降低加護病房醫護人員洗手不遵從率方案

Decline Noncompliance with Handwashing for ICU Staff

10.6142/VGHN.20.3.305

王筱華(Sheau-Hwa Wang)；張麗銀(Li-Yin Chang)；高美玲(Mei-Lin Koa)；吳杰亮(Jie-Liang Wu)；段慧貞(Hui-Chen Tuan)；盧小玨(Shiao-Jyue Lu)

洗手不遵從率 ； 洗手時機 ； 洗手步驟 ； 院內感染 ； noncompliance with handwashing ； handwashing timing ； handwashing steps ； nosocomial infections

榮總護理

20卷3期（2003 / 09 / 01）

305 - 315

繁體中文

院內感染管制，是現今各醫療院所均面臨的重要課題。美國疾病管制局明確指出：洗手，是預防院內感染最簡單與重要的方法。本專案主要針對院內感染管制中最基本、但最容易被忽略的洗手行爲作改善，經由品管國活動以捉弄加護病房醫護人員洗手的意願與動機，降低洗手時機及洗手步驟的不進從率。依現況分析之洗手不遵從原因擬定：洗手教育、推廣速乾消毒劑使用、提供護手乳液、及重新修定監測標準等對策。於91年6月開始推行，並作追蹤評值，結果使洗手時機之不遠從率由9.8%降至7.0%；洗手步驟之不遵從率由22.9%降至7.3%。本專案依美國疾病管制局的定義及本院感管會的規範，修訂了洗手時機與步驟的監測標準，做爲品管作業準刻之依據，可提供爲其他相關單位及加護病房之參考。

Today, infection control in the hospital is quite a challenge for modern medicine to overcome. The Centers for Disease Control and Prevention (CDC) have indicated that handwashing is the simplest, but most effective method to prevent nosocomial infections. This program is focused on improving the compliance with handwashing by increased motivation to comply with wash times and steps, that are the most basic, and easily ignored, to prevent the nosocomial infections. The contents which analyzed according to the activity of quality control were presented and planned on schedules, inc1uding: education, promotion of a1cohol-based hand rub, providing skin care lotion, and implementing was of monitoring the standard programs. After these activities of quality management in June 2002, we evaluated the results between June and December. The noncompliance with wash timing dec1ined from 9.8% to 7.0%. The noncompliance with performing all washing steps dec1ined from 22.9% to 7.3%. We also received CDC recommendations and suggestions from the infection control committee of VGHTC. The revised observation principles of handwashing will be the basis of guidelines and reference resources.