate of handwashing from 58.33% to 91.67%, and the rate of handwashing from27.55%to41.60%, in control group the qualified rate of handwashing 66.67%, and the rate of handwashing is 28.68%. After intervention test group own control and compared with control group have significant difference also(P<0.05).To provide test group with antiseptic hand-rub product for handwashing and contrast using flow water, the qualified rate of handwashing have not statistically significant(P>0.05), the clearance rate of germs of the group using antiseptic hand-rub product is 88.83±2.50%, and the clearance rate of germs of the group using flow water is 86.67±3.22%, the two groups have significant difference(P<0.05):the time consuming of the group using antiseptic hand-rub product is 19.33±4.33s, and the time consuming of the group using flow water is 77.67±30.92s, the two groups have significant difference(P<0.05):before intervention, after behavior education and after providing antiseptic hand-rub product the rate of handwashing have significant difference(P<0.05):the nosocomial infection rate have significant difference between test group and control group in period of intervention time(P<0.05).ConclusionThe state of handhygiene of HCWs must need improvement urgently; handwashing installations should be consumate:take the direct intervention to enhance infection control, effeetively increase the handwashing compliance and decrease the nosocomial infection rate.