Nursing Department, Federal University of Mato Grosso, Cuiabá, Brazil.
Statistics Department, Federal University of Mato Grosso, Cuiabá, Brazil.
J Clin Nurs. 2020 Jul;29(13-14):2691-2698. doi: 10.1111/jocn.15293. Epub 2020 May 11.
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.
Observational study employing cross-sectional data. Reporting rigour was demonstrated using the STROBE checklist.
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.
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.
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.
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.
全球范围内，医疗保健相关感染的发生率很高。手卫生被认为是减少医院环境中病原体传播的最有效措施。我们的目的是评估巴西中西部一家三级医院的重症监护病房的手卫生依从率。
采用横断面数据的观察性研究。使用 STROBE 清单证明报告严谨性。
观察包括护理人员、医生和物理治疗师在内的 129 名医疗团队成员的手卫生实践。使用世界卫生组织表格进行数据收集。
共观察到 3025 次手卫生机会，总体依从率仅为 46.25%。在接触体液和接触患者后，手卫生的频率更高，分别为 60.80%和 53.45%。护士的手卫生依从率更高（59.80%）。与其他科室相比，新生儿 ICU 的手卫生依从率更高。
机构内的手卫生结构较差，没有专业人员达到执行手卫生技术所需的最短时间。在所有五个时间点和所有观察到的类别和科室中，专业人员的手卫生依从率都较低，这可能受到机构内基础设施较差的影响。
鉴于全球范围内的医疗保健相关感染发生率，这项研究对于患者安全具有重要意义，尤其在欠发达国家。希望本研究的结果可以指导组织有效地、系统地评估手卫生依从率，提高手卫生依从率，从而减少卫生环境中的感染数量。
