Efeitos da implementação de um programa de educação em higienização das mãos entre os profissionais de uma unidade de terapia intensiva: análise de séries temporais interrompidas

Abstract

Objective: To evaluate the effects of an education program on the compliance of health professionals of an Intensive Care Unit (ICU) with hand hygiene. Methods: This quasi-experimental study with interrupted time-series was conducted throughout a 12-month period: five months before implementation of the educational program (baseline period), two months during the intensive phase of the program (intervention period), and five months during the program maintenance (post-intervention period). The hand hygiene compliance was monitored by one of the researchers, without knowledge of ICU team. The primary outcome was the variation of the rate of hand hygiene adherence. Mechanical ventilation duration, incidence of ventilator-associated pneumonia (VAP) and mortality at 28 and 60 days were also evaluated. Results: Based on 959 observations, we found a significant increase in hand hygiene compliance rates: from 31.5% at baseline to 65.8% during the intervention period, and 83.8% during the post-intervention period. These increments represent a prevalence ratio of hand hygiene compliance of 2.09 and 2.66, compared to baseline period, respectively (p<0.001, by Poisson regression model). Despite this improvement, there were not significant differences in VAP incidence, days on mechanical ventilation and mortality at 28 and 60 days. Conclusion: The hand hygiene educational program was able to increase the adherence of this conduct during the study, but without impact on rate of VAP, mechanical ventilation duration and mortality.