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      Avaliação prática da lavagem das mãos pelos profissionais de saúde em atividades lúdico-educativas Translated title: Practical evaluation of hand washing by health professionals through playful-educative actions Translated title: Evaluación práctica de lavadura de las manos por los profesionales de salud en atividades lúdico-educativas

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          Abstract

          Reconhecida como a mais importante medida de prevenção no controle das infecções hospitalares, a lavagem das mãos há muito vem sendo estimulada nos hospitais. Este estudo objetivou analisar a prática da lavagem das mãos pelos profissionais de saúde, mediante ações lúdico-educativas sobre o tema. Em maio de 2003, foi realizado o Dia Nacional de Controle de Infecções Hospitalares, no Instituto Fernandes Figueira, Rio de Janeiro. Durante esse evento, uma pia foi montada especialmente para os participantes realizarem a lavagem básica das mãos. Através de método observacional estruturado, foram observados 50 profissionais, em caráter voluntário. São resultados: baixo desempenho técnico, com inobservância da retirada de adornos (84%) e aplicação do sabão líquido sem que as mãos estivessem molhadas (56%). A maioria (80%) utilizou tempo superior ao recomendado (15 segundos), não realizando a lavagem de forma completa (54%). Concluiu-se que, apesar das freqüentes campanhas educativas e oferta de produtos adequados, os profissionais não realizam a técnica a contento.

          Translated abstract

          Hand washing is recognized as the most important preventive measure for the control of hospital-acquired infections. The purpose of this study was to analyze the practice of hand washing by health professionals, through playful-educative actions on the theme, accomplished during a commemorative event in May 2003, at the Fernandes Figueira Institute, in Rio de Janeiro. A sink was specially set up for the participants to accomplish the basic washing of their hands. Fifty professionals, in a volunteer basis, have been observed by means of a structured observation method. The results showed a poor technical performance, including the inobservance of the withdrawal of adornments (84%) and application of the liquid soap without previous wetting of the hands (56%). Although most (80%) participants have used more time than recommended (10 to 15 seconds), 54% didn't accomplish a complete washing. We concluded that, in spite of the frequent educational campaigns and offering of appropriate products, the professionals don't perform the technique satisfactorily.

          Translated abstract

          Reconocida como la más importante medida de prevención en el control de las infecciones hospitalarias, la lavadura de las manos ha sido mucho estimulada en los hospitales. Este estudio buscó analizar la práctica de la higienización de las manos por los profesionales de salud, mediante acciones lúdico-educativas sobre el tema en evento de la conmemoración en mayo/2003, en Instituto Fernandes Figueira/FIOCRUZ Rio de Janeiro. Un fregadero fue montado especialmente para que los candidatos realizasen la lavadura básica de las manos. A través método de observación estructurada, 50(cincuenta) profesionales en carácter voluntario fueron observados. Los resultados mostraron bajo desempeño técnico del procedimiento, que incluyeron: la inobservancia de la retirada de adornos (84%), aplicación de jabón líquido sin que las manos estuvieron mojadas (56%). No obstante la mayoría (80%) haber utilizado tiempo superior al recomendado (10 a 15 segundos), 54% no lo realizaron de forma completa. Concluimos que a pesar de las frecuentes campañas educativas, y manutención de adecuados productos para la lavadura de las manos, los profesionales no realizaron la técnica satisfactoriamente.

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          Most cited references12

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          Guideline for Hand Hygiene in Health-Care Settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force.

          The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231-43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251-69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included.
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            The effectiveness of interventions aimed at increasing handwashing in healthcare workers - a systematic review.

            Handwashing is widely accepted as being key to the prevention of hospital-acquired infection but the frequency of handwashing by healthcare workers has been found to be low. A systematic critical literature review was conducted to establish the effectiveness of interventions aimed at increasing compliance with handwashing in healthcare workers. The results showed that one-off educational interventions have a very short-term influence on handwashing behaviour. Use of strategically placed reminders, or asking patients to remind staff of the need to conduct handwashing can have a modest but more sustained effect. Feedback of performance can increase levels of handwashing but if feedback is not repeated regularly, then this effect is not maintained over long periods. Automated sinks increase the quality of handwashing but healthcare workers can be discouraged from using these because of the additional time involved. Provision of moisturized soaps appears to make little difference to handwashing behaviour but providing 'dry' hand rubs near patient beds may lead to a minimal increase in the frequency with which staff decontaminate their hands. Multifaceted approaches which combine education with written material, reminders and continued feedback of performance can have an important effect on handwashing compliance and rates of hospital-acquired infection. Copyright 2001 The Hospital Infection Society.
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              Skin irritation and dryness associated with two hand-hygiene regimens: soap-and-water hand washing versus hand antisepsis with an alcoholic hand gel.

              To compare the frequency of skin irritation and dryness associated with using an alcoholic-hand-gel regimen for hand antisepsis versus using soap and water for hand washing. Prospective randomized trial with crossover design. Irritation and dryness of nurses' hands were evaluated by self-assessment and by visual assessment by a study nurse. Epidermal water content of the dorsal surface of nurses' hands was estimated by measuring electrical capacitance of the skin. Miriam Hospital, a 200-bed university-affiliated teaching hospital. Thirty-two nurses working on three hospital wards participated in the trial, which lasted 6 weeks. Self-assessment scores of skin irritation and dryness decreased slightly during the 2 weeks when nurses used the alcoholic-hand-gel regimen (mean baseline score, 2.72; mean final score, 2.0; P=.08) but increased substantially during the 2 weeks when nurses used soap and water (mean baseline score, 2.0; mean final score, 4.8; P<.0001). Visual assessment scores by the study nurse of skin irritation and dryness did not change significantly when the alcoholic-hand-gel regimen was used (mean baseline and final scores were both 0.55), but scores increased substantially when nurses used soap and water (baseline score, 0.59; mean final score, 1.21; P=.05). Epidermal water content of the dorsal surface of nurses' hands changed little when the alcoholic-hand-gel regimen was used (mean+/-standard deviation baseline electrical capacitance reading, 24.8+/-6.8; mean final reading, 25.7+/-7.3), but decreased significantly (skin became dryer) with soap-and-water hand washing (mean baseline, 25.9+/-7.5; mean final reading, 20.5+/-5.4; P=.0003). Hand antisepsis with an alcoholic-hand-gel regimen was well tolerated and did not result in skin irritation and dryness of nurses' hands. In contrast, skin irritation and dryness increased significantly when nurses washed their hands with the unmedicated soap product available in the hospital. Newer alcoholic hand gels that are tolerated better than soap may be more acceptable to staff and may lead to improved hand-hygiene practices.
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                Author and article information

                Journal
                reuerj
                Revista Enfermagem UERJ
                Rev. enferm. UERJ
                Universidade do Estado do Rio de Janeiro (Rio de Janeiro, RJ, Brazil )
                0104-3552
                June 2006
                : 14
                : 2
                : 221-225
                Affiliations
                [01] Rio de Janeiro orgnameFIOCRUZ orgdiv1Instituto Fernandes Figueira
                [03] orgnameUniversidade Federal Fluminense orgdiv1Faculdade de Medicina
                [02] Teresópolis orgnameFundação Educacional Serra dos Órgãos orgdiv1Curso de Graduação em Enfermagem e Curso de Graduação em Odontologia
                Article
                S0104-35522006000200011 S0104-3552(06)01400211
                6b940ef8-e16a-44d1-ab5a-b1810227f16b

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

                History
                : 20 January 2006
                : 27 October 2004
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 12, Pages: 5
                Product

                SciELO Revista de Enfermagem

                Categories
                Artigos de Pesquisa

                Lavagem de mão,observación,educación,Lavadura de la mano,observation,continuing education,Hand washing,observação,educação continuada

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