運用多元化衛教方案改善精神科慢性病人手部衛生之專案

Applying a Multimodal Hygiene Strategy to Improve Hand Hygiene among Chronic Psychiatric Patients

10.6847/TJPMHN.202109_16(2).05

鄭巧羚(Chiao-Ling Cheng)；鄭珮妤(Pei-Yu Cheng)；簡美金(Mei-Chin Chien)

多元化衛教方案 ； 精神科慢性病人 ； 手部衛生 ； multimodal hygiene strategy ； chronic psychiatric patients ； hand hygiene

精神衛生護理雜誌

16卷2期（2021 / 09 / 01）

42 - 52

繁體中文

手部衛生是降低醫療照護相關感染的重要手段。本單位為台灣南部某精神科慢性病房，於2018年6月至8月間陸續發生9例上呼吸道感染，經觀察發現病人未落實手部衛生，故成立專案小組。經資料搜集分析，確定問題在於病人的觀念與行為不正確、病房未提供教具供學習、缺乏衛教課程及無監測病人洗手制度，還有單位不宜放置酒精性洗手液導致洗手不便。專案目標為改善病人手部衛生，進而減少相互感染。改善方案有舉辦團體衛教、製作洗手步驟貼紙及影片、培育洗手達人、舉行競賽並建立稽核病人的制度。經改善後病人的洗手遵從率由22.3%提升至73.9%，正確率由14.5%提升至86.4%，顯示多元化衛教策略能顯著改善病人手部衛生。

Hand hygiene is a crucial means of reducing the risk of health-care-associated infections. From June to August 2018, 9 cases of upper respiratory tract infections occurred at a chronic psychiatric unit in southern Taiwan. We observed that effective hand hygiene was not performed by inpatients. Therefore, a project team was established. Through data collection and analysis, problems were confirmed as follows: patients did not perform correct hand hygiene or have the correct attitude toward hand hygiene, no instructional materials were provided for patient education, hand hygiene educational programs or an evaluation system for patients' handwashing behavior was not available, and hand hygiene was inconvenient because alcohol-based hand sanitizers were inaccessible. The aim of the project was to improve patient hand hygiene to reduce cross infection. Improvement measures included providing group hand hygiene courses, developing stickers and videos about the correct handwashing steps, training select patients as handwashing experts, holding competitive handwashing activities, and setting up a patient evaluation system. After the project was concluded, the handwashing compliance rate increased from 22.3% to 73.9% and the handwashing competency rate increased from 14.5% to 86.4%. These results indicate that a multimodal hand hygiene strategy can notably enhance hand hygiene among patients.

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