了解基于学习型组织的多维度培训策略对ICU医护人员手卫生依从性的影响。

对2020年1月至12月我院ICU抽查的60名医护人员进行研究，应用基于学习型组织为基础的多维度手卫生培训策略对上述人员进行培训，将手卫生培训规范化。调查培训策略实施前（2020年1月至6月）与培训策略实施后（2020年7月至12月）不同手卫生时机、不同身份类型及不同职称医护人员手卫生依从性变化，并对此种培训策略对手卫生依从性的改善情况进行分析。

与培训策略实施前相比，培训策略实施后医护人员的整体手卫生依从性从86.63%提高到95.45%，差异有统计学意义（χ²=41.760，P＜0.001），其中，接触患者前从80.56%升至94.36%，差异有统计学意义（χ²=16.571，P＜0.001）；接触患者后从87.00%升至98.11%，差异有统计学意义（χ²=24.199，P＜0.001）；无菌操作前从85.71%升至97.97%，差异有统计学意义（χ²=14.713，P＜0.001）。按照身份类型进行分层，结果培训策略实施后医师、护士的手卫生依从性均较培训策略实施前明显提高，差异有统计学意义（医师：93.27% vs 85.42%，χ²=10.788，P＜0.001；护士：96.65% vs 87.61%，χ²=30.681，P＜0.001）。按照职称进行分层，结果初级职称培训策略实施后手卫生依从性较培训策略实施前有了明显提高，差异有统计学意义（95.54% vs 84.76%，χ²=41.129，P＜0.001）；但中级和高级职称培训策略实施前后无明显差异（P＞0.05）。高达88.33%的人认为基于学习型组织的多维度培训策略能够提高手卫生的正确性，81.67%的人认为此项培训能够提高手卫生的依从性。

基于学习型组织的多维度手卫生培训策略的建立，可以显著提升ICU医护人员的手卫生依从性，为ICU预防危重症患者发生医院感染提供重要保障。

To understand the effect of multidimensional training strategy based on learning organization on compliance of hand hygiene in ICU medical staff.

From January 2020 to December 2020, a total of 60 doctors and nurses who were randomly examined in ICU were studied. In order to standardize hand hygiene training, the multi-dimensional hand hygiene training strategy based on learning organization was used to train these doctors and nurses. The changes of hand hygiene compliance before (January to June 2020) and after the implementation of the training (July to December 2020) in different hand hygiene indication, different identity type and different professional titles were investigated, and the improvement of hand hygiene compliance in this training strategy was analyzed.

Compared with the first half of 2020 (before the implementation of the training strategy), the overall hand hygiene compliance of medical staff in the second half of 2020 (after the implementation of the training strategy) increased from 86.63% to 95.45%, and the difference was statistically significant (χ²=41.760, P＜0.001), among those, before contact with patients, it increased from 80.56% to 94.36%, and the difference was statistically significant (χ²=16.571, P＜0.001); from 87.00% to 98.11% after contact with patients, and the difference was statistically significant (χ²=24.199, P＜0.001); before aseptic operation, it increased from 85.71% to 97.97%, and the difference was statistically significant (χ²=14.713, P＜0.001). After the implementation of the training strategy, the hand hygiene compliance of doctors and nurses was significantly improved. The hand hygiene compliance of doctors before and after implementation was 85.42% and 93.27%, and the difference was statistically significant (χ²=10.788, P＜0.001), and that of nurses before and after implementation was 87.61% and 96.65%, and the difference was statistically significant (χ²=30.681, P＜0.001), and the differences were statistically significant. The hand hygiene compliance of medical staff with primary title was significantly improved before and after the training, and the difference was statistically significant (95.54% vs 84.76%, χ²=41.129, P＜0.001). However, there was no significant difference in hand hygiene compliance of medical staff with intermediate titles and senior professional titles before and after the training (P＞0.05). Up to 88.33% believed that the training based on multi-dimensional training strategy of learning organization could improve the correctness of hand hygiene, 81.67% believed that the training could improve the compliance of hand hygiene.

The establishment of multidimensional hand hygiene training strategy based on learning organization can significantly improve the compliance with hand hygiene of ICU medical staff, and provide important guarantee for ICU to prevent nosocomial infection in critically ill patients.