霍桑效应对手卫生依从性的影响
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张红芳

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R197.323

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Hawthorne effect on hand hygiene compliance
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    摘要:

    目的 了解霍桑效应对不同工作岗位人员、不同科室及五个手卫生时机手卫生依从率的影响,为合理利用霍桑效应,切实提高手卫生依从率提供依据。方法 采用直接观察法对不同科室同类人群选用常规调查法和隐蔽型调查法进行手卫生依从性调查,对其结果进行分析,同时统计调查同期洗手液及手消毒剂使用量。结果 常规调查组、隐蔽型调查组手卫生用品消耗量为26.9、27.5 mL/床日,两组比较,差异无统计学意义(P>0.05)。常规调查组、隐蔽型调查组手卫生依从率分别为79.7%(985/1 236)、49.8%(646/1 298),两组手卫生依从率比较,差异具有统计学意义(χ2=247.166,P<0.01)。其中护士最高,医生在隐蔽型调查组和常规调查组手卫生依从率分别为31.6%和82.6%,常规调查组提高了161.4%。常规调查组无菌操作前、内科组手卫生依从率最高(86.5%、88.7%),隐蔽型调查组接触患者血液体液后、重症组手卫生依从率较高(69.2%、78.5%)。接触患者前常规调查组较隐蔽型调查组依从率提高了127.0%(分别为81.5%、35.9%)。除接触患者血液体液后,其余4个手卫生指征、不同科室间两调查组依从率比较,差异均有统计学意义(均P<0.05)。结论 隐蔽型调查结合洗手液及手消毒剂使用量能较真实反映不同科室、不同岗位人员的手卫生依从率,常规观察组因霍桑效应手卫生依从率偏高,实际工作中可利用霍桑效应持续刺激,提高医务人员手卫生依从率。

    Abstract:

    Objective To understand Hawthorne effect on compliance rate of hand hygiene(HH) of staff of diffe-rent occupations, different departments and five HH opportunities, so as to provide basis for rational use of Hawthorne effect and improve HH compliance rate. Methods The direct observation method was adopted to investigate HH compliance of the same kind of population in different departments through routine survey method and concealed survey method, results were analyzed, the consumption of hand sanitizer and hand disinfectant used at the same period was investigated. Results Consumption of HH products in routine survey group and concealed survey group were 26.9 mL/bed-day and 27.5 mL/bed-day respectively, there was no significant difference between two groups (P>0.05). HH compliance rates in routine survey group and concealed survey group were 79.7% (985/1 236) and 49.8% (646/1 298) respectively, difference was statistically significant (χ2=247.166, P<0.01). Nurses had the highest HH compliance rate, HH compliance rate of doctors in concealed survey group and routine survey group were 31.6% and 82.6% respectively, routine survey group increased by 161.4%. HH compliance rates were the highest in routine survey group before aseptic manipulation and in internal medicine group (86.5% and 88.7% respectively), HH compliance rates of concealed survey group after touching patient's blood and body fluid were both higher (69.2% and 78.5% respectively). Compared with concealed survey group, HH compliance rates before touching patients in routine survey group increased by 127.0% (81.5% and 35.9% respectively). Except for touching patients' blood and body fluid, there were significant differences in compliance rates of the other four HH indicators and different departments between two groups (all P<0.05). Conclusion Concealed survey combined with the consumption of hand sanitizer and hand disinfectant can truly reflect HH compliance rate of staff in different departments and staff with different occupations, Hawthorne effect on HH compliance in routine survey group is higher, continuous stimulation through Hawthorne effect on practical work can be used to improve HH compliance rate of health care workers.

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引用本文

胡继梅, 张红芳, 陈玉兰,等.霍桑效应对手卫生依从性的影响[J]. 中国感染控制杂志,2020,19(12):1102-1107. DOI:10.12138/j. issn.1671-9638.20206008.
HU Ji-mei, ZHANG Hong-fang, CHEN Yu-lan, et al. Hawthorne effect on hand hygiene compliance[J]. Chin J Infect Control, 2020,19(12):1102-1107. DOI:10.12138/j. issn.1671-9638.20206008.

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  • 收稿日期:2020-03-25
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  • 在线发布日期: 2020-12-28
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