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波兰医学生和医生手部卫生程序依从性差——是无效教育基础的结果还是组织文化的影响?

Poor Hand Hygiene Procedure Compliance among Polish Medical Students and Physicians-The Result of an Ineffective Education Basis or the Impact of Organizational Culture?

作者信息

Wałaszek Marta, Kołpa Małgorzata, Wolak Zdzisław, Różańska Anna, Wójkowska-Mach Jadwiga

机构信息

State Higher Vocational School in Tarnów, 33-100 Tarnów, Poland.

Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, ul. Czysta 18, 31-121 Kraków, Poland.

出版信息

Int J Environ Res Public Health. 2017 Sep 7;14(9):1026. doi: 10.3390/ijerph14091026.

Abstract

: The objective of the study was to examine the knowledge of Polish physicians and medical students about the role of hand hygiene (HH) in healthcare-associated infection (HAI) prevention. : A survey was conducted using an author-prepared questionnaire, which was filled out on the first day of hospital work (or internship) by newly admitted physicians who had worked in other hospitals and students of different medical schools in Poland. : 100 respondents participated in the study: 28 students, 18 medical interns and 54 physicians. : As many as 3/4 of physicians and students did not use the HH techniques correctly. The respondents declared that they perform HH in the following situations: 74.4% of respondents before an aseptic task; 60.8% before patient contact; 57.0% after patient contact; 11.5% after body fluid exposure risk, and only two respondents (1.1%) after contact with patient surroundings. 64% of respondents declared that their supervisor checked their knowledge of the HH technique when they were touching patients, but their supervisors checked the five instances for HH only in the case of 27 respondents (27%). Students experienced any control of HH in the workplace less often. Interns and physicians mentioned that the most important preventive action in HAI is HH, but for students it is the use of gloves. : The level of knowledge and skills of physicians and students in the field of HH is insufficient. Deficiencies in skills and knowledge of HH were identified as early as at the level of the first internship.

摘要

该研究的目的是调查波兰医生和医学生对手卫生(HH)在预防医疗相关感染(HAI)中作用的了解情况。使用作者编写的问卷进行了一项调查,问卷由刚入职且曾在其他医院工作过的医生以及波兰不同医学院的学生在医院工作(或实习)的第一天填写。100名受访者参与了该研究:28名学生、18名医学实习生和54名医生。多达四分之三的医生和学生没有正确使用手卫生技术。受访者宣称他们在以下情况下会进行手卫生:74.4%的受访者在进行无菌操作前;60.8%在接触患者前;57.0%在接触患者后;11.5%在有体液暴露风险后,只有两名受访者(1.1%)在接触患者周围环境后。64%的受访者宣称当他们接触患者时,其上级会检查他们对手卫生技术的了解情况,但上级仅对27名受访者(27%)检查了手卫生的五个时机。学生在工作场所较少经历对手卫生的检查。实习生和医生提到在预防医疗相关感染中最重要的预防措施是手卫生,但对学生来说是使用手套。医生和学生在手卫生领域的知识和技能水平不足。早在实习初期就发现了手卫生技能和知识方面的不足。

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