Hand hygiene by the nursing team in home care: a cross-sectional study

to identify whether nursing professionals carry out hand hygiene, how they do it, and what resources are available for this practice during home visits.

Method:

cross-sectional study conducted in a public Home Care service. The World Health Organization instrument was used to observe the hand hygiene technique, the time of performance, and the product used.

Results:

a total of 940 hand hygiene opportunities taking place in 231 home visits were observed. Overall adherence was 14.4%, with the practice of hand hygiene being higher after contact with the patient (53.7%). Before aseptic procedures, after risk/exposure to body fluids, after contact with the patient’s environment, and before contact with the patient, adherence was 0.4%. Regarding the quality of the technique, in none of the 135 practices the recommended steps were followed. As for the structure available in the households, 35 (15.2%) had accessible sinks and none had liquid soap and alcohol-based formulation.

Conclusion:

adherence to hand hygiene by nursing professionals in home care was low, the technique was not performed, and households did not have resources for the practice.

DESCRIPTORS
Hand Hygiene; Home Nursing; Nursing Care; Patient Safety; Occupational Risks; Infection Control

Variables	Hand hygiene
	Before (231)		After (231)
	n	%	n	%
Hand hygiene
Yes	11	4.8	124	53.7
No	220	95.2	107	46.3
Use of soap and water
Yes	0	0	4	1.7
No	231	100.0	227	98.3
Use of hand sanitizer
Yes	1	0.4	83	35.9
No	230	99.6	148	64.1
Only rinsed with water
Yes	10	4.3	35	15.2
No	221	95.7	196	84.8
Only rinsed with SS (0.9%)
Yes	0	0	2	0.8
No	231	100.0	229	99.2

Time recommended by WHO	Number of opportunities observed	Hand hygiene performed	Adherence rate (percentage)
Before contact with the patient	231	11	4.8
After contact with the patient	231	124	53.7
Before performing aseptic procedures	176	0	0
After risk/exposure to body fluids	176	0	0
After contact with the patient’s environment	126	0	0
Total of opportunities	940	135	14.4

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Jéssica Fernanda Corrêa Cordeiro, Avenida dos Bandeirantes, 3900, Campus Universitário, Bairro Monte Alegre, 14040-902 – Ribeirão Preto, SP, Brazil, jessica.cordeiro@usp.br