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目的:结合运用两种采样方法,强化外科手消毒管理,确保外科手消毒质量。方法:手术室院感监控护士按卫生部推荐棉拭子涂擦采样法(以下称棉拭子法)进行常规监测,院感科专职人员用指端戳压采样法(以下称指端戳压法),分别随机抽取医生、手术室护士、实习生(包括低年资轮转医生)于术前外科手消毒后2分钟内采样,将监测结果进行比较。结果:强化培训前棉拭子法共监测54人次,全部无细菌生长,无菌检出率100%,而指端戳压法共监测138人次,有65人次无细菌生长,无菌检出率占47.10%;强化培训后棉拭子法共监测69人次,还是全部无细菌生长,无菌检出率100%,与强化培训前无差异,而指端戳压法共监测398人次,有372人次无细菌生长,无菌检出率占93.47%。对强化培训前、后两种监测方法无菌检出率分别进行χ~2检验,强化培训前χ~2=46.09,P<0.001,强化培训后χ~2=4.77,P>0.05;对强化培训前、后指端戳压法无菌检出率进行χ~2检验,χ~2=146.29,P<0.001,差异有统计学意义。结论结合运用两种采样方法,强化外科手消毒管理,能更好的监督外科手术人员规范洗手,以确保外科手消毒质量。
Objective: To combine two kinds of sampling methods to strengthen the management of surgical hand disinfection and ensure the quality of surgical hand disinfection. Methods: The hospital nurses in the operating room monitored nurses according to the Ministry of Health recommended cotton swab rubbed sampling method (hereinafter referred to as cotton swab method) for routine monitoring, nosocomial sense of full-time staff with the end-finger stamping sampling method Method) were randomly selected doctors, operating room nurses, trainees (including low senior doctor) to preoperative surgical hand disinfection within 2 minutes after sampling, the monitoring results were compared. Results: Before the intensive training, cotton swabs were monitored for 54 person-times, all without bacterial growth and the rate of aseptic detection was 100%. A total of 138 person-times were detected by finger-tip stamping method, 65 were bacterial-free and the rate of aseptic detection Accounting for 47.10%; intensive training cotton swab method to monitor a total of 69 people, or all without bacterial growth, the detection rate of 100% sterile, and no difference before intensive training, while the end-point stamping method were monitored 398 people, 372 The number of bacteria-free growth, aseptic detection rate of 93.47%. The detection rate of sterility before and after intensified training were respectively tested by χ ~ 2 test, χ ~ 2 = 46.09, P <0.001 before intensive training, χ ~ 2 = 4.77, P> 0.05 after intensive training; Before and after training, the positive rate of end-point lancing method was tested by χ ~ 2 test, χ ~ 2 = 146.29, P <0.001, the difference was statistically significant. Conclusion The combination of two sampling methods to strengthen the management of surgical hand disinfection can better supervise the surgical staff to regulate the hand washing to ensure the quality of surgical hand disinfection.