Survey And The Intervention Experiment On Nurses' Hands Hygiene

Objective Through the study and investigation for current situation of microbial contamination on the nurses' hands,to enhance the nurses' concept of handwashing and control the hospital infection.Research the effective intervention to improve the handwashing state;increase the handwashing compliance and decrease the nosocomial infection rate.To provide the scientific evidence for the prevention,control and management of nosocomial infections.Object and Methods Use the investigative method of qualitation and quantitation conjuncted,the study take 150 nurses randomly from the medical and surgery department and intensive care unit(ICU)and clinic service and emergency of a grade-A comprehensiveness hospital of Tianjin as the observation objects.Observe the nurses' handwashing rate as handwashing indicated appearancing and sampled the hands of nurses 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.Results 1.The detection results of microbial contamination on the nurses' hands and handwashing installations:after handwashing 150 nurses' hands samples that all contaminated,account 100%;among the total 54 samples over-standard,account 36%. There are 7564 strains are cultured of 150 samples of nurses' hands and the capital bacteriums are coagulase negative staphylococcus(CNS),Gram positive Spore-Forming,mould,budding fungus,microbacterium,stato-bacillus,et al.The samples of nurses' hands are detected pathogenic bacteria,including:Staphyl- ococcus aureus(SA),Bacillus coli,drug sensitive test to show that there are meticillin-resistant Staphylococcus aureus(MRSA),meticillin-resistant coagulase negative staphylococcus (MRCNS),and superspectrumβ-lactamase bacterium(ESBL_S)on the samples.The microbion on the the nurses' hands are coincidence with the capital germs of nosocomial infections in this hospital at recent years.2.The performed condition of hand hygiene:the average rate of compliance of hand hygiene of 150 nurses are 30.79±28.03%.After each handwashing indicated appearancing,the higher rates of compliance of hand hygiene are after handle filth, before go to toilet,and after touch patients,the rates are 75.87±28.97%, 68.45±35.49%,and 57.86±32.64%respectively.Among the 20 factors to influence performance of hand hygiene,the most important factors are:①the work too busy,②cleanser,antiseptics cause asteatosis cutis,③the effectually monitoring not establish for the effect of handwashing.3.The prehension of knowledge of hand hygiene:the average mark of knowledge of hand hygiene is 19.02±2.09,among the total the average mark of knowledge of hand hygiene indicated is 14.06±1.25,and the average mark of correlated knowledge of hand hygiene is 4.97±1.18.The nurses with different age,educational background and professional title whose marks of knowledge of hand hygiene havn't significant difference(P＞0.05),but nurses of ICU whose marks higher than nurses of the medical and surgery department and clinic service and emergency(P＜0.05).After statistically analysis the score of the health information of hand hygiene and the compliance of hand hygiene are not correlation(P＞0.05).4.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 nurses' hands after handwashing have significant difference;after intervention the qualified rate of handwashing from 63.64%to 90.91%,and the rate of handwashing from 28.41%to 55.27%,incontrol group the qualified rate of handwashing is 68.18%,and the rate of handwashing is 27.59%.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-rubproduct 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 89.59±3.14%,and the clearance rate of germs of the group using flow water is 86.59±3.38%,the two groups have significant difference(P＜0.05);the time consuming of the group using antiseptic hand-rub product is 19.00±2.33s,and the time consuming of the group using flow water is 163.55±44.49s,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).Conclusion There are pathogenic bacterias and drug resistant strains on the hands of nurses after the error handwashing behavior,the pathogenic bacterias and drug resistant strains are coincidence with the capital germs of nosocomial infections in this hospital at recent years.The state of hand hygiene of nurses must need improvement urgently;handwashing installations should be consummate;take the direct intervention to enhance infection control,effectively increase the handwashing compliance and decrease the nosocomial infection rate.