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      Monitoramento da adesão à higiene das mãos em uma unidade de terapia intensiva Translated title: Monitoreo de la adhesión a la higiene de las manos en una unidad de terapia intensiva Translated title: Monitoring hand hygiene adherence in an intensive care unit

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          Abstract

          RESUMO Objetivo caracterizar a adesão da prática de higienização das mãos pelos profissionais de saúde. Método estudo transversal, com a equipe multidisciplinar da unidade de terapia intensiva de um hospital do Rio de Janeiro, entre janeiro e fevereiro de 2017. A coleta de dados foi através da observação direta com um formulário adaptado. Foram realizadas 165 observações analisadas pelo software R. O projeto foi aprovado por Comitê de Ética em Pesquisa. Resultados em 13% das observações foi alcançado o padrão ouro que corresponde a higiene das mãos antes e após o contato com o paciente com a técnica correta. Todas as categorias profissionais realizaram mais a higienização das mãos após o contato com o paciente. Conclusão verificou-se baixa taxa de adesão à higienização das mãos pelos profissionais de saúde. Contudo, a categoria enfermeiro é a que mais higieniza as mãos antes e após o contato com o paciente, conforme a técnica correta.

          Translated abstract

          RESUMEN Objetivo caracterizar la adhesión de la práctica de higienización de las manos por los profesionales de salud. Método estudio transversal, con el equipo multidisciplinario de la unidad de terapia intensiva de un hospital de Río de Janeiro, entre enero y febrero de 2017. La recolección de datos fue a través de la observación directa con un formulario adaptado. Fueron realizadas 165 observaciones analizadas por el software R. El proyecto fue aprobado por el Comité de Ética en Investigación. Resultados en el 13% de las observaciones se alcanzó el patrón oro que corresponde a la higiene de las manos antes y después del contacto con el paciente, utilizando la técnica correcta. Todas las categorías profesionales realizaron más la higienización de las manos después del contacto con el paciente. Conclusión se verificó baja tasa de adhesión a la higienización de las manos por los profesionales de salud. Sin embargo, la categoría enfermera es la que más higieniza las manos antes y después del contacto con el paciente según la técnica correcta.

          Translated abstract

          ABSTRACT Objective to characterize health professionals’ adherence to hand hygiene procedure. Method this cross-sectional study with the multidisciplinary team of an intensive care unit at a hospital in Rio de Janeiro was conducted between January and February 2017. Data were collected in 165 direct observations using an adapted form, and analyzed by R software. The project was approved by the research ethics committee. Results the gold standard (hand hygiene before and after contact with the patient using the correct technique) was achieved in 13% of the observations. All categories of health personnel performed hand hygiene more after contact with the patient. Conclusion the rate of adherence to hand hygiene by health professionals was low. However, the category that most hygienized hands before and after contact with patients, using the correct technique, was nurses.

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          Most cited references20

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          Knowledge, Attitude, and Practice of Hand Hygiene among Medical and Nursing Students at a Tertiary Health Care Centre in Raichur, India

          Background. Hand hygiene is recognized as the leading measure to prevent cross-transmission of microorganisms. Regarding hospital acquired infections, the compliance of nurses with hand washing guidelines seems to be vital in preventing the disease transmission among patients. There is a paucity of studies exploring this subject in Asia. Especially medical and nursing student's knowledge of standard hand hygiene precautions is rarely compared. Methods. A cross-sectional study was conducted among 98 medical and 46 nursing students in a tertiary medical college in India. Knowledge was assessed using WHO hand hygiene questionnaire. Attitude and practices were evaluated by using another self-structured questionnaire. Z test was used to compare the percentage of correct responses between medical and nursing students. A P value less than 0.05 was considered significant. Results. Only 9% of participants (13 out of 144) had good knowledge regarding hand hygiene. Nursing students knowledge (P = 0.023) , attitude (P = 0.023), and practices (P < 0.05) were significantly better than medical students.
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            Hand Hygiene Compliance in an Emergency Department: The Effect of Crowding.

            Emergency department (ED) crowding results from the need to see high volumes of patients of variable acuity within a limited physical space. ED crowding has been associated with poor patient outcomes and increased mortality. The authors evaluated whether ED crowding is also associated with reduced hand hygiene compliance among health care workers.
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              The World Health Organization '5 moments of hand hygiene': the scientific foundation.

              The World Health Organization (WHO) launched the first Global Patient Safety Challenge in 2005 and introduced the '5 moments of hand hygiene' in 2009 in an attempt to reduce the burden of health care associated infections. Many NHS trusts in England adopted this model of hand hygiene, which prompts health care workers to clean their hands at five distinct stages of caring for the patient. Our review analyses the scientific foundation for the five moments of hand hygiene and explores the evidence, as referenced by WHO, to support these recommendations. We found no strong scientific support for this regime of hand hygiene as a means of reducing health care associated infections. Consensus-based guidelines based on weak scientific foundations should be assessed carefully to prevent shifting the clinical focus from more important issues and to direct limited resources more effectively. We recommend caution in the universal adoption of the WHO '5 moments of hand hygiene' by orthopaedic surgeons and other health care workers and emphasise the need for evidence-based principles when adopting hospital guidelines aimed at promoting excellence in clinical practice.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                reuerj
                Revista Enfermagem UERJ
                Rev. enferm. UERJ
                Universidade do Estado do Rio de Janeiro (Rio de Janeiro, RJ, Brazil )
                0104-3552
                March 2019
                : 26
                : 0
                : e33087
                Affiliations
                [1] Rio de Janeiro orgnameUniversidade Federal do Estado do Rio de Janeiro Brazil bru-rocha@ 123456hotmail.com.
                [3] Rio de Janeiro orgnameUniversidade Federal do Estado do Rio de Janeiro Brazil bruno.simoes@ 123456uniriotec.br.
                [4] Rio de Janeiro orgnameUniversidade Federal do Estado do Rio de Janeiro Brazil danigalpa@ 123456gmail.com.
                [2] Rio de Janeiro orgnameUniversidade Federal do Estado do Rio de Janeiro Brazil carreiroma59@ 123456gmail.com.
                Article
                S0104-35522018000100343
                10.12957/reuerj.2018.33087
                5df465f2-67b8-4c97-b09f-80e904058e62

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 05 March 2018
                : 05 July 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 29, Pages: 0
                Product

                SciELO Revista de Enfermagem

                Categories
                Artigos de Pesquisa

                Higiene de las manos,monitorización,infección hospitalaria,enfermería,Hand hygiene,monitoring,cross infection,nursing,Higiene das mãos,monitoramento,infecção hospitalar,enfermagem

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