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Master's Dissertation
DOI
https://doi.org/10.11606/D.22.2022.tde-10112022-132143
Document
Author
Full name
Daiane Cristina Cruz
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2022
Supervisor
Committee
Menegueti, Mayra Gonçalves (President)
Laus, Ana Maria
Lopes, Ana Elisa Ricci
Martins, Maria Auxiliadora
Title in Portuguese
Avaliação do consumo de solução alcoólica e solução degermante para higiene das mãos em unidade de terapia intensiva no período pré e durante a pandemia da COVID-19
Keywords in Portuguese
COVID-19
Cuidado intensivo
Higiene de mãos
Solução alcóolica
Solução degermante
Abstract in Portuguese
Introdução: As Infecções Relacionadas a Assistência à Saúde (IRAS) são motivos de preocupação para os hospitais. De acordo com a Organização Mundial de Saúde (OMS) as práticas deficientes para a prevenção das IRAS causam danos aos pacientes. Objetivo: Comparar o consumo da solução alcoólica e clorexidina degermante, as densidades de incidência das infecções relacionadas à assistência à saúde, a carga de trabalho de enfermagem e a taxa de paciente-dia em uma unidade de terapia intensiva antes e durante a pandemia. Método: Estudo de coorte retrospectivo, realizado no período pré e durante a pandemia da doença do Coronavírus Disease 2019 (COVID-19), que compreendeu o período de janeiro de 2018 a dezembro de 2021, sendo o período pré de janeiro de 2018 a dezembro de 2019 e o período durante a pandemia de janeiro de 2020 a dezembro de 2021. Esta pesquisa foi realizada em uma unidade de terapia intensiva com 10 leitos de um hospital universitário, secundário e de média complexidade.Resultado: Houve um aumento do consumo dos produtos utilizados para higiene das mãos durante a pandemia da COVID-19. O consumo médio de solução alcoólica foi de 49,999 ml/paciente-dia no período pré pandemia e de 78,829 ml/paciente-dia durante a pandemia da COVID-19 (p=0,0001). O consumo médio de clorexidina degermante foi de 3,664 ml no período pré pandemia e de 5,632 ml durante a pandemia da COVID-19 (p=0,0436). Quanto à densidade de incidência de infecções relacionadas à assistência à saúde, houve aumento na incidência de pneumonia associada à ventilação mecânica (PAV), 2,28 versus 10,0 episódios por mil pacientes dia (p=0,0091). Não houve alteração na densidade de incidência de infecção primária da corrente sanguínea relacionada ao cateter venoso central (IPCSRCVC) (p=0,7146) e na infecção do trato urinário relacionada à sonda vesical de demora (ITUSVD) (p=0,2249). Também não houve alteração na carga de trabalho de enfermagem verificada pelo Nursing Activities Score (p=0,3775) e na taxa de paciente-dia (p=0,9849). Conclusão: Concluímos que houve um aumento do consumo de solução alcoólica e de clorexidina degermante para higiene de mãos durante a pandemia da COVID-19 comparado ao período antes da pandemia. Este aumento do consumo foi evidenciado mesmo sem diferença do número de pacientes dia atendidos e da carga de trabalho de enfermagem, provavelmente pelo medo dos profissionais de se contaminarem durante a pandemia. As densidades de incidência de ITUSVD e de IPCSRCVC não se alteraram, mas a PAV teve um aumento substancial, provavelmente associada a doença COVID-19, que, por atingir os pulmões, pode aumentar o risco do desenvolvimento desta infecção.
Title in English
Evaluation of the consumption of alcoholic and degerming solutions for hand hygiene in an intensive care unit before and during the COVID-19 pandemic
Keywords in English
Alcoholic solution
COVID-19
Degerming solution
Hand hygiene
Intensive care
Abstract in English
Introduction: Healthcare-Related Infections (HAI) are reasons of concern for hospitals. According to the World Health Organization (WHO) poor practices for the prevention of HAI cause harm to patients. Objective: To compare the consumption of alcohol solution and chlorhexidine degerming, the incidence densities of HAI, the nursing workload and the patientday rate in an intensive care unit before and during the pandemic. Method: Retrospective cohort study, carried out in the period before and during the coronavirus disease (COVID-19) pandemic, which comprised the period from January 2018 to December 2021, with the pre period from January 2018 to December 2019 and the period during the pandemic from January 2020 to December 2021. This research was carried out in an intensive care unit with 10 beds of a university, secondary and medium complexity hospital. Result: There was an increase in the consumption of products used for hand hygiene during the COVID-19 pandemic. The average consumption of alcoholic solution was 49.999 ml/patient-day in the pre-pandemic period and 78.829 ml/patient-day during the COVID-19 pandemic (p=0.0001). The average consumption of chlorhexidine degerming was 3.664 ml in the pre-pandemic period and 5.632 ml during the COVID-19 pandemic (p=0.0436). As for the incidence density of healthcare-associated infections, there was an increase in the incidence of ventilator-associated pneumonia (PAV), 2.28 versus 10.0 episodes per thousand patient days (p=0.0091). There was no change in the incidence density of primary bloodstream infection related to central venous catheter (IPCSRCVC) (p=0.7146) and urinary tract infection related to indwelling urinary catheter (ITUSVD) (p=0.2249) . There was also no change in the nursing workload verified by the Nursing Activities Score (p=0.3775) and in the patient-day rate (p=0.9849). Conclusion: We conclude that there was an increase in the consumption of alcohol solution and chlorhexidine degerming agent for hand hygiene during the COVID-19 pandemic compared to the period before the pandemic. This increase in consumption was evidenced even with no difference in the number of patients seen and the nursing workload, probably due to the fear of professionals of contaminating themselves during the pandemic. The incidence densities of ITUSVD and IPCSRCVC did not change, but PAV had a substantial increase, probably associated with COVID-19 disease, which, by reaching the lungs, may increase the risk of developing this infection.
 
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Publishing Date
2022-11-21
 
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