Abstract
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. Observational and correlational study carried out in critical areas of a university hospital in the Midwest region of Brazil. 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). Hand hygiene adherence was affected and/or influenced by the physical structure, use of procedure gloves, work regime, and patient safety climate.
Highlights
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
Despite the results of hand hygiene (HH) adherence being lower than the recommended in all professional categories, moments and sections, we observed that HH adherence is affected, or is influenced by the physical structure of the units, type of employment relationship, perceived patient safety climate, and use of procedure gloves
Low HH adherence is influenced by infrastructure and glove use
Summary
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. Conclusions: Hand hygiene adherence was affected and/or influenced by the physical structure, use of procedure gloves, work regime, and patient safety climate. The most recent, the “Multimodal Strategy for Improving Hand Hygiene Adherence” [4] has five components: system change, training/ education, performance observation/feedback, reminders in the workplace and institutional security environment [5]. Hand hygiene (HH) adherence has been considerably lower than that recommended worldwide [7,8]
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