Eficiência de intervenções na limpeza e desinfecção de superfícies numa estratégia de saúde da família

Abstract

Contaminated environmental surfaces may facilitate the transmission of microorganisms. In light of this, a strategy to mitigate this impact is the development of an efficient cleaning and disinfection process (C&D), using monitoring methods. Starting from this context, this study was intended to evaluate the impact of an intervention program in the cleaning and disinfection (C&D) of surfaces in a unit linked to the Family Health Strategy. It was a prospective intervention with a quantitative approach. The study consisted of four phases: phase I (situational diagnosis), phase II (intervention program), phase III (evaluation of C&D immediately after the intervention program) and phase IV (long-term evaluation of C&D). The intervention program was developed with the C&D team, with the monitoring through the methods: visual evaluation, quantification of adenosine triphosphate (ATP) and counting of colony-forming units (CFU), standardization of the used sanitizer, alignment of the used techniques and inputs. At the end of each stage, a total of 240 evaluations were obtained, which represents a total of 720 evaluations performed at the end of phases I, III and IV, taking into account the three methods of visual monitoring, ATP and CFU. In phase I, it was observed that failure rates of 57.5%, 20.0% and 90% were obtained. After the educational intervention, the amounts of short-term failure decreased to 0%, 2.5% and 50% (phase III data); and, in-long term, it decreased to 5%, 0% and 65% (phase IV data) for the visual, ATP and culture methods, respectively. Therefore, with this investigation, it was possible to identify a reduction of microbial load by means of CFU values and ATP readings in all the evaluated surfaces, comparing the before and the after the implementation of a C&D program. Although this reduction was not statistically significant in all the evaluated surfaces, one should highlight that, before the intervention in phase I, only the surface of the consultation table had a significant difference. As for phase III, we had seven surfaces with significant results: reception counter (P=0.021), gynecological table (P=0.014), dressing trolley (P=0.030) and nursing consultation table (P=0.014); three cases for bacterial counting: reception counter (P=0.014), patient stretcher (P=0.042) and nursing consultation table (P=0.014). With regard to phase IV, we had eight significant results. Accordingly, one can suggest that the implemented intervention program had a positive impact.