Higienização da mão dominante e a mensuração de ATP da equipe de enfermagem na Unidade de Terapia Intensiva

Abstract

The nursing staff in the Intensive Care Unit (ICU) give a high complexity assistance to patients often severe using a device increasing the risk of acquiring and transmit Hospital Infection (HI) currently called Infection Related to Health Care (IRHC). Aimed to evaluate the presence of ATP in the dominant hand of the nursing staff in the following situations: before donning sterile gloves and immediately after removal of the sterile glove and after antisepsis of the hands after removal of the sterile glove and its interface with the intervening factors for hand hygiene of health professionals. A quantitative, descriptive-exploratory, cross study, held in adult ICU of six beds. The study included 34 members of the nursing staff, 12 nurses and 22 aides /nursing technicians In the statistical analysis, paired t test was done , to identify differences between the average ATP and chi- square (x2) test also, to determine differences between groups. The significance level was 5%. The data were processed in the program SPSS 15. The hands and nails were photographed and to diagnostic evaluation of the skin integrity, we used two forms: one for the researcher and another for the Dermatologist. The project was submitted to the Committee of Ethics in Research of the Institution in study and approved by the protocol No. 0900811. 136 swabs were carried out in four stages. The variation of ATP of the first moment ranged from 46 to 6382 RLU ; the second from 11 to 3087 RLU; the third from 234 to 3942 RLU; the fourth from 12 to 768 RLU. The evaluation of the obtained data showed that a clean hand has 419.8 RLU for ATP. The data also show reduction in the amount of ATP after hand hygiene, an increase of ATP in the dominant hand immediately after the removal of sterile glove and a new finding of reduction of ATP in the dominant hand after the performance of the antiseptic hand procedure. Concerning to participants , 13 consider their hands IH vehicle, 12 use adornment during assistance , 23 do not clean the hands properly, although all participants 100% recognizing that the hand hygiene technique should be performed to prevent bacterial growth. Complaints of dryness were frequent, seven practitioners were referred to a dermatologist and a higher average of ATP was found in the hands of those who had skin lesions. The data for the measurement of ATP in the four stages of cleaning revealed that the procedure for hand hygiene decreased contamination of the dominant hand , because there was a reduction of ATP found in the data, whereas the use of sterile gloves increased the amount of ATP and the reduction in the amount found after the hygiene procedure , proving that even after removing sterile gloves hands need to be cleaned immediately. The test for measurement of ATP did not show an reading error, no reaction in the hands of participants, consisted of a very useful tool for training on the subject, it is easy to perform, had excellent acceptance by the group, and converges with the actions to “cleaner and safer care”.