中国血液净化

›› 2011, Vol. 10 ›› Issue (4): 216-218.

• 护理园地 • 上一篇    下一篇

血液透析室护理人员手卫生现状调查

武向兰 檀 敏 赵慧萍 雷 娟 王 颖 杨洪杰   

  1. 北京大学人民医院肾内科
  • 收稿日期:2010-11-25 修回日期:1900-01-01 出版日期:2011-04-12 发布日期:2011-04-12
  • 通讯作者: 檀敏

A survey of the practice of hand hygiene among nurses in a hemodialysis center

WU Xiang-lan, TAN Min, ZHAO Hui-ping, LEI Juan, WANG Ying, YANG Hong-jie   

  1. Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China
  • Received:2010-11-25 Revised:1900-01-01 Online:2011-04-12 Published:2011-04-12

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摘要： 目的 了解北京大学人民医院血液透析室护理人员的手卫生现状, 从而进一步加强对护理人员手卫生的管理,提高手卫生质量。 方法 采用隐蔽式现场观察的方法,观察血液透析室护理人员洗手和戴手套的过程,了解护士为患者连续上机时的手卫生现状。通过手细菌培养菌落计数的方法监测血液透析室护理人员的手卫生效果。 结果 被调查护理人员15人，主管护师5人，护师3人，护士7人。共观察护理人员洗手次数426次,其中按照规定洗手合格率95.42%,进入工作区前洗手合格率为77.33%，每次更换手套之间洗手率98.91%，上机结束后洗手合格率为100%。洗手液用量合格率为73.00%，洗手部位是否正确的合格率为77.46%，搓洗时间＞15 s的合格率为84.27%，手干燥方法正确的合格率为88.97%。为不同患者上机须更换手套的达标率98.91%，手套完好率85.22%。90.67%的护理人员手培养细菌总数＜10 cfu/cm2，符合2001年版《北京市血液透析质量管理规范》标准。Logistic回归分析结果显示洗手液用量和手干燥方法是手卫生效果的独立影响因素。 结论 血液透析室护理人员有洗手意识，能够认真洗手，并能按照要求更换手套，手卫生效果监测的合格率较高。但日常手卫生执行情况还存在一些问题，应进一步加强关于手卫生规范性的宣传教育,配备干手设施，提高血液透析室的工作质量。

关键词: 手卫生, 血液透析, 护理人员

Abstract: 【Abstract】Objective To improve the administration and the quality of hand hygiene, we evaluated the present situation of hand hygiene in nurses working in the hemodialysis center of Peking University People’s Hospital. Methods (a) We observed without notice the processes of hand hygiene including wash hands and wear gloves in nursing staff members and the situation of hand hygiene when they were working for the patients for continuous hemodialysis. (b) We also counted colonies on bacterial cultures for their hands to monitor the effect of the hand hygiene procedures. Results (a) Fifteen nurses were investigated. The qualified rate of hand washing procedures was 91.75% before they entered into the working area, was 100% after they contacted the patients, and was 99.66% during glove exchanges. The rate of required amount of hand lotion used during hand washing was 42.61%. The correct rate of washing position was 61.86%, and the rate of required time for washing was 63.57%. The correct rate of hand drying method was 86.25%. The correct rate of glove exchange procedure was 99.66% when change services from one to another patient. The intact rate of gloves was 97.25%. (b) The total colony amount of hand bacterial culture <10cfu/cm2, consistent with the standard in “Quality Control Standard for Hemodialysis, Beijing, 2001” was found in 90.67% nurses. Logistic regression analysis showed that the amount of liquid soap used and hand drying method were the independent factors for hand hygiene quality. Conclusion The nursing staff in hemodialysis units must understand the importance of hand washing, the procedures of hand washing, and the situation to change gloves. The qualified rate of hand hygiene was relatively high in this study, but several shortages existed in implementation of routine hand hygiene procedures. Therefore, the importance of hand hygiene in the quality control of hemodialysis should be re-emphasized. In addition, hand washing facilities such as hand drying sets should be examined routinely.

Key words: Dialysis, Nurse