洗手方案對加護病房護理人員洗手行為效果之探討

The Study on the Effectiveness of Handwashing Protocol on ICU Nurses’Handwashing Practices

本研究主要目的為探討洗手方案對加護病房護理人員洗手行為之影響。研究方式為實驗法（pre-experimental study）中之單組前後測設計。研究對象為中部地區一所360床醫院內加護病房上白班的護理人員共12位。前測觀察為期6週，每週一～週五早上八點半～九點半，二位觀察員以執行洗手程序的護理項目評估表，觀察護理人員接觸病人前後洗手情形。繼而為期8週的洗手方案宣導，接著再做6週的後測觀察，以知前測與後測護理人員的洗手行為有無差異。結果發現洗手方案能提升加護病房護理人員執行各項護理程序的洗手率，護理人員戴手套後洗手率大幅增加，並降低加護病房的院內感染率。本研究成果證實洗手方案具有臨床運用與推廣之價值。

The purpose of this study was conducted to investigate the effectiveness of handwashing practices. The research design is one-group pre-experimental study. Between 8:30 and 9:30 AM on each week-day for six weeks, two trained observers used a nurses’ handwashing practices assessment tool to chart whether 12 nurses in a 12-bed ICU washed their hands or not after each patient contact. Following this observation period, two four-week inter-ventions were introduced in sequence. During a 6-week post-test period, charting the 12 nurses’ handwashing pactices was repeated. The result revealed the effectiveness of handwashing pro-tocol not only improving the rates of nurses’ handwashing practices before or after performing nursing procedures(65.8%) and enhancing nurses’ handwashing practices after wearing gloves(62.4%), but also on decreasing the rates of nosocomial infection in ICU(below 6.0%). The research result demonstrates the positive value of handwashing protocol on clinical practice and reinforcemet.