Knowledge of and adherence to standard precautions in a hemodialysis unit
a cross-sectional study
Keywords:
Universal precautions, Accidents, occupational, Patient safety, Nursing, team, Renal dialysisAbstract
BACKGROUND: Standard precautions (SPs) are recommended safety measures for healthcare professionals to follow, with a view to preventing healthcare-related infections (HCRIs) and for their own protection. Inadequate adherence to these measures can lead to occurrences of occupational accidents and HCRIs. OBJECTIVES: To ascertain the knowledge of and adherence to SP measures among the nursing staff of a hemodialysis service and the relationship of these variables to occurrences of work accidents with biological material. DESIGN AND SETTING: Descriptive cross-sectional and correlational study with a quantitative approach developed in a hemodialysis clinic in Minas Gerais. METHODS: Data were collected through sociodemographic questionnaires and questionnaires on knowledge of and adherence to SPs. RESULTS: 29 professionals participated in the study. It is noteworthy that all of them had already participated in training related to SPs. However, no relationship was identified between knowledge of (15.17 points) and adherence to (71.86 points) SPs. In addition, inferential analysis showed that there was a relationship between suffering a work accident with biological material and the sociodemographic data and knowledge of and adherence to standard precautions. CONCLUSION: Knowledge of the SPs that had been established did not mean mastery of the subject. Despite positive results regarding adherence, factors requiring improvement were observed. It was possible to infer the characteristics that gave rise to greater risk of occurrences of accidents at work. Thus, this study showed the importance of assessing knowledge of and adherence to SP, in order to optimize and direct continuing education towards resolving occupational exposure.
Downloads
References
Prevention CfDCa. Guide to infection prevent for outpatient settings: minimum expectations for safe care. Atlanta: CDC; 2015. Available from: https://www.cdc.gov/infectioncontrol/pdf/outpatient/guide.pdf Accessed in 2021 (Aug 10).
Piai-Morais TH, Orlandi F de S, Figueiredo RM. Fatores que influenciam a adesão às precauções-padrão entreprofissionais de enfermagem em hospital psiquiátrico [Factors influencing adherence to standard precautions among nursing professionals in psychiatric hospitals]. Rev Esc Enferm USP. 2015;49(3):478-85. PMID: 26107709; https://doi.org/10.1590/S0080-623420150000300016.
Porto JS, Marziale MH. Reasons and consequences of low adherence to standard precautions by the nursing team. Rev Gaucha Enferm. 2016;37(2):e57395. PMID: 27253597; https://doi.org/10.1590/1983-1447.2016.02.57395. Erratum in: Rev Gaucha Enferm. 2016;37(2):e57395x.
Souza Terra F, Costa AMDD, Figueiredo ET, et al. As principais complicações apresentadas pelos pacientes renais crônicos durante as sessões de hemodiálise. Rev Bras Clin Med. 2010;8(3):187-92.
Silva KA, Nunes ZB. As intervenções de enfermagem mais prevalentes em um serviço de hemodiálise frente às intercorrências com a fístula arteriovenosa durante a sessão de hemodiálise. J Health Sci Inst. 2011;29(2):110-3. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/lil-606306 Accessed in 2021 (Aug 10).
Sousa MRG, Camargo Silva AEB, Bezerra ALQ, et al. Prevalência de eventos adversos em uma unidade de hemodiálise [Prevalence of adverse events in a hemodialysis unit] [Prevalencia de eventos adversos en una unidad de hemodiálisis]. Rev Enferm UERJ, Rio de Janeiro. 2016;24(6):e18237. https://doi.org/10.12957/reuerj.2016.18237.
Barbosa D, Lima L, Silbert S, et al. Evaluation of the prevalence and risk factors for colonization by vancomycin-resistant Enterococcus among patients on dialysis. Am J Kidney Dis. 2004;44(2):337-43. PMID: 15264193; https://doi.org/10.1053/j.ajkd.2004.04.038.
Freitas MC, Pacheco-Silva A, Barbosa D, et al. Prevalence of vancomycin-resistant Enterococcus fecal colonization among kidney transplant patients. BMC Infect Dis. 2006;6:133. PMID: 16923193; https://doi.org/10.1186/1471-2334-6-133.
Tokars JI, Frank M, Alter MJ, Arduino MJ, editors. National surveillance of dialysis-associated diseases in the United States, 2000. Seminars in dialysis. 2002;15(3):162-71. https://doi.org/10.1046/j.1525-139X.2002.00051.x.
de Figueiredo RM, Maroldi MA. Internação domiciliar: risco de exposição biológica para a equipe de saúde [Home care: health professionals at risk for biological exposure]. Rev Esc Enferm USP. 2012;46(1):145-50. PMID: 22441278; https://doi.org/10.1590/S0080-62342012000100020.
Tipple AF, Silva EA, Teles SA, et al. Acidente com material biológico no atendimento pré-hospitalar móvel: realidade para trabalhadores da saúde e não saúde [Accident with biological material at the prehospital mobile care: reality for health and non-healthcare workers]. Rev Bras Enferm. 2013;66(3):378-84. PMID: 23887787; https://doi.org/10.1590/s0034-71672013000300012.
Faria LBG, Santos CTB, Faustino AM, Oliveira LMAC, Cruz KCT. Conhecimento e adesão do enfermeiro às precauções padrão em unidades críticas [Knowledge and adherence of the nurse to standard precautions in critical units]. Texto Contexto Enferm. 2019;28:e20180144. http://dx.doi.org/10.1590/1980-265X-TCE-2018-0144
Valim MD, de Morais RB, Marziale MHP. Instrumentos e fatores impactantes sobre o conhecimento das medidas de precauções-padrão entre trabalhadores de saúde [Instruments and impacting factors on standard precautions knowledge among health workers]. Enfermería Global. 2016;15(1):272-88. https://doi.org/10.6018/eglobal.15.1.223561.
von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573-7. PMID: 17938396; https://doi.org/10.7326/0003-4819-147-8-200710160-00010. Erratum in: Ann Intern Med. 2008;148(2):168.
Valim MD, Pinto PA, Marziale MHP. Questionário de conhecimento sobre as precauções-padrão: estudo de validação para utilização por enfermeiros brasileiros [Questionnaire on standard precaution knowledge: validation study for Brazilian nurses use]. Texto Contexto Enferm. 2017;26(3):e1190016. https://doi.org/10.1590/0104-07072017001190016.
Valim MD, Marziale MH, Hayashida M, Rocha FL, Santos JL. Validity and reliability of the Questionnaire for Compliance with Standard Precaution. Rev Saude Publica. 2015;49:87. PMID: 26759967; https://doi.org/10.1590/S0034-8910.2015049005975.
Brasil. Ministério da Saúde. Portaria nº 389, de 13 de março de 2014. Define os critérios para a organização da linha de cuidado da Pessoa com Doença Renal Crônica (DRC) e institui incentivo financeiro de custeio destinado ao cuidado ambulatorial pré-dialítico. Diário Oficial da União da República Federativa do Brasil. 2014;151(50). Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2014/prt0389_13_03_2014.html Accessed in 2021 (Aug 10).
Machado MH, Aguiar Filho W, de Lacerda WF, et al. Características gerais da enfermagem: o perfil sócio demográfico. Enferm Foco. 2016;7(ESP):9-14. Available from: http://revista.cofen.gov.br/index.php/enfermagem/article/view/686/296 Accessed in 2021 (Aug 10).
Brevidelli MM, Cianciarullo TI. Psychosocial and organizational factors relating to adherence to standard precautions. Rev Saude Publica. 2009;43(6):907-16. PMID: 19967259; https://doi.org/10.1590/s0034-89102009010700001.
Souza TPM, de Souza Rocha IL, da Cruz YA, et al. Fatores impactantes na adesão e conhecimento da equipe de enfermagem às precauções-padrão. Enfermería Global. 2020;19(1):413-59. http://dx.doi.org/10.6018/eglobal.19.1.373851
da Cruz FF, Gonçalves RP, Raimundo SR, Amaral MS. Segurança do paciente na UTI: uma revisão da literatura [Patient safety in the ICU: a review of the literature]. Revista Científica FacMais. 2018;XII(1):167-87. Available from: https://revistacientifica.facmais.com.br/wp-content/uploads/2018/06/12.-SEGURAN%C3%87A-DO-PACIENTE-NA-UTI-UMA-REVIS%C3%83O-DA-LITERATURA.pdf Accessed in 2021 (Aug 10).
Silva DMD, Marques BM, Galhardi NM, Orlandi FS, Figueiredo RM. Hands hygiene and the use of gloves by nursing team in hemodialysis service. Rev Bras Enferm. 2018;71(4):1963-9. PMID: 30156684; https://doi.org/10.1590/0034-7167-2017-0476.
Trannin KPP, Campanharo CRV, Lopes MCBT, Okuno MFP, Batista REA. Adesão à higiene das mãos: intervenção e avaliação. Cogitare Enferm. 2016;21(2):1-7. https://doi.org/10.5380/ce.v21i2.44246.
Oliveira AC, Paula AO. Intervenções para elevar a adesão dos profissionais de saúde à higiene de mãos: revisão integrativa. Rev. Eletr. Enferm. 2013;15(4):1052-60. https://doi.org/10.5216/ree.v15i4.21323.
Martins Mendonça K, Ferreira Veiga Tipple A, Custódia Silva e Sousa A, Severino Pereira M, Rapparini C. Accidentes con material biológico en los servicios de urgencia y emergencia. Cienc Enferm. 2014;20(2):65-71. http://dx.doi.org/10.4067/S0717-95532014000200007
Carvalho DC, Rocha JC, Gimenes MCA, Santos EC, Valim MD. Acidentes de trabalho com material biológico na equipe de enfermagem de um hospital do Centro-Oeste brasileiro. Esc Anna Nery. 2018;22(1):e20170140. https://doi.org/10.1590/2177-9465-EAN-2017-0140.
Ribeiro AS, Gabatz RIB, Neves ET, de Mello Padoin SM. Caracterização de acidente com material perfurocortante e a percepção da equipe de enfermagem. Cogitare Enferm. 2009;14(4):660-6. http://dx.doi.org/10.5380/ce.v14i4.16379
