黄晓琳 梁景星 林沛卿

【摘要】 目的：調查社区卫生服务中心医护人员的手卫生情况，通过实施集束化手卫生干预措施，提高社区卫生服务中心医护人员的手卫生知识知晓率、手卫生依从率、手卫生正确率以及手消毒剂的使用量，从而达到提高社区卫生服务中心医护人员手卫生依从性的目的。方法：采用随机整群抽样、问卷调查及单盲法，从佛山市南海区第二人民医院所属的11个社区卫生服务中心随机抽取6个社区卫生服务中心，对医护人员实施集束化手卫生干预措施，对比干预前后手卫生知识知晓率、手卫生依从率、手卫生正确率以及手消毒剂使用量的变化情况。结果：实施集束化手卫生干预措施后，6个社区卫生服务中心医护人员的手卫生知识知晓率、手卫生依从率、手卫生正确率均有提高，比较差异均有统计学意义（P<0.05）。手消毒剂使用量干预前为0.96 mL，平均（1.04±0.54）mL；干预后为1.88 mL，平均（1.92±0.69）mL，增加了0.92 mL，平均（0.88±0.50）mL，比较差异均有统计学意义（P<0.05）。

结论：社区卫生服务中心的医护人员普遍对手卫生的认识不足，通过实施集束化手卫生干预措施，社区卫生服务中心医护人员的手卫生依从性得到了显著提高。

【关键词】 手卫生； 集束化干预； 社区卫生服务中心； 医护人员； 依从性

【Abstract】 Objective：To investigate the hand hygiene situation of medical staff in community health service centers.To improve the hand hygiene knowledge， hand hygiene compliance，correct rate of hand hygiene，and the amount of hand disinfectant of medical staff by bundle interventions，and to achieve the purpose of improving the hand hygiene compliance of medical staff in community health service centers.Method：The random cluster sampling，questionnaire investigation and single blind method were used.Six community health service centers were randomly selected from 11 community health service centers of the Second Peoples Hospital of Nanhai District Foshan City.Bundle interventions of hand hygiene were used in medical staff.The hand hygiene knowledge，hand hygiene compliance，correct rate of hand hygiene and the amount of hand disinfectant were compared before and after bundle interventions.Result：After bundle interventions of hand hygiene，the hand hygiene knowledge，hand hygiene compliance，and correct rate of hand hygiene of medical staff were all improved in six community health service centers，the difference was statistically significant（P<0.05）.Before interventions，the amount of hand disinfectant was 0.96 mL， average （1.04±0.54）mL；after interventions，it was 1.88 mL，average（1.92±0.69）mL，an increase of 0.92 mL，average（0.88±0.50）mL，the difference was statistically significant（P<0.05）.Conclusion：The hand hygiene knowledge of medical staff is generally lacked in community health service centers.The hand hygiene compliance has been significantly improved by bundle interventions of hand hygiene in medical staff of community health service centers.

【Key words】 Hand hygiene； Bundle interventions； Community health service center； Medical staff； Compliance

First-authors address：Nanhai Hospital of Guangdong Peoples Hospital，The Second Peoples Hospital of Nanhai District in Foshan City，Foshan 528251，China

doi：10.3969/j.issn.1674-4985.2018.31.038

手卫生作为降低医院感染最简单、最有效的措施，正在全世界范围内引起广泛关注[1]。手卫生是一个较广泛的概念，是指清除或破坏手表面微生物的任何方法，是医务人员洗手、卫生手消毒和外科手消毒的总称[2]。中国疾病预防控制中心曾光专家指出：手部卫生关系到医患安全，提高医院医疗水平，保证医疗质量的大事。……