Precaução padrão na hemodiálise: conhecimento e fatores que influenciam a adesão entre profissionais de saúde

Abstract

Standard precautions are a set of basic and essential measures that must be applied during the care of all patients, regardless of their health conditions or the suspected or confirmed diagnosis of infectious diseases. Adherence to these measures is fundamental for the prevention and control of healthcare-associated infections and is especially critical for patients undergoing renal replacement therapy, particularly hemodialysis, as infections are among the main causes of hospitalizations and complications, especially primary bloodstream infections, which are often linked to the failure to strictly follow these precautions. However, despite being widely recommended across all healthcare services, and several years having passed since their publication, adherence to standard precautions remains a significant challenge, revealing persistent gaps in both knowledge and practice. In this context, the aim of this study was to assess the knowledge and determining factors that influence adherence to standard precautions among healthcare professionals working in hemodialysis. This is a multicenter, descriptive, cross-sectional, and quantitative study conducted in four healthcare facilities in Minas Gerais, Brazil, involving the participation of nurses, nursing technicians, and physicians. Data were collected using questionnaires in mixed formats (printed and electronic via Google Forms), composed of three self-administered instruments: one to gather sociodemographic and workrelated data, the Standard Precaution Knowledge Questionnaire, and the instrument Factors Influencing Adherence to Standard Precautions Scale. Data analysis was carried out using the Statistical Package for the Social Sciences (SPSS) version 21.0 and R software (version 4.4.0), using the lavaan package, specific for structural equation modeling. Among the results, it was found that although the overall performance of healthcare professionals in basic standard precaution practices was satisfactory, many demonstrated a limited understanding of the purpose of standard precautions, focusing more on self-protection than on infection prevention, and there were still weaknesses in knowledge about additional precautions related to transmission modes, especially in specific contexts such as tuberculosis management. A significant association was also found between knowledge and whether the professional had received training on standard precautions, including participation in training sessions within the last six months. Regarding the determining factors of adherence, the barriers included individual issues such as age, subjective judgment, self-confidence, and risk perception, as well as institutional aspects such as inadequate training and the absence of continuing education programs. On the other hand, facilitators included horizontal leadership, the provision of realtime feedback, the use of visual reminders, and the implementation of regular training sessions. Recognizing these factors is essential for the development of effective strategies, such as investments in education and initiatives that reinforce the importance of adherence to standard precautions.