Pediatric Critical Care Medicine:
May 2014 - Volume 15 - Issue 4_suppl - p 213
Multimodal Strategy To Promote Hand Hygiene Compliance In a Pediatric Intensive Care Unit
Pedreira, M.; Belela-Anacleto, A.; Kusahara, D.; Peterlini, M.
Background and aims: Studies have been demonstrated that adherence to hand hygiene (HH) is unsatisfactory across the world and show compliance rates of around 40%.
Aims: To comparePICUhealthcare workers’ (HCW) compliance to HH practices before and after interventions to promote adherence; verify PICU HCW’s previous knowledge about HH and identify predictors of intention to perform the behavior ‘HH during patient care in the PICU’.
Methods: Quasi-experimental study conducted in a PICU of a teaching hospital from Brazil, that involved manipulation of the variable ‘HH’ through the implementation of interventions on infrastructure, education and performance feedback. Descriptive method was adopted for knowledge and behavior intention studies. Sample consisted on 1261 HH opportunities observed in three study periods. Descriptive and inferential data analysis were conducted (p<0.005).
Results: There was significant (p=0.010) improvement of HH compliance rate (‘Preintervention Phase’ 27.3%, ‘Phase 1 - postintervention’ 33.1%, ‘Phase 2 - postintervention’ 37.0%) and in the use of the alcoholic solution (p<0.001). The indication ‘after patient contact’ was related to the highest global HH rate (49.8%) and to higher levels of compliance (p=0.005). 'Contact precautions' and 'glove usage' didn’t influence HH. ‘Direct patient contact’ (p=0.016) and ‘equipment and furniture handling’ (p<0.001) were associated with compliance increase. Knowledge about HH was considered insufficient for 95.0% of the HCW. The construct ‘perceived social pressure’ was the predictor factor (p=0.026) of HH behavior intention.
Conclusions: There was a significant increase in PICU HCW’ compliance to HH practices, although rates are considered low. Previous HH knowledge was insufficient and ‘perceived social pressure’ represented the predictor factor of HH behavior.Acknowledgements: CNPq. 476088/2010-0.