Hand hygiene in emergency care: cross-sectional study on adherence and behavior of the team

Introduction: Healthcare professionals working in emergency care perform hand hygiene on a few occasions when in contact with the patient and/or nearby areas. Aim : To verify adherence and behavior of healthcare professionals regarding hand hygiene practices in emergency care. Outlining: Cross-sectional, descriptive, quantitative study conducted with 39 healthcare professionals working in emergency care. Data were analyzed using descriptive statistics and multiple linear regression. Results: A total of 230 observations were made during day and night shifts. The majority did not use adornments during their workday (81.0%). The adherence rate was 33.0%, with the lowest frequency before performing aseptic procedures (24.0%) and before contacting the patient (27.1%). Nurses stood out among the evaluated professionals (39.5%). There was no statistical difference between the products used for hand hygiene and the adherence rate (p=0.20). Implications: It is necessary to implement strategies to sensitize healthcare professionals about hand hygiene, as the participants' performance was low.


INTRODUCTION
Hand hygiene (HH) is one of the essential measures for the prevention and control of Healthcare-Associated Infections (HAIs), as well as being one of the international goals for Patient Safety. This topic has been widely discussed since the launch of the World Alliance for Patient Safety, and is included in the health and well-being actions of the challenges presented in the 2030 Agenda for Sustainable Development Goals (SDGs). [1][2][3] At various levels of healthcare, this practice contributes to the reduction of microorganism    10,15 It is inferred that the higher adherence can be attributed to professional self-protection and the fear of being colonized by microorganisms during direct patient care.
Therefore, there is a tendency for higher adherence to HH after patient contact. Studies conducted in critical sectors have reported higher values, ranging from 60.9% to 88.7%. 12,14 Overall, the adherence rate to hand hygiene after exposure to bodily fluids found (37.2%) was higher than that found in neonatal ICU (4.9%) and emergency medical services in four countries (9.0%). 12,15 Regarding the consumption of alcohol-based The choice of using alcohol-based hand rub for HH was also observed globally, reaching 27.6%, ranging from 10.0% to 40.9%. 13 As it is a fundamental input associated with the technique's performance, the need to constantly monitor its use in healthcare services as an important care indicator is understood.
A study that compared the consumption of alcohol-based hand rub in a teaching hospital before and after the COVID-19 pandemic recorded a significant increase in the post-pandemic period. 17
ALSA, CA, CFS, CRA, YNAP, LRF: substantial contributions to the conception or design of the work; analysis and interpretation of data. ALSA, CA, CFS, CRA, YNAP, LRF, OMAB: writing the article and critical review. All authors agree and are responsible for the content of this version of the manuscript to be published.

ACKNOWLEDGMENTS
To the Graduate Program in Nursing of the Federal University of Juiz de Fora.

AVAILABILITY OF DATA
Not applicable.

FUNDING SOURCE
Coordination for the Improvement of Higher Education Personnel. Process no. 88881.708866/2022-01.

CONFLICTS OF INTEREST
There are no conflicts of interest to declare.