看護師の手洗い行動に関係する因子の検討

Factors Influencing Hand Hygiene Behavior of Nurses

要旨

【目的】本研究は，手洗い行動に関係性の強い因子を明らかにし手洗い行動の改善への示唆を得ることを目的とした．

【方法】2病院の看護師93名を対象に構成的観察法と自記式質問紙法を実施し，手洗い行動(手洗いの実施・手洗いの質)と経験，教育，関心，知識，忙しさ(看護業務量・スタッフ不足)の関係の有無・関係の強さを探索した．

【結果】手洗いの実施には看護業務量，教育，経験が影響していた．手洗いの質には看護業務量とスタッフ不足が影響していた．手洗いの実施では，看護業務量の変数である1時間の仕事数が25を超えるとオッズ比は7.75となり，35を超えると12.99となった(CI.1.54～39.03，1.64～102.72)．手洗いの質では，仕事数が25を超えるとオッズ比は6.86となり，35を超えると28.52(CI.1.43～32.95，2.43～335.08)となった．

【結論】手洗い行動に関係する因子は，忙しさ，教育，経験であり，手洗い行動を改善するためには，看護業務の見直しを中心とした忙しさの改善，擦式手指消毒剤を使用した手洗いの推奨とトレーニング，感染に関する院内教育の充実の必要性が示唆された．

Abstract

　Objective：The purpose of this study was to identify the factors influencing hand hygiene behavior (compliance and quality)of nurses strongly and to provide suggestions for improvement.

　Method：An observational study and a questionnaire survey were conducted with 93subjects, nurses at the two hospitals. Factors were experience, education, concern of infection control, knowledge, and workload：intensity of patient care and understaffing.

　Results：Factors influencing compliance were identified as intensity of patient care,education, and experience. Factors influencing quality of hand hygiene were identified as intensity of patient care and understaffing. Noncompliance was higher when intensity of patient care was high (compared with ＜25incidents of patient care per hour, 25to 34incidents：OR (odds ratio). 7.75(CI, 1.54to 39.03)；＞35incidents：OR.12.99(CI,1.64to 102.72)).Quality of hand hygiene was inferior when intensity of patient care was high (compared with ＜25incidents of patient care per hour, 25to 34incidents：OR. 6.86(CI, 1.43to 32.95)；＞35incidents：OR. 28.52(CI, 2.43to 335.08)).

　Conclusion：These results suggest that factors influencing hand hygiene behavior may be workload, education, and experience. In order to improvement of hand hygiene behavior, improvement of patient care system, recommendation and training for handrub, and enforcement of hospital-wide educational program of infection control may be useful.