ADESÃO ÀS MEDIDAS ASSÉPTICAS E FREQUÊNCIA DE TOQUE EM SUPERFÍCIES AMBIENTAIS POR PROFISSIONAIS DE ENFERMAGEM DURANTE A ADMINISTRAÇÃO ENDOVENOSA DE MEDICAMENTOS: ESTUDO OBSERVACIONAL

Abstract

The environmental surfaces near the patient can act as reservoirs and transmission pathways for pathogens through contact with the hands of healthcare professionals. The objective of this study was to analyze adherence to aseptic measures and surface contact by nursing professionals during intravenous medication administration. This was a cross-sectional observational study conducted in an adult Intensive Care Unit (ICU) at a university hospital in the Midwest of Brazil. The sampling was non-probabilistic convenience sampling, and the inclusion criteria were: Nursing professionals, including nurses or nursing technicians, who routinely performed intravenous medication administration. Those with less than 6 months of experience in the ICU were excluded. A non-participating researcher applied the sociodemographic and occupational questionnaires. Subsequently, the Nursing professionals were observed in real-life care situations at all times. For the analysis of non-parametric data, the Prevalence Ratio (PR) was calculated with a 95% confidence interval (CI). A total of 135 observations were conducted, comprising 1,083 episodes of contact with environmental surfaces near the patients. The most-touched surfaces by the hands of professionals were infusion pumps (29.1%) and tubing sets (28.1%). The mean number of touches on the continuous infusion pump (2.33) and tubing sets (2.26) accounted for 57.24% of the total touch frequency. In the afternoon shift, there was a higher frequency of touches on the mechanical ventilator (p=0.026, mean of 0.10 ± 0.17) and on other unspecified surfaces (p=0.021, mean of 1.40 ± 0.59). Professionals with up to 10 years of experience touched the infusion pump more frequently (p=0.049) compared to their counterparts with over 10 years of experience, with an average of 3.25±0.82 touches per medication administration episode. A total of 11 aseptic compliance indicators were analyzed. In total, 6 aseptic measures were classified as inadequate by more than 80% of the participants. Aseptic measures I - Disinfection of the ampoule or vial; II - Disinfection of connectors or injectors; and III - Hand hygiene before intravenous administration were inadequately performed by 100% of the professionals. The compliance prevalence for glove usage is 4.86 times higher in women (PR: 4.86; 95% CI: 0.80 - 29.42; p=0.008) compared to men. The night shift showed a higher level of inadequacy regarding glove donning (p=0.028). The results highlight that the intravenous medication administration procedure, although commonly performed in ICUs, has vulnerabilities, especially regarding adherence to aseptic measures. These data indicate the need for a review of previously standardized institutional protocols and team training to promote safer and more effective care.