三级医院护士联合使用手卫生和非无菌手套:一项多方法研究
Mireille Dekker1, Rosa van Mansfeld2, Marjon Borgert3
1Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands. m.vanoijen@amsterdamumc.nl.
护士很少将手部卫生 (HH) 和非无菌手套 (NSG) 结合使用正确. 提高合规性需要简化协议,利用护士的自我保护本能和习惯.
科学领域:
- 医疗保健实践 医疗保健实践
- 预防和控制感染的预防和控制.
- 护理研究 护理研究
背景情况:
- 手部卫生 (HH) 和非无菌手套 (NSG) 的使用在日常患者护理中至关重要,但却相互交织在一起.
- 评估HH和NSG的联合应用和影响因素对于改善医疗保健安全至关重要.
研究的目的:
- 评估护士对HH和NSG的联合应用.
- 确定影响护士遵守联合HH和NSG协议的决定因素.
主要方法:
- 这是一项多方法研究,结合了对205个护理事件的直接观察和对10名护士的半结构面试.
- 利用Flottorp的检查清单来探索实践的决定因素.
主要成果:
- 正确的NSG和HH联合应用仅在19%的单一手术发作和2%的多手术发作中观察到.
- 关键影响因素包括护士运行和整合协议的能力,风险评估,自我保护的冲动,以及护理事件的紧迫性/复杂性.
- 协议知识有限,视觉提醒是主要信息来源.
结论:
- 护士正确结合使用HH和NSG的比例显著低.
- 分碎的指令阻碍了有效的集成;推简化,融合协议.
- 未来的策略应该考虑习惯形成和护士的自我保护动机.
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