Objective: Evaluate, from the literature, the effectiveness of the implementation of the multimodal strategy for health professionals compliance with Hand Hygiene and its sustainability over time. Method: Integrative review, with a view to answering the following question: “Is the implementation of the multimodal strategy effective in health professionals compliance with Hand Hygiene and can it be sustained over time?”. The MEDLINE, SCOPUS, LILACS and CINAHL databases were used to retrieve the primary articles. Results: Twenty-five studies were analyzed. Among the components of the multimodal strategy, three need to be better worked: health education, feedback from practices and management involvement. Although it needs to focus more on its five elements, interventions based on the multimodal strategy have favored HH compliance and its long-term sustainability. Conclusion: The strategy proved to be effective for HH compliance, especially when all integrating components are adequately addressed.
Aims and objectives The rates of healthcare‐associated infections are high around the world. Hand hygiene is considered the most effective measure to reduce the transmission of pathogens in the hospital environment. Our objective was to evaluate adherence to hand hygiene in critical units of a tertiary‐level hospital in Central‐West Brazil. Design Observational study employing cross‐sectional data. Reporting rigour was demonstrated using the STROBE checklist. Methods Observation of hand hygiene practices of 129 professionals from the health team, including nursing staff, physicians and physical therapists. Data collection was carried out using the World Health Organization form. Results A total of 3,025 hand hygiene opportunities were observed, and the overall rate of adherence was only 46.25%. There was a greater frequency of hand hygiene after risk of exposure to bodily fluids and after contact with patients, 60.80% and 53.45%, respectively. Nurses obtained a higher rate of adherence to hand hygiene (59.80%). The neonatal ICU had a higher rate of adherence to hand hygiene when compared to other sectors. Conclusions The physical structure for hand hygiene in the institution was poor, and no professionals reached the minimum time required for execution of hand hygiene techniques. There were low rates of adherence to hand hygiene by professionals at all five times and in all categories and sectors observed, which may have been influenced by poor infrastructure present in the institution. Relevance to clinical practice This study is of great relevance to patient safety, given the rates of healthcare‐associated infections worldwide, with emphasis on underdeveloped countries. It is hoped that the results of this research can guide organisations to validly and systematically evaluate adherence to hand hygiene and achieve higher rates of adherence to hand hygiene and consequently reduce the number of infections in health environments.
Objetivou-se avaliar o clima de segurança entre trabalhadores de saúde de ambientes obrigatórios e a percepção de gestores sobre as práticas de higiene das mãos. Trata-se de um estudo transversal e analítico, realizado com profissionais de saúde (n = 142) e gestores (n = 54) de um hospital público. A equipe assistencial respondeu ao Questionário de Atitudes de Segurança ( SAQ ) e os gestores responderam ao pedido recomendado pela OMS sobre higiene das mãos. Observou-se que a percepção de clima de segurança esteve comprometida em todos os domínios adquiridos, com pior avaliação para a Percepção de conteúdo. Para os gestores há pouco comprometimento dos profissionais de saúde com a prática de higiene das mãos e além disso, 37% dos gestores não acreditam que a participação do paciente seja ação eficaz na melhoria dessa prática. Constatou-se que o clima de segurança deficitário e a percepção limitada sobre higiene das mãos é uma dualidade que pode comprometer a segurança do paciente.
Introduction: The aim of this study was to monitor adherence to hand hygiene by health professionals working in critical sections and to assess the factors that influenced adherence, such as physical structure of the units, use of procedure gloves, employment bond of the worker, and perception of patient safety climate. Methodology: Observational and correlational study carried out in critical areas of a university hospital in the Midwest region of Brazil. Results: The overall hand hygiene adherence rate was 46.2% (n = 3,025). Adherence was higher among nurses 59.8% (n = 607) than among nursing technicians (p < 0.001), and the section with the greatest adherence was the neonatal Intensive Care Unit 62.9% (n = 947) (p < 0.001). Unlike the neonatal unit, in the adult unit the dispensers of alcohol-based handrubs were poorly located, without arms reach, and the taps were manual. In this section, a greater frequency of procedure glove use was also observed, 90.6% (n = 536), as compared to the other sections (p < 0.001). Regarding safety climate perception, temporary employees had higher means as compared to regular employees (p = 0.0375). Conclusions: Hand hygiene adherence was affected and/or influenced by the physical structure, use of procedure gloves, work regime, and patient safety climate.
Objetivo: Avaliar a percepção da equipe de enfermagem sobre o clima de segurança organizacional em um hospital que é referência na região metropolitana da capital de Mato Grosso, Brasil, e verificar se houve diferença estatisticamente significante na percepção do clima de segurança organizacional entre as categorias dos auxiliares, técnicos de enfermagem e enfermeiros. Método: Estudo descritivo, transversal, com profissionais da enfermagem, por meio do questionário autoaplicável Safety Attitudes Questionnaire (SAQ), adaptado e validado para o Brasil. Resultados: A amostra foi composta por 139 profissionais de enfermagem. A média dos domínios do SAQ variou entre 42 a 73 pontos, classificada como baixa. A avaliação dos domínios evidenciou as menores médias para condições de trabalho e percepção da equipe de enfermagem sobre a gerência da unidade e gerência do hospital, respectivamente. Conclusão: Foi verificado baixa percepção do clima de segurança na instituição, visto que não foi alcançado escore satisfatório em nenhum dos domínios investigados, exceto para o domínio satisfação do trabalho, ainda assim, de forma limítrofe. Dessa forma, percebeu-se o distanciamento da administração do hospital e da gestão da unidade em atividades relacionadas à segurança do paciente, o que pode influenciar diretamente na adesão a comportamentos seguros pelos profissionais da equipe e diminuir a qualidade da assistência. Objetivo: Evaluar la percepción del equipo de enfermería del clima de seguridad organizacional en un hospital que es referencia en la región metropolitana de la capital de Mato Grosso, Brasil, y verificar si hubo diferencia estadísticamente significante en la percepción del clima de seguridad organizacional entre las categorías de los auxiliares, técnicos de enfermería y enfermeros.Método: Estudio descriptivo, transversal, con profesionales de enfermería, por medio del cuestionario auto aplicable Safety Attitudes Questionnaire (SAQ), adaptado y validado para el portugués del Brasil.Resultados: La muestra estuvo compuesta por 139 profesionales de enfermería. El promedio de los dominios del SAQ varió entre 42 a 73 puntos, clasificada como baja y la evaluación de los dominios evidenció las menores medias para condiciones de trabajo y percepción del equipo de enfermería sobre la gerencia de la unidad y gerencia del hospital, respectivamente.Conclusión: Se verificó una baja percepción del clima de seguridad en la institución, ya que no se alcanzó un puntaje satisfactorio en ninguno de los dominios investigados, excepto para el dominio satisfacción del trabajo, aún así, de forma limíte. De esta forma, se percibió el distanciamiento de la administracion del hospital y de la gerencia de las unidades relacionadas con la seguridad del paciente, lo que puede influir directamente en la adhesión a comportamientos seguros por los profesionales del equipo de salud y disminuir la calidad de la asistencia. Objective: To evaluate the perception of the nursing team regarding the organizational safety climate in a referral hospital in the metropolitan region of the capital of Mato Grosso, Brazil, and to verify whether there were statistically significant differences in the perception of the organizational safety climate among the nursing assistant, nursing technician and nurse categories. Method: A descriptive, transversal study with nursing professionals, using the self-administered Safety Attitudes Questionnaire (SAQ), adapted and validated for Brazil. Results: the sample consisted of 139 nursing professionals. The mean of the SAQ domains ranged from 42.07 to 73.13 points, classified as a poor perception. The evaluation of the domains evidenced lower means for working conditions and perception of management of the unit and of the hospital, respectively.Conclusion: There was a low perception of the organizational safety climate in the institution, since a satisfactory score was not achieved in any of the domains investigated, with the exception of the job satisfaction domain, although, in a borderline manner. In this way, it was possible to perceive the distancing of the hospital and unit management from activities related to patient safety, which can directly influence adherence to safe behaviors by the professionals of the team and decrease the quality of the care.
Background: We aimed to monitor hand hygiene (HH) of health professionals in three critical sectors of a university hospital, to verify the physical structure of these units for HH, gloves use and perception of professionals regarding the patient's safety climate Methods: An observational, correlational study, conducted in critical sectors of a hospital. The study population consisted of nurses, nursing technicians, physicians, resident physicians and physiotherapists. The data were collected through four questionnaires to evaluate HH, factors related to adherence to it and sociodemographic characteristics. Results: A total of 148 professionals and 3.025 opportunities for HH were observed. Adherence to HH was higher among nurses when compared to nursing professionals (p <0.05), and there was a difference between different sectors (p <0.05). Professionals who previously participated in training had greater adherence (47.79% CI95% 45.38-50.20) to HH than professionals who did not participate (44.62% CI95% 41.95-47.29). There was a statistical difference between the perception of the security climate and the type of employment bond of the professional, as well as the sector in which it operates. Conclusion: Adherence to HH was affected and / or influenced by the physical structure, use of procedure gloves, work regimen and perceived patient safety climate. Keywords: Hand hygiene; Cross Infection; Patient Safety; Safety culture
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