Palavras-chave
desinfeção de mãos, serviços preventivos de saúde, higiene de mãos, prevenção de doença.
Como Citar
Observância da estratégia de higiene das mãos em ambientes assistenciais. (2020). Investigación En Enfermería: Imagen Y Desarrollo, 22. https://doi.org/10.11144/Javeriana.ie22.cehm
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Resumo
Introdução: Embora a higiene das mãos seja a medida mais importante na mitigação do risco biológico em ambientes hospitalares, tem evidência científica que mostra baixo cumprimento das recomendações entre trabalhadores assistenciais. Objetivo: Avaliar o cumprimento de cinco dimensões que fortalecem a estratégia de higiene das mãos para a prevenção do risco biológico em ambientes assistenciais. Método: Estudo observacional, de corte transversal, em cinco instituições prestadoras de serviços de saúde. Foi aplicada estatística descritiva. Com o Teste da Mediana avaliou-se se havia diferenças significativas entre o grupo de profissionais por instituição de saúde, considerando significante uma p ≤ 0,05. Finalizou-se com análise discriminante. Resultados: A representatividade ocorreu nas instituições hospitalares de primeiro nível onde a equipe de enfermagem, seguido pelos médicos, apresentou melhor cumprimento do protocolo de lavagem de mãos. Esse porcentual foi impactado pelo menor cumprimento do fornecimento de suprimentos e infraestrutura. Há uma perfeita diferenciação entre os resultados do município de Cali em relação aos de Caicedonia, em contraste com os de Popayán, Buga e Buenaventura. Conclusão: Encontrou-se não inobservância do protocolo de higiene das mãos, com qualificação inaceitável para os fatores de suprimentos/infraestrutura e técnica de higiene das mãos.
1. Li Shen, An J, An J, et al. Implementation of WHO multimodal strategy for improvement of hand hygiene: a quasi-experimental study in a Traditional Chinese Medicine hospital in Xi’an, China. Antimicrob Resist Infect Control. 2017;6:98. https://doi.org/10.1186/s13756-017-0254-4
2. Pereira EBS, Jorge MT, Oliveira EJ, Júnior ALR, Santos LRL, Mendes-Rodrigues C. Evaluation of the multimodal strategy for improvement of hand hygiene as proposed by the World Health Organization. J Nurs Care Qual. 2017;32(2):E11-9. https://doi.org/10.1097/ncq.000000000000019
3. World Health Organization. Report on the burden of endemic health care-associated infection worldwide [internet]. Geneva, Switzerland: WHO/Patient Safety; 2011. Disponible en: https://apps.who.int/iris/bitstream/10665/80135/1/9789241501507eng.pdf
4. Jia H, Hou T, Li W, Ma Q, Liu W, Yang Y, et al. Economic loss due to healthcare-associated infection in 68 general hospitals in China. Chinese J Infect Control. 2016;15:637-41. https://doi.org/10.1155/2019/2590563
5. Zimlichman E, Henderson D, Tamir O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med. 2013;173(22):2039-46. https://doi.org/10.1001/jamainternmed.2013.9763
6. Junior CN, Mello DS, Padoveze MC, et al. Characterization of epidemiological surveillance systems for healthcare-associated infections (HAI) in the world and challenges for Brazil. Cad Saude Publica. 2014;30(1):11-20. https://doi.org/10.1590/0102-311X00044113
7. Chen JK, Wu KS, Lee SS, et al. Impact of implementation of the World Health Organization multimodal hand hygiene improvement strategy in a teaching hospital in Taiwan. Am J Infect Control. 2016;44:222-7. https://doi.org/10.1016/j.ajic.2015.10.004
8. Musu M, Lai A, Mereu NM, et al. Assessing hand hygiene compliance among healthcare workers in six Intensive Care Units. J Prev Med Hyg. 2017;58(3):E231-7.
9. Valim MD, Rocha ILS, Souza TPM, Cruz YAD, Bezerra TB, Baggio É, Morais RB, Ribeiro AC. Efficacy of the multimodal strategy for hand hygiene compliance: an integrative review. Rev Bras Enferm. 2019 Apr;72(2):552-65. http://dx.doi.org/10.1590/0034-7167-2018-0584
10. Alshehari AA, Park S, Rashid H. Strategies to improve hand hygiene compliance among healthcare workers in adult intensive care units: a mini systematic review. J Hosp Infect. 2018;100(2):152-8. https://doi.org/10.1016/j.jhin.2018.03.01
11. Squeri R, Genovese C, Palamara MAR, Trimarchi G, La Fauci1 V. “Clean care is safer care”: correct handwashing in the prevention of healthcare associated infections. Ann Ig. 2016;28:409-15. https://doi.org/10.7416/ai.2016.2123
12. Teker B, Ogutlu A, Gozdas HT, Ruayercan S, Hacialioglu G, Karabay O. Factors affecting hand hygiene adherence at a private hospital in Turkey. Eurasian J Med. 2015;47(3):208-12. https://doi.org/10.5152/eurasianjmed.2015.78
13. Oliveira AC, Gama CS, Paula AO. Multimodal strategy to improve the adherence to hand hygiene and self-assessment of the institution for the promotion and practice of hand hygiene. J Public Health. 2018;40(1):163-8. https://doi.org/10.1093/pubmed/fdx035
14. Secretaría Distrital de Salud, Asociación Colombiana de Infectología Capítulo Central. Protocolo de lavado de manos limpias atención segura: estrategia multimodal para el mejoramiento de la higiene de lavado de protocolo de lavado de manos en Bogotá [internet]. Bogotá. Disponible en: http://www.saludcapital.gov.co/sitios/VigilanciaSaludPublica/Todo%20IIH/Estrategia%20Distrital%20Manos%20Limpias%20Atencion%20Segura.pdf
15. Organización Mundial de la Salud. Marco de autoevaluación de la higiene de las protocolo de lavado de manos 2010: 8ntroducción e instrucciones de uso [internet]. Disponible en: https://www.who.int/gpsc/country_work/hhsa_framework_es.pdf?ua=1
16. Organización Mundial de la Salud. Directrices sobre componentes básicos para los programas de prevención y control de infecciones a nivel nacional y de establecimientos de atención de salud para pacientes agudos [internet]. Washington, D. C.: Organización Panamericana de la Salud; 2016. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/255764/9789275319635-spa.pdf;jsessionid=2B08B64456F567460094B9B77B93F660?sequence=1
17. Organización Mundial de la Salud. Higiene de las protocolo de lavado de manos en la atención sanitaria ambulatoria/residencias de la tercera edad y a domicilio [internet]. Disponible en: https://www.who.int/gpsc/5may/Hand_Hygiene_When_How_Leaflet_OPC_Sp_web_2012.pdf?ua=1
18. Schwadtke L, Graf K, Lutze B, von Lengerke T, Chaberny IF. Compliance with hand hygiene guidelines on intensive care units at a university medical centre with surgical focus. Deutsche Medizinische Wochenschrift. 2014;139(25-26):1341-5. https://doi.org/10.1055/s-0034-137014
19. Karaaslan A, Kepenekli Kadayifci E, Atıcı S et al. Cumplimiento de los trabajadores de la salud con las prácticas de higiene de protocolo de lavado de manos en unidades de cuidados intensivos neonatales y pediátricos: observación abierta: perspectiva interdisciplinaria. Infect Dis. 2014;2014:306478. https://doi.org/10.1155/2014/306478
20. Pitter D, Allegranzi B. Hand hygiene promotion strategies. Inhand hygiene: a handbook for medical professionals. Florida: Wiley-Blackwell; 2017. p. 123-33.
21. Rynga D, Kumar S, Gaind R, Kumar Rai A. Hand hygiene compliance and associated factors among health care workers in a tertiary care hospital: self-reported behaviour and direct observation. Int J Infect Control. 2017;13(1). https://doi.org/10.3396/ijic.v13i1.17137
22. Yin J, Reisinger HS, Vander Weg M, Schweizer ML, Jesson A, Morgan DJ, Forrest G, Graham M, Pineles L, Perencevich. Establishing evidence-based criteria for directly observed hand hygiene compliance monitoring programs: a prospective, multicenter cohort study. Infect Control Hosp Epidemiol. 2014 Sep;35(9):1163-8. https://doi.org/10.1086/677629
23. Sopjani I. Health care personnel’s attitude toward hand hygiene in regard to the prevention of health-care associated infections: a cross sectional study at the University Hospital Pristine. Open Journal of Nursing. 2016;6:841-52. https://doi.org/10.4236/ojn.2016.610083
24. Ataiyero Y, Dyson J, Graham M. Barriers to hand hygiene practices among health care workers in sub-Saharan African countries: a narrative review. Am J Infect Control. 2018;47(5):565-73. https://doi.org/10.1016/j.ajic.2018.09.014
25. Dreidi MM, Alrimawi I, Saifan AR, Batiha A-M. Hand hygiene knowledge, practices and attitudes among nurses and physicians. Health. 2016;8:456-62. https://doi.org/10.4236/health.2016.85048
26. Ibeneme S, Maduako V, Ibeneme GC, et al. Hand hygiene practices and microbial investigation of hand contact swab among physiotherapists in an Ebola endemic region: implications for public health. Biomed Res Int. 2017;5841805:1-14.
27. Werzen A, Thom KA, Robinson GL, et al. Comparing brief, covert, directly observed hand hygiene compliance monitoring to standard methods: a multicenter cohort study. Am J Infect Control. 2019;47(3):346-8. https://doi.org/10.1016/j.ajic.2018.08.015
28. Kurtz S. Measuring and accounting for the Hawthorne effect during a direct overt observational study of intensive care unit nurses. Am J Infect Control. 2017;45(9):995-1000.
29. Albright J, White B, Pedersen D, Carlson P, Yost L, Littau Ch. Use patterns and frequency of hand hygiene in healthcare facilities: analysis of electronic surveillance data. Am J Infect Control. 2018;46(10):1104-109.
30. Alshehari A, Park S, Rashid H. Strategies to improve hand hygiene compliance among health care workers in adult intensive care units: a mini systematic review. J Hosp Infect. 2018;100(2):152-5.
31. Ribeiro de Macedo RD, Oliveira EM, Pio da Silva, V et al. Positive deviance: using a nurse call system to evaluate hand hygiene practices. Am J Infect Control. 2012;40:946-50.
32. Marraa AR, Edmondb MB. New technologies to monitor healthcare worker hand higiene. Clin Microbiol Infect. 2014;20(1):29-33. https://doi.org/10.1111/1469-0691.12458
33. Pineles L, Morgan DJ, Limper HM, Weber SG, Thom KA, Perencevich EN, Harris A D, Landon EM. Accuracy of a radiofrequency identification (RFID) badge system to monitor hand hygiene behavior during routine clinical activities. Am J Infect Control. 2014; 42(2):144-7. https://doi.org/10.1016/j.ajic.2013.07.014
2. Pereira EBS, Jorge MT, Oliveira EJ, Júnior ALR, Santos LRL, Mendes-Rodrigues C. Evaluation of the multimodal strategy for improvement of hand hygiene as proposed by the World Health Organization. J Nurs Care Qual. 2017;32(2):E11-9. https://doi.org/10.1097/ncq.000000000000019
3. World Health Organization. Report on the burden of endemic health care-associated infection worldwide [internet]. Geneva, Switzerland: WHO/Patient Safety; 2011. Disponible en: https://apps.who.int/iris/bitstream/10665/80135/1/9789241501507eng.pdf
4. Jia H, Hou T, Li W, Ma Q, Liu W, Yang Y, et al. Economic loss due to healthcare-associated infection in 68 general hospitals in China. Chinese J Infect Control. 2016;15:637-41. https://doi.org/10.1155/2019/2590563
5. Zimlichman E, Henderson D, Tamir O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med. 2013;173(22):2039-46. https://doi.org/10.1001/jamainternmed.2013.9763
6. Junior CN, Mello DS, Padoveze MC, et al. Characterization of epidemiological surveillance systems for healthcare-associated infections (HAI) in the world and challenges for Brazil. Cad Saude Publica. 2014;30(1):11-20. https://doi.org/10.1590/0102-311X00044113
7. Chen JK, Wu KS, Lee SS, et al. Impact of implementation of the World Health Organization multimodal hand hygiene improvement strategy in a teaching hospital in Taiwan. Am J Infect Control. 2016;44:222-7. https://doi.org/10.1016/j.ajic.2015.10.004
8. Musu M, Lai A, Mereu NM, et al. Assessing hand hygiene compliance among healthcare workers in six Intensive Care Units. J Prev Med Hyg. 2017;58(3):E231-7.
9. Valim MD, Rocha ILS, Souza TPM, Cruz YAD, Bezerra TB, Baggio É, Morais RB, Ribeiro AC. Efficacy of the multimodal strategy for hand hygiene compliance: an integrative review. Rev Bras Enferm. 2019 Apr;72(2):552-65. http://dx.doi.org/10.1590/0034-7167-2018-0584
10. Alshehari AA, Park S, Rashid H. Strategies to improve hand hygiene compliance among healthcare workers in adult intensive care units: a mini systematic review. J Hosp Infect. 2018;100(2):152-8. https://doi.org/10.1016/j.jhin.2018.03.01
11. Squeri R, Genovese C, Palamara MAR, Trimarchi G, La Fauci1 V. “Clean care is safer care”: correct handwashing in the prevention of healthcare associated infections. Ann Ig. 2016;28:409-15. https://doi.org/10.7416/ai.2016.2123
12. Teker B, Ogutlu A, Gozdas HT, Ruayercan S, Hacialioglu G, Karabay O. Factors affecting hand hygiene adherence at a private hospital in Turkey. Eurasian J Med. 2015;47(3):208-12. https://doi.org/10.5152/eurasianjmed.2015.78
13. Oliveira AC, Gama CS, Paula AO. Multimodal strategy to improve the adherence to hand hygiene and self-assessment of the institution for the promotion and practice of hand hygiene. J Public Health. 2018;40(1):163-8. https://doi.org/10.1093/pubmed/fdx035
14. Secretaría Distrital de Salud, Asociación Colombiana de Infectología Capítulo Central. Protocolo de lavado de manos limpias atención segura: estrategia multimodal para el mejoramiento de la higiene de lavado de protocolo de lavado de manos en Bogotá [internet]. Bogotá. Disponible en: http://www.saludcapital.gov.co/sitios/VigilanciaSaludPublica/Todo%20IIH/Estrategia%20Distrital%20Manos%20Limpias%20Atencion%20Segura.pdf
15. Organización Mundial de la Salud. Marco de autoevaluación de la higiene de las protocolo de lavado de manos 2010: 8ntroducción e instrucciones de uso [internet]. Disponible en: https://www.who.int/gpsc/country_work/hhsa_framework_es.pdf?ua=1
16. Organización Mundial de la Salud. Directrices sobre componentes básicos para los programas de prevención y control de infecciones a nivel nacional y de establecimientos de atención de salud para pacientes agudos [internet]. Washington, D. C.: Organización Panamericana de la Salud; 2016. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/255764/9789275319635-spa.pdf;jsessionid=2B08B64456F567460094B9B77B93F660?sequence=1
17. Organización Mundial de la Salud. Higiene de las protocolo de lavado de manos en la atención sanitaria ambulatoria/residencias de la tercera edad y a domicilio [internet]. Disponible en: https://www.who.int/gpsc/5may/Hand_Hygiene_When_How_Leaflet_OPC_Sp_web_2012.pdf?ua=1
18. Schwadtke L, Graf K, Lutze B, von Lengerke T, Chaberny IF. Compliance with hand hygiene guidelines on intensive care units at a university medical centre with surgical focus. Deutsche Medizinische Wochenschrift. 2014;139(25-26):1341-5. https://doi.org/10.1055/s-0034-137014
19. Karaaslan A, Kepenekli Kadayifci E, Atıcı S et al. Cumplimiento de los trabajadores de la salud con las prácticas de higiene de protocolo de lavado de manos en unidades de cuidados intensivos neonatales y pediátricos: observación abierta: perspectiva interdisciplinaria. Infect Dis. 2014;2014:306478. https://doi.org/10.1155/2014/306478
20. Pitter D, Allegranzi B. Hand hygiene promotion strategies. Inhand hygiene: a handbook for medical professionals. Florida: Wiley-Blackwell; 2017. p. 123-33.
21. Rynga D, Kumar S, Gaind R, Kumar Rai A. Hand hygiene compliance and associated factors among health care workers in a tertiary care hospital: self-reported behaviour and direct observation. Int J Infect Control. 2017;13(1). https://doi.org/10.3396/ijic.v13i1.17137
22. Yin J, Reisinger HS, Vander Weg M, Schweizer ML, Jesson A, Morgan DJ, Forrest G, Graham M, Pineles L, Perencevich. Establishing evidence-based criteria for directly observed hand hygiene compliance monitoring programs: a prospective, multicenter cohort study. Infect Control Hosp Epidemiol. 2014 Sep;35(9):1163-8. https://doi.org/10.1086/677629
23. Sopjani I. Health care personnel’s attitude toward hand hygiene in regard to the prevention of health-care associated infections: a cross sectional study at the University Hospital Pristine. Open Journal of Nursing. 2016;6:841-52. https://doi.org/10.4236/ojn.2016.610083
24. Ataiyero Y, Dyson J, Graham M. Barriers to hand hygiene practices among health care workers in sub-Saharan African countries: a narrative review. Am J Infect Control. 2018;47(5):565-73. https://doi.org/10.1016/j.ajic.2018.09.014
25. Dreidi MM, Alrimawi I, Saifan AR, Batiha A-M. Hand hygiene knowledge, practices and attitudes among nurses and physicians. Health. 2016;8:456-62. https://doi.org/10.4236/health.2016.85048
26. Ibeneme S, Maduako V, Ibeneme GC, et al. Hand hygiene practices and microbial investigation of hand contact swab among physiotherapists in an Ebola endemic region: implications for public health. Biomed Res Int. 2017;5841805:1-14.
27. Werzen A, Thom KA, Robinson GL, et al. Comparing brief, covert, directly observed hand hygiene compliance monitoring to standard methods: a multicenter cohort study. Am J Infect Control. 2019;47(3):346-8. https://doi.org/10.1016/j.ajic.2018.08.015
28. Kurtz S. Measuring and accounting for the Hawthorne effect during a direct overt observational study of intensive care unit nurses. Am J Infect Control. 2017;45(9):995-1000.
29. Albright J, White B, Pedersen D, Carlson P, Yost L, Littau Ch. Use patterns and frequency of hand hygiene in healthcare facilities: analysis of electronic surveillance data. Am J Infect Control. 2018;46(10):1104-109.
30. Alshehari A, Park S, Rashid H. Strategies to improve hand hygiene compliance among health care workers in adult intensive care units: a mini systematic review. J Hosp Infect. 2018;100(2):152-5.
31. Ribeiro de Macedo RD, Oliveira EM, Pio da Silva, V et al. Positive deviance: using a nurse call system to evaluate hand hygiene practices. Am J Infect Control. 2012;40:946-50.
32. Marraa AR, Edmondb MB. New technologies to monitor healthcare worker hand higiene. Clin Microbiol Infect. 2014;20(1):29-33. https://doi.org/10.1111/1469-0691.12458
33. Pineles L, Morgan DJ, Limper HM, Weber SG, Thom KA, Perencevich EN, Harris A D, Landon EM. Accuracy of a radiofrequency identification (RFID) badge system to monitor hand hygiene behavior during routine clinical activities. Am J Infect Control. 2014; 42(2):144-7. https://doi.org/10.1016/j.ajic.2013.07.014
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