目的: 探讨霍桑效应对重症医学科医务人员(health care workers,HCWs)手卫生依从性产生的影响,为加强医疗机构对手卫生管理提供参考依据。方法: 对比直接观察法和隐蔽观察法下手卫生的依从性的不同,使用感控工作间应用程序进行数据的导入和导出,利用SPSS 26.0对近1年医务人员手卫生执行率进行统计分析。结果: 2020年7月至12月隐蔽观察组的手卫生执行率为81.8%,2021年1至6月直接观察组的手卫生执行率为88.0%,差异有统计学意义(P＜0.05)。隐蔽观察组护士手卫生执行率最高,为90.3%,医疗人员手卫生执行率为74.3%,医技人员手卫生执行率为50.2%,其他人员手卫生执行率为60.5%;直接观察组护士手卫生执行率升高至93.6%,医疗人员手卫生执行率升高至84.0%,医技人员手卫生执行率升高至80.0%,其他人员手卫生执行率升高至87.0%,两组差异均有统计学意义(P＜0.05)。直接观察组接触患者前、无菌操作前、接触周围物品后的手卫生执行率与隐蔽观察组相比均升高,差异有统计学意义(P＜0.05)。结论: 受直接观察法下霍桑效应影响的医务人员的手卫生执行率有所提高,但仍需进一步加强对医务人员手卫生管理,尤其应重视针对不同岗位人员的个性化管理。

Objective: To explore Hawthorne effect on the hand hygiene compliance of health care workers (HCWs) in intensive care unit, and to provide reference for the rational use of Hawthorne effect to strengthen the hand hygiene management in medical institutions in the future. Methods: The difference of compliance between direct observation method and concealed observation method was compared. The data were imported and exported using application program of sensor-controlled workplace. SPSS 26.0 was used for statistical analysis of the hand hygiene implementation rate of HCWs in the past one years. Results: The hand implementation rate in the concealed observation group was 81.8% from July 2020 to December 2020, and that of the direct observation group was 88.0% from January 2021 to June 2021, with statistical significance (P＜0.05). In the concealed observation group, the highest rate of hand hygiene was 90.3% for nurses, 74.3% for medical staff, 50.2% for medical technic staff, and 60.5% for other workers. In the direct observation group, the rate of hand hygiene rose to 93.6% for nurses and 84.0% for medical staff. The hand hygiene implementation rate of medical technic staff increased to 80.0%, and that of other staff increased to 87.0%, with statistical significance between the two groups (P＜0.05). The hand hygiene implementation rate of the direct observation group before contacting with patients, before aseptic operation and after contacting with surrounding objects was higher than that of the concealed observation group, and the difference was statistically significant (P＜0.05). Conclusion: The hand hygiene implementation rate of medical staff affected by Hawthorne effect under direct observation has been improved, but it is still necessary to further strengthen the hand hygiene management of medical staff, especially the personalized management of staff on different positions.