Infraestrutura e adesão à higienização das mãos: desafios à segurança do paciente

Abstract

Considering the importance of hands in the chain of transmission of microorganisms, this observational research investigated the material infrastructure and compliance of hand hygiene in an intensive care unit in the south of Brazil in 2010. The data was collected by direct non-participant observation and through the use of self-administered questionnaires to be completed by the 39 participants, which was analyzed with the assistance of the chi2 Test, descriptive statistics and quantitative discourse analysis. Although health professionals overestimate compliance rates, recognize the practice as relevant to the prevention of infection and refer there are no impeding factors, of the 1,277 opportunities observed, compliance was 26% and significantly lower before patient contact and the use of aseptic procedures than after patient contact: infrastructure was shown to be deficient. The results indicate risk to patient safety, and thus, the planning of corrective actions to promote hand washing is relevant.

Adesão Da Equipe De Enfermagem Na Higienização Das Mãos Em Unidade De Terapia Intensiva Neonatal E Pediátrica

“…In Paraná, also in adult ICU, an observational study investigated three professional categories. After analyzing the opportunities and professionals' adherence to the 5 moments of HH, it was found higher adherence to the moments 3 and 4 than to the moments 1 and 2 (14) . It is important to point that the ICU environment, adult or not, receive critically ill patients presenting an increased risk of infections.…”

“…Thus, it can be inferred that the patient has been exposed to a high risk of infection in approximately 50% of the invasive procedures. Research about HH also in Neonatal ICU, shows that low compliance of the HH implies in a high risk of transmission of pathogens that causes infections to babies and also poses a great challenge for the infection-control service (14) . In the pediatric ICU, the total adherence to HH among professional categories was of the assistant at all moments, except in moment 5.…”

“…Between the working shifts, moments 1 (85.7%), 2 (85.7%), and 5 (57.1%) had better adherence by the morning shift; the moment 3 (100%) by the afternoon shift and the moment 4 had high adherence by the night shift (90.9%). In Paraná, observational study in adult ICU investigated HH opportunities, reporting adherence of 26.5% and 73.5% of non-compliance; between shifts, the adherence was 28.6% in the morning, 22.8% in the afternoon and 28.8% in the night (14) . It may be noted by data presented that, although in some moments, the nursing team showed low adherence (7.1% -moment 5), and by category, assistants and nurses, often present 0% to HH adherence; in other moments, there are high adherence rates such as in moment 1 (100%) by the team in the Neonatal ICU.…”

Assistência de enfermagem e o enfoque da segurança do paciente no cenário brasileiro

“…In another study, a greater adhesion to the practice (44.52%) occurred after the contact with the patient (BaTHKe et al, 2013).…”

Knowledge of Nursing and Physiotherapy Students on Hand Hygiene

“…Foi apresentada a pesquisa e entregues os questionários aos que contemplaram os crité- Estudos com médicos, enfermeiros, técnicos de enfermagem e fisioterapeutas em UTIs que avaliaram a adesão à HM concluíram que esta era realizada mais como uma medida de proteção individual, quando comparada àquelas relativas à proteção do paciente, na medida em que a adesão foi maior após o contato com o paciente. 19,20 Pesquisa denota que os profissionais de saúde estão expostos ao risco de infecções pelo contato direto com o paciente e seu ambiente. Entretanto, quando o contato envolve fluidos corporais, como regiões potencialmente contaminadas, a adesão à HM aumenta, o que está relacionado à busca do autocuidado por parte dos profissionais.…”