Yue Jingjing, Pan Huijuan
Department of Hospital Infection Management, Xiaodian District People's Hospital, Taiyuan, China.
Management Office, Jiangsu Provincial Geriatric Hospital (Jiangsu Province Official Hospital), Nanjing, China.
Front Public Health. 2025 Aug 20;13:1588336. doi: 10.3389/fpubh.2025.1588336. eCollection 2025.
This study aimed to enhance hand hygiene compliance among healthcare workers (HCWs) to reduce the incidence of hospital-acquired infections (HAIs) by employing the Plan-Do-Check-Act (PDCA) cycle, a quality management approach introduced by W. Edwards Deming.
A tailored Hand Hygiene Survey Form was developed based on the Hand Hygiene Technical Specification for Healthcare Personnel and WHO guidelines. Data was collected from January 2017 to December 2023 and Jiangsu Provincial Geriatric Hospital (Jiangsu province official hospital), including hand hygiene compliance metrics (assessed via observations of WHO's Five Moments for Hand Hygiene), hospital infection cases, and consumption of hand hygiene consumables. A questionnaire survey identified factors affecting compliance, leading to the implementation of targeted interventions, including regular training, performance assessments, promotional campaigns, and monitoring of consumable usage.
The survey revealed that the need for a diverse range of hand sanitizers (95.53%), timely replenishment of consumables (63.70%), and skin irritation from frequent use (48.83%) significantly impact hand hygiene compliance. From 2017 to 2023, there was a significant increase in hand hygiene compliance rate from 49.25 to 86.67%, accuracy rate from 13.02 to 86.67%, and awareness rate from 61.61 to 96.52%. The total consumption of hand sanitizers increased from 6,277,457 mL in 2017 to 18,130,112 mL in 2023, and the daily consumption per bed-day rose from 8.15 mL to 16.65 mL. The hospital infection rate decreased from 2.63% in 2017 to 0.90% in 2023. A strong negative correlation was observed between hand hygiene compliance rate ( = -0.962, < 0.001) and hospital infection rates, indicating that higher compliance is associated with lower infection rates.
The continuous application of the PDCA cycle and targeted interventions significantly improved hand hygiene compliance and reduced HAIs. The study emphasized the importance of ongoing monitoring, feedback, and corrective actions. It also highlighted the need for improving the supply and quality of hand hygiene consumables, enhancing education and supervision, and establishing incentive mechanisms to promote hand hygiene compliance. Despite limitations such as potential overestimation of actual hand hygiene consumables usage, the use of intelligent dispensers with identity recognition is recommended for more accurate data capture in future efforts.
本研究旨在通过采用由W.爱德华兹·戴明引入的质量管理方法——计划-执行-检查-行动（PDCA）循环，提高医护人员（HCWs）的手卫生依从性，以降低医院获得性感染（HAIs）的发生率。
根据《医务人员手卫生技术规范》和世界卫生组织指南，制定了一份量身定制的手卫生调查问卷。收集了2017年1月至2023年12月江苏省老年医院（江苏省公立医院）的数据，包括手卫生依从性指标（通过观察世界卫生组织的手卫生五个时刻进行评估）、医院感染病例以及手卫生耗材的消耗量。通过问卷调查确定影响依从性的因素，从而实施针对性干预措施，包括定期培训、绩效评估、宣传活动以及对耗材使用情况的监测。
调查显示，对手消毒剂种类多样的需求（95.53%）、耗材的及时补充（63.70%）以及频繁使用导致的皮肤刺激（48.83%）显著影响手卫生依从性。2017年至2023年，手卫生依从率从49.25%显著提高到86.67%，正确率从13.02%提高到86.67%，知晓率从61.61%提高到96.52%。手消毒剂的总消耗量从2017年的6277457毫升增加到2023年的18130112毫升，每床日的日消耗量从8.15毫升增加到16.65毫升。医院感染率从2017年的2.63%降至2023年的0.90%。手卫生依从率与医院感染率之间存在很强的负相关性（r = -0.962，P < 0.001），表明依从性越高，感染率越低。
持续应用PDCA循环和针对性干预措施显著提高了手卫生依从性并降低了医院获得性感染。该研究强调了持续监测、反馈和纠正措施的重要性。它还突出了改善手卫生耗材供应和质量、加强教育与监督以及建立激励机制以促进手卫生依从性的必要性。尽管存在如对手卫生耗材实际使用量可能高估等局限性，但建议在未来工作中使用具有身份识别功能的智能分配器以获取更准确的数据。
