O Uso de Metodologia Ativa para a Adesão à Higiene das Mãos no Atendimento Pré-Hospitalar: Um Estudo Quase Experimental

Abstract

The hands hygiene (HH) is one of the important, cost-effective and effective measures to prevent and control infections. However, the adherence to hand hygiene by health professionals is low and it is believed that adherence is even lower in the Emergency Mobile Care Service (EMCS) due to structural conditions and emergency care. This research aimed to evaluate the effectiveness of educational action with the use of active methodologies to increase adherence to hygiene at the hands of prehospital care professionals. This is a near-experimental, before-and-after study, performed at a pre-hospital emergency care service in the Central South region, with head office in Aparecida de Goiânia (Center-West). The study population was composed of professionals who work in pre-hospital care: nurses, nursing technicians, doctors and drivers who are also first responders who participated in the educational intervention. The study was consisted of three phases: the first and third phases corresponded to the collection of pre and post-intervention data. Data were collected by direct non-participant observation and recorded on a checklist from January to March and October 2016 respectively. The second phase was constituted of the educational intervention carried out from June to July of 2016 with the use of Active Methodologies (Arch of Maguerez). The results showed an increase (p<0.001) in the adherence of the professionals to the hygiene of the hands even with an interval of three months after an educational intervention. Although, the adherence to HH was statistically significant, it was not uniform at all times, with higher adherence to HH after contact with body fluids (p<0.02); patient (p<0.001) and environment (p<0.001). The educational intervention with Problem-solving Methodology increased HH practices with the use of alcoholic solution (p<0.001) and with correct technique (p<0.01), which also culminated in a higher consumption of alcohol gel (p=0.03). The problem-solving methodology proved to be effective in working towards adherence to HH in prehospital care and should be a dynamic practice in order to deal with the new issues that have arisen in this process of learning and transforming reality.