Practice of surgical hand antisepsis in a university hospital: an observational prevalence study
DOI:
https://doi.org/10.17058/reci.v15i1.19191Keywords:
Antisepsis, Surgicenters, Cross InfectionAbstract
Background and Objectives: surgical hand antisepsis is an essential measure in surgical site infection prevention, with the aim of reducing and eliminating the microbial load on the skin of professionals participating in surgical procedures. However, studies have shown that the surgical team has neglected this practice. In this context, the research aimed to assess the practice of hand surgical antisepsis among members of the surgical team of a teaching hospital. Methods: an observational, descriptive, quantitative study, conducted from September 20 to October 20, 2023. The data were transcribed in a spreadsheet, tabulated and analyzed by means of absolute and relative frequency. Results: a total of 238 surgical antisepsis were observed in the hands. In 100% of the practices, professionals did not use adornments; rubbing of the hands up to the elbow occurred in 96.22%; keeping the hands above the elbow occurred in 80.25%; rinsing in full running water occurred in 78.57%; and rinsing in a single direction occurred in 83.19%. However, the time used to perform the technique was adequate in 12.74% of observations for the first shift surgery and, in 23.53%, for the second. The overall adequacy of the practice was 9.31% and 17.65% for the first and second antisepsis of the shift, respectively. Conclusion: the research revealed deficiencies mainly in the time dedicated to practice, low general adequacy in the practice of surgical antisepsis of the hands, the hospital role as an educational institution in multiprofessional training in health.
Downloads
References
World Health Organization. Global report on infection prevention and control. Executive summary. Geneva: World Health Organization; 2022 [citado 2023 nov 21]. 182 p. Disponível em: https://iris.who.int/bitstream/handle/10665/354489/9789240051164-eng.pdf?sequence=1
Brasil. Agência Nacional de Vigilância Sanitária. Medidas de Prevenção de Infecção Relacionada à Assistência à Saúde. Brasília: Anvisa; 2017 [citado 2023 nov 27]. 122 p. Disponível em: https://portaldeboaspraticas.iff.fiocruz.br/biblioteca/medidas-de-prevencao-de-infeccao-relacionada-a-assistencia-a-saude/
Centers For Disease Control And Prevention. National Healthcare Safety Network (NHSN). Patient Safety Component Manual. Atlanta: CDC; 2023 [citado 2023 nov 15]. 445 p. Disponível em: https://www.cdc.gov/nhsn/pdfs/validation/2023/pcsmanual_2023.pdf
Seidelman JL, Mantyh CR, Anderson DJ. Surgical Site Infection Prevention: A Review. JAMA [internet] 2023 [citado 2023 nov 21] 329 (3):244-252. https://doi.org/10.1001/jama.2022.24075
Mota APA, Costa EAM. Adhering to hand hygiene in Brazilian hospital services: a review study. RSD [Internet] 2023[citado 2023 nov 10] 12 (4):1-15. https://doi.org/10.33448/rsd-v12i4.41066
Brasil. Agência Nacional de Vigilância Sanitária. Segurança do Paciente em Serviços de Saúde: Higienização das Mãos. Capítulo 7: Higiene das mãos, p. 57-67. Brasília: Anvisa; 2009 [citado 2023 nov 11]. 109 p. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/seguranca_paciente_servicos_saude_higienizacao_maos.pdf
Organização Mundial de Saúde. Guia de implementação. Guia para a Implementação da Estratégia Multimodal da OMS para melhoria da higiene de mãos. Genebra: WHO; 2009 [citado 2023 nov 20] 48p. Disponível em: https://proqualis.fiocruz.br/sites/proqualis.fiocruz.br/files/Guia_de_Implementao_estratgia_multimodal_de_melhoria_da_HM.pdf
Oliveira AC, Gama CS. Surgical antisepsis practices and use of surgical gloves as a potential risk factors to intraoperative contamination. Esc. Anna Nery Rev Enferm [internet] 2016 [citado 2023 nov 12] 20 (2):370-377. https://doi.org/10.5935/1414-8145.20160051
Schwartz X, Schmitz M, Safdar N, Pop-Vicas A. Adherence to surgical hand antisepsis: Barriers and facilitators in a tertiary care hospital. Am J Infection Control [internet] 2018 [citado 2023 nov 09] 46 (6):714–16. https://doi.org/10.1016/j.ajic.2017.12.011
Organização Pan-Americana da Saúde. Agência Nacional de Vigilância Sanitária. Manual para observadores: estratégia multimodal da OMS para a melhoria da higienização das mãos. Brasília: Organização Pan-Americana da Saúde; 2008 [citado 2023 dez 01]. 60 p. Disponível em: https://proqualis.fiocruz.br/sites/proqualis.fiocruz.br/files/MANUAL%20PARA%20OBSERVADORES.pdf
National Services Scotland. Hand Hygiene: Surgical hand antisepsis in the clinical setting. Literature Review. ARHAI Scotland; 2023 [citado 2023 dez 03]. 55 p. Disponível em: https://www.nipcm.hps.scot.nhs.uk/media/2226/2023-10-17-surgical-hand-antisepsis-v62-final.pdf
Neto AS, Marques SG, Bomfim MRQ, et al. Microbiological Analysis of Surgeons’ Hands in a Public Hospital in São Luis, Maranhão State, Brazil: A Cross-Sectional Study. Microorganisms [internet] 2023 [citado 2023 nov 02] 11 (8):1-24. https://doi.org/10.3390/microorganisms11081895
Speth, J. Guidelines in Practice: Hand Hygiene. AORN J [internet] 2023 [citado 2024 jan 05] 18 (2): 101-108. https://doi.org/10.1002/aorn.13964
Santos M, Almeida A, Lopes C, et al. Risco Biológico e/ou Químico eventualmente associado ao uso de adereços pelo Trabalhador (como anéis, alianças, relógios, pulseiras). Revista Portuguesa de Saúde Ocupacional on line [internet] 2020 [citado 2023 out 20] 9:1-14. https://doi.org/10.31252/RPSO.04.04.2020
Peixoto JGP, Branco A, Dias CAG, Millão LF, Caregnato RCA. Antissepsia cirúrgica das mãos com preparação alcoólica: redução microbiana em diferentes tempos de uso no centro cirúrgico. Rev SOBECC [Internet] 2020 [citado 2023 out 23] 25 (2):83-9. https://doi.org/10.5327/Z1414-4425202000020004
Lopes, AER. Comparação da tolerância e aceitabilidade de cirurgiões à aplicação de solução alcoólica versus aplicação de antissépticos degermantes para o preparo cirúrgico das mãos: um ensaio clínico pareado [tese]. Ribeirão Preto (SP): Universidade de São Paulo; 2019 [citado 2023 out 15]. https://doi.org/10.11606/T.22.2020.tde-19112019-192529
Alcaide-Jiménez A, Arredondo-Provecho AB, Díaz-Martín M, et al. Adecuación de la higiene prequirúrgica de manos en un hospital universitario de Madrid. Rev Esp Salud Pública [internet] 2022 [citado 2023 dez 27] 96:1-9. Disponível em: https://www.sanidad.gob.es/biblioPublic/publicaciones/recursos_propios/resp/revista_cdrom/VOL96/ORIGINALES/RS96C_202206047.pdf
Mukherjee R, Roy P, Parik M. Achieving Perfect Hand Washing: an Audit Cycle with Surgical Internees. Indian Journal of Surgery [internet] 2020 [citado 2023 nov 15] 83 (5):1166–1172. https://doi.org/10.1007/s12262-020-02619-8
Pripp AH. Hawthorne-effekten. Tidsskrift for den Norske laegeforening [internet] 2020 [citado 2024 fev 9]. https://doi.org/10.4045/tidsskr.20.0395
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Beatriz Talluly Bespalhok, Débora Cristina Ignácio Alves, Fabiana Gonçalves de Oliveira Azevedo Matos, Lara Adrianne Garcia Paiano da Silva
This work is licensed under a Creative Commons Attribution 4.0 International License.
The author must state that the paper is original (has not been published previously), not infringing any copyright or other ownership right involving third parties. Once the paper is submitted, the Journal reserves the right to make normative changes, such as spelling and grammar, in order to maintain the language standard, but respecting the author’s style. The published papers become ownership of RECI, considering that all the opinions expressed by the authors are their responsibility. Because we are an open access journal, we allow free use of articles in educational and scientific applications provided the source is cited under the Creative Commons CC-BY license.
