使用橘色洗手貼紙對增加護理人員接觸導尿管洗手遵從率之成效

Application of an Orange-colored Label on the Bag Containing the Foley’s Catheter to Improve the Nurses’ Hand-wash Rates

泌尿道感染是最常見的院內感染，與低洗手率有極大的相關，而儘管已有許多促進洗手的策略，但臨床人員洗手率仍然偏低。因此，本研究擬探討橘色洗手貼紙提升護理人員接觸導尿管前後洗手率的成效。採前、後測實驗性設計，於某醫學中心加護病房進行，研究對象為轉入48小時無泌尿道感染之內外科病人，收案者依收案條件選取個案並採隨機分派方式進入實驗組61人，對照組74人，共135人。對照組接受病房常規，實驗組接受於導尿管的尿袋貼上橘色洗手貼紙。研究工具為橘色洗手貼紙及感染危險因子表。收案日收集前測洗手率； 收案後7天中隨機抽取3天每天8小時觀察後測洗手率，第7天收集菌尿症。統計使用x2、t及曼惠特U檢定。主要結果：(1)實驗組洗手率顯著高於對照組，以接觸導尿管後高出14.8％最多。(2)實驗組後測接觸導尿管前、後之洗手率，皆顯著高於前測；比接觸導尿管前提升13.7％，比接觸後提升7.4％為多。(3)導尿管第7天菌尿症，實驗組無，顯著低於對照組6人。結論：使用橘色洗手貼紙可提升接觸導尿管洗手率，尤其是接觸前，並可因此間接減少菌尿症。研究結果可提供增加洗手率設計參考。

The purpose of this study was to evaluate whether the presence of an orange label on the bag containing the Foley’s catheter improved the hand wash rate of nurses who handled the catheters. This study was conducted in a medical center ICU. In this study, 135 patients were randomly enrolled and assigned into the experimental (N = 64) and control groups (N = 71). The bag containing the Foley’s catheter for patients in the control group did not have the orange label and were, therefore, handled in a routine manner; however, the bag containing the catheter for patients in the experimental group was labeled with an orange-colored paper. The hand-wash rates of nurses were determined during Foley’s catheter care from days 1-7 in both the groups. We used the Statistical Package for the Social Sciences (SPSS) version 17.0 to analyze the data using t test and Mann-Whitney U test. The hand-wash rates in the experimental group were significantly different from those in the control group. The hand-wash rates of the nurses’ were high (up to 86.9%) during Foley’s catheter care. Furthermore, urine cultures from the experimental group showed significantly lower bacterial growth than those from the control group.