Adherence to hand hygiene in critical sectors: Can we go on like this?

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.

Instruments for evaluating compliance with infection control practices and factors that affect it: an integrative review.

AIMS AND OBJECTIVES: To search for instruments to measure compliance with infection control practices and to report on which dimensions and contents the instruments evaluate, their psychometric characteristics, compliance and factors influencing compliance. BACKGROUND: Low compliance with infection control practices has been reported among healthcare professionals around the world over the years. Existing data concerning health professionals' compliance with standard precautions are based on measuring instruments. DESIGN: Integrative review. METHODS: The descriptors were identified and used separately and in combination to search in the following databases: Lilacs, PubMed (MEDLINE), ISI Web of Knowledge, Scopus and CINAHL. The selected articles complied with inclusion and exclusion criteria. RESULTS: Twenty-three studies were analysed, resulting in the identification of 18 instruments. No instrument addressed all compliance topics, and the most commonly addressed topics were the use of personal protective equipment, hand hygiene and safe practices in the handling of cutting material. Most authors explored content validity and some performed reliability analysis by means of Cronbach's alpha and test-retest. Countries in the sample have different human development indices, and countries with medium and low human development indices show less compliance. Some variables were strong predictors of compliance: training, perceptions of safe environment, perception of obstacles to comply with standard precautions and knowledge. CONCLUSIONS: Compliance is below the recommended levels. Health professionals seem to be selective in following standard precautions. Significant influences include institutional management and psychosocial variables, which deserve further study. RELEVANCE TO CLINICAL PRACTICE: Health managers and government policies and interventions should pay greater attention to this subject.

Hand hygiene compliance in a Brazilian COVID-19 unit: the impact of moments and contact precautions.

BACKGROUND: Healthcare-associated infections are among the most common complications during hospitalization. These infections increase morbidity and mortality and they increase length of hospital stay and the cost of healthcare. The aims of our study were to monitor hand hygiene (HH) compliance, HH technique quality and factors related to HH practice among health professionals in a COVID-19 Intensive Care Unit (ICU). METHODS: An observational, prospective study. Between September and December 2021, we observed 69 healthcare professionals in an eight-bed ICU for patients with COVID-19 in midwestern Brazil. We used the WHO observation form to collect data. The dependent variable was HH compliance and independent variables were professional category, sex, HH quality (3-step technique for at least 15 s), number of HH opportunities observed, observation shift and inappropriate glove use. RESULTS: We observed 1185 HH opportunities. The overall compliance rate was 26.4%, but only 6.5% were performed with the correct 3-step technique for the minimum time. HH compliance was considerably lower for moments "before" tasks (6.7%; 95% CI 4.8%, 9.2%) compared with moments "after" tasks (43.8%; 95% CI 39.9%, 47.8%). The logistic model found that inappropriate glove use, night shift and physicians (p < 0.001) were associated with low HH compliance. The infrastructure analysis found that the unit had an insufficient number of alcohol-based handrub (ABHR) dispensers at the point of care and that the mechanism for activating them was poorly designed. CONCLUSIONS: HH compliance was very low. Inappropriate glove use was associated with low compliance and the unit's infrastructure did not support good HH practice. The fact that healthcare professionals were more likely to do HH after tasks, suggests that they use HH to protect themselves rather than the patients. Adequate infrastructure and ongoing health education with a focus on HH while caring for patients in contact precautions are essential for improving HH compliance and patient safety.

Occurrence of musculoskeletal disorders, burnout, and psychological suffering in Brazilian nursing workers: A cross-sectional study.

Background: Musculoskeletal disorders (MSDs) pose a pervasive concern among nursing professionals due to the high physical workload. Simultaneously, the complex relationship between MSDs and mental health outcomes in this population remains an area of significant interest and importance. Objective: This study aimed to investigate the occurrence of MSDs and their relationships with burnout and psychological suffering within the nursing workforce. Methods: A cross-sectional study was conducted in 2020 involving 291 nursing professionals in Brazil. Standardized questionnaires were employed to gather information on MSDs, mental health outcomes, and pertinent work-related factors. Robust statistical analyses were conducted to ascertain the prevalence of MSDs, establish associations between MSDs and mental health outcomes, and delineate the influence of work-related factors on these associations. Statistical analysis was performed using the R software. Results: The study revealed a significant prevalence of musculoskeletal injuries (MSIs) among nursing workers, focusing on regions that include the lower back, upper back, neck, and shoulders. Individuals with MSIs in the lower back showed a marked increase in emotional exhaustion (p = 0.02), as did those with MSIs in the upper back (p <0.01) and depersonalization (p = 0.07). On the other hand, nursing professionals who reported MSIs in the neck and shoulders had considerably higher scores in emotional exhaustion (p <0.01 and p = 0.01, respectively) and depersonalization (p = 0.05 and p = 0.05, respectively). However, no significant correlations emerged between MSIs and depression or work-related factors. Conclusions: This study highlights the urgency of implementing proactive measures to prevent and manage MSDs within the nursing profession. Moreover, it emphasizes the critical need to enhance working conditions and provide robust support mechanisms to safeguard the mental health of nursing professionals.Open AccessOpen Access.

[Cultural adaptation of "Questionnaires for Knowledge and Compliance with Standard Precaution" to Brazilian Portuguese]. / Adaptação cultural do "Questionnaires for Knowledge and Compliance with Standard Precaution" para o Português Brasileiro.

The aim of this study was to adapt the "Questionnaires for Knowledge and Compliance with Standard Precaution" to Brazilian Portuguese. This was a methodological study with the following steps: 1) initial translations; 2) synthesis of translations; 3) analysis by a committee of experts; 4) back translation; 5) semantic validation; and 6) pretest. The sample was composed of 42 nurses, 12 of which participated in the semantic validation, and 30 of which participated in the pretest. The study was conducted in a teaching hospital in the state of São Paulo, Brazil. The semantic validation showed that the questionnaires are understandable, easy to complete, and appropriate in regard to knowledge and compliance with standard precautions. The pretest confirmed the final version. Therefore, the process of cultural adaptation was shown to be satisfactory, and the questionnaires are adapted to Brazilian Portuguese, and their process of validation should be continued to test the psychometric characteristics. After that, the instruments will be ready for use in Brazil.

Common mental disorders, productivity and presenteeism in nursing workers.

OBJECTIVE: To investigate the association between the occurrence of common mental disorders with loss of productivity and presenteeism in nursing workers at a public health service. METHOD: This is a cross-sectional study, with 291 workers from Midwestern Brazil. Data collection carried out from October 2019 to January 2020, with instruments for sociodemographic characterization, labor and health conditions: Self Reporting Questionnaire-20, Standford Presenteeism Scale and Work Limitations Questionnaire. Data were analyzed using descriptive and inferential statistics, with Mann-Whitney tests and logistic regression, respecting a significance level of 5%. RESULTS: The occurrence of common mental disorders was 4.27 times more likely to experience presenteeism, 10.17% of compromised overall productivity, and impairment of mental/interpersonal and production demands. CONCLUSION: The occurrence of common mental disorders was associated with presenteeism, with repercussions in loss of productivity of nursing workers.

Impact of an educational intervention on standard precautions during the COVID-19 pandemic.

OBJECTIVE: To evaluate the impact of an educational intervention on the knowledge of nursing professionals regarding standard precautions. METHODS: This is an almost experimental study conducted with 100 nursing professionals. Data collection was performed using a sociodemographic characterization instrument and the Standard Precautions Knowledge Questionnaire. The educational intervention was based on five moments, where the approach to questions with less than 70% accuracy was intensified. RESULTS: There was a significant difference between the scores of healthcare professionals before (16.20 ± 1.51) and after (16.90 ± 1.31) the educational intervention (W=3.336; p < 0.05). Regarding knowledge about hand hygiene after glove use, an increase in knowledge from 83% to 93% was obtained. CONCLUSIONS: A positive effect on the professionals' knowledge was recorded, demonstrating advances regarding the strengthening of already acquired knowledge and the understanding of new knowledge.

Adherence to standard precautions by nursing professionals in a public university hospital: a cross-sectional study.

INTRODUCTION: The aim of this study was to analyze the adherence to standard precautions by nursing professionals in a public university hospital, and to identify associated factors. METHODOLOGY: This was a cross-sectional study with the nursing staff of a public university hospital. The participants provided sociodemographic and immunization data, training data on standard precautions and occupational accident history, and responded to the questionnaire on adherence to standard precautions (QASP). Descriptive data analysis and Pearson's Chi-square test (χ²) were performed, followed by Fisher's exact test to verify the association between the adherence to standard precautions (total score ≥ 76 points) and the sample characterization variables. Additionally, binary logistic regression indicated the odds ratio (OR) of the sample characterization variables for adherence to standard precautions. A p value ≤ 0.05 was considered statistically significant. RESULTS: The average score for adherence to standard precautions, through QASP, by nursing professionals evaluated was 70.5 points. Association between the adherence to standard precautions and the professionals' sample characterization variables was not identified. However, it was observed that experienced professionals (≥15 years of experience in the institution) were more likely to adhere to standard precautions (OR 0.062; IC95% [0.006-0.663]; p = 0.021). CONCLUSIONS: In general, the adherence to standard precautions by nursing professionals working in health service in this study can be considered inadequate, highlighting major weaknesses in hand hygiene practices, use of personal protective equipment (PPE), recapping of used needles, and conduct after suffering occupational accidents. Experienced professionals were more likely to adhere to standard precautions.

Monitoring of surface cleaning and disinfection in a Brazilian pediatric unit.

Background: Understanding the correlation between the methods of monitoring surface cleaning and disinfection (SCD) is fundamental for better infection control. Purpose: This study aims to correlate the SCD monitoring methods in a Brazilian pediatric unit. This is an exploratory, longitudinal, and correlational study. Methods: The study was conducted in a pediatric hospitalization unit of a medium-sized hospital from December 2020 to March 2021. Four high-contact surfaces were analyzed before and after the cleaning and disinfection process by means of visual inspection, quantification of adenosine triphosphate (ATP), and colony-forming unit (CFU) count. The study consisted of three stages: stage I involving situational diagnosis of the SCD process; stage II referring to the implementation of the Surface Cleaning and Disinfection Standardization Program (SCDSP); and stage III involving long-term assessment after implementing the program. A total of 192 assessments were performed in each stage, totaling 576 in the three study stages. Conclusions: A significant correlation was found between the ATP quantification methods and microbial count in the bed railing (p = 0.009) and companion's armchair (p = 0.018) surfaces. In both cases, Spearman's correlation coefficients were positive, indicating a positive correlation between ATP and microbial count scores, that is, the higher the ATP values (in RLUs), the greater the microbial counts (in CFUs/cm2). The analysis of the ROC curves suggests that the surfaces presenting ATP below 108 RLUs can be considered approved. The ATP method yielded 78.6% sensitivity; in turn, microbial count presented a sensitivity of 85.7%. It is important to use different methods to monitor the cleaning and disinfection of surfaces, as each one has different sensitivity and specificity.

Knowledge of and adherence to standard precautions in a hemodialysis unit: a cross-sectional study.

BACKGROUND: Standard precautions (SPs) are recommended safety measures for healthcare professionals to follow, with a view to preventing healthcare-related infections (HCRIs) and for their own protection. Inadequate adherence to these measures can lead to occurrences of occupational accidents and HCRIs. OBJECTIVES: To ascertain the knowledge of and adherence to SP measures among the nursing staff of a hemodialysis service and the relationship of these variables to occurrences of work accidents with biological material. DESIGN AND SETTING: Descriptive cross-sectional and correlational study with a quantitative approach developed in a hemodialysis clinic in Minas Gerais. METHODS: Data were collected through sociodemographic questionnaires and questionnaires on knowledge of and adherence to SPs. RESULTS: 29 professionals participated in the study. It is noteworthy that all of them had already participated in training related to SPs. However, no relationship was identified between knowledge of (15.17 points) and adherence to (71.86 points) SPs. In addition, inferential analysis showed that there was a relationship between suffering a work accident with biological material and the sociodemographic data and knowledge of and adherence to standard precautions. CONCLUSION: Knowledge of the SPs that had been established did not mean mastery of the subject. Despite positive results regarding adherence, factors requiring improvement were observed. It was possible to infer the characteristics that gave rise to greater risk of occurrences of accidents at work. Thus, this study showed the importance of assessing knowledge of and adherence to SP, in order to optimize and direct continuing education towards resolving occupational exposure.

Factors associated with presenteeism in nursing workers.

OBJECTIVE: to analyze factors associated with presenteeism in nursing workers with sociodemographic variables, health and work conditions, productivity and musculoskeletal symptoms. METHODS: this is a cross-sectional, descriptive and analytical study, with 306 nursing workers from a hospital and municipal emergency room in a Brazilian capital. The Stanford Presenteeism Scale, the Work Limitations Questionnaire, the Nordic Musculoskeletal Questionnaire and a demographic questionnaire on nursing professionals' working conditions and health were used. Bivariate and multivariate analyzes were performed, respecting a significance level of 5%. RESULTS: presenteeism was found in 43.8% of professionals and significant associations with CLT work (p=0.002), workplace - Intensive Care Units (p=0.008), physical exercise twice a week (p=0.008), presence of musculoskeletal symptoms, with low back pain being representative (p=0.001). The productivity loss was 8.8. CONCLUSIONS: the study confirms a high rate of presenteeism among nursing workers.

Factors associated to suicide risk in stricto sensu postgraduate students: a cross-sectional study.

OBJECTIVE: to analyze factors associated to suicide risk in postgraduate students. METHOD: a cross-sectional analytical study, developed with 565 stricto sensu postgraduate students from August to September 2019. Data collection took place using a validated instrument containing demographic, socioeconomic, health and academic variables; as well as variables of Module C of the Mini International Neuropsychiatric Interview (MINI), version 5.0; of the CAGE (Cut down, Annoyed by criticism, Guilty and Eye-opener) questionnaire; and the Depression, Anxiety and Stress Scale (DASS-21). Descriptive and multiple statistical analysis was performed using the Poisson regression model, with a significance level of 5%. RESULTS: 40.8% prevalence of current suicide risk. The following variables were associated to current suicide risk: age > 30 years old (p=0.029), absence of faith (p=0.015), depression (p<0.001) and anxiety (p=0.018) symptoms, use of psychotropic drugs during the course (p<0.001), not having a meaningful and inspiring academic work (p=0.013), not having a good relationship with colleagues from the postgraduate school (p=0.033), having family relationship impaired by the demands of the postgraduate school (p=0.036) and concern about the financial situation (p=0.048). CONCLUSION: a high prevalence of current suicide risk was identified among postgraduate students, as well as a significant association of this risk with demographic, socioeconomic, academic and health variables.

Influencing factors of hand hygiene in critical sections of a brazilian hospital.

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.

Construct and Criterion Validity of the Postmenopause Sexuality Questionnaire - PMSQ.

OBJECTIVE: To assess the construct and criterion validity of the Postmenopause Sexuality Questionnaire (PMSQ). METHODS: The present methodological questionnaire validation study included postmenopausal women. The construct validity was tested by factor analysis and the criterion validity was performed using the correlation between the PMSQ and the Female Sexual Function Index (FSFI). The ROC curve was used to verify sensitivity, specificity and to determine the cutoff point of the PMSQ. RESULTS: A total of 181 women with a mean age of 56.4 ± 5.7 years old were evaluated. The exploratory factor analysis showed that the PMSQ presented Kaiser test = 0.88 and χ2 = 3293.7 (p < 0.001), commonalities ≥ 0.5, and extraction of 9 factors with eigenvalue ≥ 1; explaining 66.3% of the total variance. The PMSQ presented factor loadings between 0.4 and 0.8. A strong correlation between the 2 questionnaires (r = 0.79; p = 0.000) was shown. The cutoff point of the PMSQ was ≤ 55.5, assuming 87.9% sensitivity and 78.9% specificity (p < 0.001). CONCLUSION: Since the PMSQ showed a strong correlation with the FSFI questionnaire, it presented good psychometric properties to assess the sexuality in postmenopausal women. Based on these results, the PMSQ could be widely tested as a specific instrument to examine the sexual function in postmenopausal women. Future studies, designed to examine the PMSQ instrument in different populations, are needed.

OBJETIVOS: Validar o construto e o critério do Questionário para Avaliação da Sexualidade Feminina após a Menopausa (QSFM). MéTODOS: Estudo metodológico de validação de questionário incluiu mulheres na pós-menopausa. A validade de construto foi testada por meio da análise fatorial e a validade de critério foi realizada por meio da correlação entre o QSFM e o Índice de Função Sexual Feminina (FSFI). A Curva ROC foi utilizada para verificar sensibilidade, especificidade e determinar o ponto de corte do QSFM. RESULTADOS: Foram avaliadas 181 mulheres, com idade média de 56,4 ± 5,7 anos. A análise fatorial exploratória mostrou que o QSFM apresentou teste de Kaiser = 0,88 e χ2 = 3293,7 (p < 0,001), comunalidades ≥ 0,5 com extração de nove fatores com autovalor ≥ 1; explicando 66,3% da variância total. O QSFM apresentou cargas fatoriais entre 0,4 e 0,8. Uma forte correlação entre os dois questionários (r = 0,79; p = 0,000) foi demonstrada. O ponto de corte do QSFM foi ≤ 55,5, assumindo sensibilidade de 87,9% e especificidade de 78,9% (p < 0,001). CONCLUSãO: Como o QSFM demonstrou uma forte concordância com o questionário FSFI, ele apresentou boas propriedades psicométricas para avaliar a sexualidade em mulheres na pós-menopausa. Com base nesses resultados, o QSFM pode ser amplamente utilizado como um instrumento específico para examinar a função sexual em mulheres na pós-menopausa. Estudos futuros são necessários para examinar o instrumento QSFM em diferentes populações.

Factors associated with health dissatisfaction of elementary school teachers.

OBJECTIVE: To evaluate factors associated with health dissatisfaction of public elementary school teachers. METHODS: Cross-sectional study conducted among teachers from a Midwest capital, in 2017. A self-administered questionnaire composed of a collection of validated instruments and additional questions was used. Poisson Regression was performed, considering significance p <0.05. RESULTS: sample composed of 326 teachers, with an average age of 43 years, 87.1% female. Concerning health conditions, 19.5% were dissatisfied and 31.5% were indifferent. In a simultaneous analysis of the factors of interest, a statistically significant association was found among teacher's health dissatisfaction and the presence of symptoms of common mental disorders (PRa= 2.28), musculoskeletal symptoms in the last 12 months (PRa= 1.71), voice disorders (PRa= 1.29), never/rarely waking up rested (PRa= 1.45), never/rarely engage in physical activity/sports (PRa= 1.57), among other factors. CONCLUSION: never/rarely waking up rested and engaging in physical activity/sports, the presence of common mental disorders, musculoskeletal symptoms and voice disorders were associated with health dissatisfaction.

Localization of the SureWash Pocket® mobile health app to Brazilian Portuguese.

OBJECTIVES: To localize the textual interface of the SureWash Pocket® mobile health app and to present the methodological experience used in the localization process. METHOD: Software localization study to Brazilian Portuguese. The localization process was carried out between December 2018 and June 2019 in the city of Cuiabá/MT, through six steps: permission to localize the software; two independent translations; synthesis of translations; evaluation of the validity of the textual interface by a Committee of Expert Judges; back translation; and publication. RESULTS: The textual interfaces were organized into 107 items and analyzed by ten expert judges. In the first round, 64% of the items reached a pre-established minimum agreement level of 90%. During the second round, 39 remaining items were adapted according to consensual suggestions and the pre-final version was consolidated. CONCLUSION: The localization process suggests that the localized SureWash Pocket® is considered valid and can be used for an educational intervention on hand hygiene.

Hospital obstetric practices and their repercussions on maternal welfare. / Práticas obstétricas hospitalares e suas repercussões no bem-estar materno.

OBJECTIVE: To analyze the association of care practices performed by obstetric professionals with maternal welfare/malaise levels. METHOD: A quantitative study conducted in a Prepartum/Childbirth/Postpartum Unit of a Teaching Hospital with puerperal women who underwent vaginal births. An association was performed between obstetric practices and maternal welfare/malaise levels. RESULTS: There were 104 puerperal women who participated. Obstetric practices which caused mothers to feel unwell and which obtained statistical significance were: amniotomy (p = 0.018), episiotomy (p = 0.05), adoption of horizontal positions in the expulsive period (p = 0.04), the non-use of non-invasive care technologies (p = 0.029), and non-skin-to-skin contact between mother and child (p = 0.002). For most women, the presence of a companion favored welfare, even though it did not have a statistically significant association. After performing logistic regression, non-performance of amniotomy was the only variable which showed significance in maternal welfare. CONCLUSION: Humanized obstetric practices have greater potential to promote maternal welfare. The importance of obstetric nurses conducting practices which provide greater welfare to mothers is emphasized.

Adesão à técnica de higiene das mãos: estudo observacional / Adhesión a la técnica de higiene de manos: estudio observacional / Adherence to hand hygiene technique: an observational study

Resumo Objetivo Verificar a adesão e a qualidade da técnica de higiene das mãos realizada por profissionais de saúde nos momentos preconizados e identificar os fatores impactantes. Métodos Estudo observacional, com 41 profissionais de Unidade de Terapia Intensiva Adulto de um hospital de ensino brasileiro. A coleta de dados foi de setembro a dezembro de 2021, utilizando questionário sociodemográfico e formulário de observação da Organização Mundial da Saúde. Foram aplicados testes estatísticos de análise binomial e modelo de regressão logística de efeitos mistos e adotou-se nível de significância de 0,05. Resultados Um total de 1.055 oportunidades de Higiene das Mãos foram observadas, a taxa de adesão foi de 23,98% e pode-se verificar que os profissionais não executaram a técnica preconizada. O teste binomial verificou maior adesão aos momentos "após" quando comparados aos momentos "antes" (p< 0,001) e foi constatado impacto negativo do uso de luvas (p< 0,001). O modelo logístico reforçou a maior adesão nos momentos "após". Ainda que a adesão esteja baixa entre todas as categorias profissionais, o modelo logístico demonstrou mais chances de higiene das mãos pelos enfermeiros. Conclusão A adesão à higiene das mãos foi consideravelmente baixa principalmente considerando a técnica adequada. Foi verificado impacto negativo do uso de luvas na adesão higiene das mãos. Os profissionais demonstraram maiores chances de aderirem a higiene das mãos nos momentos "após" quando comparados aos momentos "antes".

Resumen Objetivo Verificar la adhesión y la calidad de la técnica de higiene de manos realizada por profesionales de la salud en los momentos recomendados e identificar los factores impactantes. Métodos Estudio observacional con 41 profesionales de una unidad de cuidados intensivos adulta de un hospital universitario brasileño. La recopilación de datos se realizó de septiembre a diciembre de 2021, mediante un cuestionario sociodemográfico y un formulario de observación de la Organización Mundial de la Salud. Se aplicaron pruebas estadísticas de análisis binominal y el modelo de regresión logística de efectos mixtos, y se adoptó un nivel de significación de 0,05. Resultados Se observó un total de 1.055 oportunidades de higiene de manos. El índice de adhesión fue del 23,98 % y se pudo verificar que los profesionales no ejecutan la técnica recomendada. La prueba binominal verificó una mayor adhesión en los momentos "después" comparado con los momentos "antes" (p<0,001) y se constató un impacto negativo del uso de guantes (p<0,001). El modelo logístico reforzó la mayor adhesión en los momentos "después". Aunque la adhesión sea baja en todas las categorías profesionales, el modelo logístico demostró mayor probabilidad de higiene de manos por parte de los enfermeros. Conclusión La adhesión a la higiene de manos fue considerablemente baja, sobre todo si se considera la técnica adecuada. Se verificó un impacto negativo del uso de guantes en la adhesión a la higiene de manos. Los profesionales demostraron mayores probabilidades de adhesión a la higiene de manos en los momentos "después" comparado con los momentos "antes".

Abstract Objective To verify adherence and quality of hand hygiene techniques performed by health professionals at recommended times and identify impacting factors. Methods This is an observational study, with 41 professionals from the Adult Intensive Care Unit of a Brazilian teaching hospital. Data collection took place from September to December 2021, using a sociodemographic questionnaire and observation form from the World Health Organization. Statistical tests of binomial analysis and mixed-effects logistic regression model were applied, and a significance level of 0.05 was adopted. Results A total of 1,055 hand hygiene opportunities were observed; the adherence rate was 23.98%; and it can be seen that professionals did not perform the recommended technique. The binomial test verified greater adherence to moments "after" when compared to moments "before" (p< 0.001) and a negative impact of using gloves was found (p< 0.001). The logistical model reinforced greater adherence in moments "after". Even though adherence is low among all professional categories, the logistical model demonstrated more chances of hand hygiene by nurses. Conclusion Adherence to hand hygiene was considerably low, especially considering the appropriate technique. A negative impact of using gloves on hand hygiene adherence was verified. Professionals demonstrated greater chances of adhering to hand hygiene in the moments "after" when compared to moments "before".

Efficacy of the multimodal strategy for Hand Hygiene compliance: an integrative review.

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.

Assessment of the infrastructure of a COVID-19 unit and health professionals' perception about safety attitudes / Avaliação da infraestrutura de uma unidade COVID-19 e a percepção de profissionais de saúde sobre as atitudes de segurança / Evaluación de la infraestructura de una unidad COVID-19 y la percepción de los profesionales de la salud sobre las actitudes de seguridad

Background and objectives: does the COVID-19 Intensive Care Unit have a favorable structure to sanitize the hands of health professionals? What is the perception of health professionals about the organizational safety of that sector? It aims to assess the structure for hand hygiene in an Intensive Care Unit for patients with COVID-19 and the perception of safety attitude by health professionals. Methods: an analytical, cross-sectional study with 62 health professionals from a university hospital in the state of Mato Grosso, Brazil. The unit structure commands for hand alignment and safety attitudes were used. Results: flaws were found in the infrastructure that can hinder and prevent hand hygiene by professionals at the point of care. The safety attitude was impaired in all domains. No difference was found between the median scores regarding professional categories. Conclusion: investment is urgently needed in improving infrastructure with alcoholic preparation supply at the point of assistance. The study demonstrates the negative impact of the perception of low management involvement in patient safety actions and poor infrastructure for hand hygiene.(AU)

Justificativa e objetivos: a Unidade de Terapia Intensiva COVID-19 possui estrutura favorável para a higienização das mãos dos profissionais de saúde? Qual a percepção dos profissionais de saúde acerca da segurança organizacional do referido setor? Tem como objetivo avaliar a estrutura para higiene das mãos de uma Unidade de Terapia Intensiva destinada a pacientes com COVID-19 e a percepção da atitude de segurança pelos profissionais de saúde. Métodos: estudo analítico, transversal, com 62 profissionais de saúde de um hospital universitário do estado de Mato Grosso, Brasil. Foram utilizados os questionários de estrutura da unidade para higienização das mãos e o de atitudes de segurança. Resultados: constataram-se falhas na infraestrutura que podem dificultar e impedir a realização da higiene das mãos pelos profissionais no ponto da assistência. A atitude de segurança esteve prejudicada em todos os domínios. Não foi encontrada diferença entre as medianas dos escores com relação às categorias profissionais. Conclusão: se faz urgente o investimento na melhoria da infraestrutura com fornecimento de preparações alcoólicas no ponto da assistência. O estudo demonstra o impacto negativo da percepção do baixo envolvimento da gestão nas ações de segurança do paciente e infraestrutura precária para higiene das mãos.(AU)

Justificación y objetivos: ¿La Unidad de Cuidados Intensivos COVID-19 cuenta con una estructura favorable para la higiene de manos de los profesionales de la salud? ¿Cuál es la percepción de los profesionales de la salud sobre la seguridad organizacional en ese sector? Tiene como objetivo evaluar la estructura para la higiene de manos en una Unidad de Cuidados Intensivos destinada a pacientes con COVID-19 y la percepción de actitudes de seguridad por parte de los profesionales de la salud. Métodos: estudio transversal analítico con 62 profesionales de la salud de un hospital universitario en el estado de Mato Grosso, Brasil. Se utilizaron los comandos de la estructura de la unidad para la alineación de las manos y las actitudes de seguridad. Resultados: se encontraron fallas en la infraestructura que pueden dificultar e impedir la realización de la higiene de manos por parte de los profesionales en el punto de atención. La actitud de seguridad se vio afectada en todos los dominios. No se encontró diferencia entre las medianas de las puntuaciones con respecto a las categorías profesionales. Conclusión: urge invertir en mejorar la infraestructura con el suministro de preparados alcohólicos en el punto de atención. El estudio demuestra el impacto negativo de la percepción de una baja implicación de la dirección en las acciones de seguridad del paciente y una infraestructura deficiente para la higiene de manos.(AU)