摘 要
手术室作为医院感染控制的关键区域，护士手卫生是预防手术部位感染的重要环节。本研究旨在探讨手术室护士手卫生依从性的影响因素及其干预措施的效果，以期为提高手卫生依从性提供科学依据。通过文献回顾和现状分析发现，尽管手卫生的重要性已被广泛认可，但实际执行情况仍不理想。为此，本研究采用横断面调查与干预实验相结合的方法，在某三甲医院手术室选取120名护士作为研究对象，通过问卷调查、现场观察及微生物检测等手段收集数据。结果显示，干预前护士手卫生依从率为63.5%，经过为期三个月的综合干预措施（包括培训教育、流程优化、监督反馈等），依从率提升至87.2%，差异具有统计学意义（P0.05）。同时，手部细菌菌落数明显减少，表明干预措施有效改善了手卫生状况。本研究创新性地将行为心理学理论应用于手卫生干预方案设计中，通过构建激励机制和营造积极文化氛围，显著提高了护士的手卫生意识和执行力，为同类研究提供了新的思路和方法，对降低手术室感染风险具有重要实践价值。
关键词：手卫生依从性；手术室感染控制；护士行为干预；微生物检测；行为心理学应用
Abstract
The operating room, as a critical area for infection control in hospitals, plays a pivotal role in preventing surgical site infections through nurses' hand hygiene practices. This study aims to investigate the factors influencing hand hygiene compliance among operating room nurses and evaluate the effectiveness of intervention measures to provide scientific evidence for improving compliance. Through literature review and current situation analysis, it was found that despite widespread recognition of the importance of hand hygiene, actual implementation remains suboptimal. To address this issue, a combined cross-sectional survey and intervention experiment approach was adopted, selecting 120 nurses from the operating room of a tertiary hospital as subjects. Data were collected using questionnaires, on-site observations, and microbiological testing. Results showed that pre-intervention hand hygiene compliance was 63.5%, which increased to 87.2% after a three-month comprehensive intervention involving education and training, process optimization, and supervision with feedback, demonstrating statistically significant improvement (P0.05). Concurrently, the number of bacterial colonies on hands significantly decreased, indicating effective enhancement of hand hygiene status. Innovatively, this study applied behavioral psychology theory to the design of hand hygiene interventions by establishing incentive mechanisms and fostering a positive cultural atmosphere, thereby markedly enhancing nurses' awareness and execution of hand hygiene. This provides new insights and methods for similar studies and holds significant practical value in reducing the risk of infection in operating rooms.
Keywords：Hand Hygiene Compliance；Surgical Room Infection Control；Nurse Behavior Intervention；Microbial Testing；Application Of Behavioral Psychology
目 录
摘 要 I
Abstract II
引 言 1
第一章 手术室感染控制现状分析 2
1.1 手术室感染发生率统计 2
1.2 感染控制措施综述 2
1.3 护士手卫生重要性 3
第二章 护士手卫生依从性影响因素 4
2.1 个人因素对依从性的影响 4
2.2 环境因素对依从性的作用 4
2.3 管理制度与依从性的关系 5
第三章 提高手卫生依从性的策略研究 6
3.1 教育培训体系构建 6
3.2 监督反馈机制建立 6
3.3 激励措施的实施效果 7
第四章 手卫生依从性改进效果评估 8
4.1 改进前后数据对比分析 8
4.2 感染率变化趋势观察 8
4.3 综合效益评价 9
结 论 10
参考文献 11
致 谢 12
