降低加護病房醫護人員洗手不遵從率方案

Decline Nocompliance with Handwashing for ICU Staff

院內感染管制，是現今各醫療院所均面臨的重要課題。美國疾病管制局明確指出：洗手，是預防院內感染最簡單與重要的方法。本專案主要針對院內感染管制中最基本、但最容易被忽略的洗手行為作改善，經由品管圈活動以提昇加護病房醫護人員洗手的意願與動機，配合感染管制委員會的宣導，降低洗手時機及洗手步驟的不遵從率。依現況分析之洗手不遵從原因擬定：洗手教育、推廣速乾消毒劑使用、提供護手乳液、及重新修定監測標準等對策。於91年6月開始推行，並作追蹤評值，結果使洗手時機之不遵從率由9.8%降至7.0%；洗手步驟之不遵從率由22.9%降至7.3%。本專案依美國疾病管制局的定義及本院感管會的規範，修訂了洗手時機與步驟的監測標準，做為品管作業準則之依據，可提供為其他相關單位及加護病房之參考。

Today, the infection control of hospital is challenge to the modern medicine. The Centers for Disease Control and Prevention (CDC) have indicated definitely that handwashing is the simplest, most effective method to prevent nosocomial infections. This program is focus on improve the compliance of handwashing by increased motivation to decline the noncompliance wash timing and steps, that is the most basic, easily ignored to prevent the nosocomial infections. The contents which analyzed according to the activity of quality control were presented and planned on schedules including: education, promote alcohol-based hand rub, provided skin care lotion, and rebuilt monitor standard programs. After these activities of quality management in June 2002, we evaluated the results between June and December. The noncompliance washing timing decline from 9.8% to 7.0%. The noncompliance washing steps decline from 22.9% to 7.3%. Besides, we also received CDC recommendation and suggestion of infection control committee of VGHTC revised the observation principle of hand wash whish will be the basis guideline and reference resources.