KNOWLEDGE AND ADHERENCE OF THE NURSE TO STANDARD PRECAUTIONS IN CRITICAL UNITS

descriptive and cross-sectional study, with a quantitative approach, with the population of nurses from a university hospital in the Distrito Federal, Brazil. For data collection, three instruments were used. A semi-structured questionnaire with identification and occupational data of nurses, the questionnaire to evaluate knowledge to standard precautions and the Questionnaire of adherence to standard precautions. Descriptive analysis was used with absolute and relative frequency values.

Results:

the population was composed of 40 participating nurses, 75% were female, with an average age of 32.5 years, ranging from 24 to 50 years. Professionals with five or more years of training (67.5%) predominated, 25 (62.5%) had only one job and had experience in the area of critical patient care for more than three years. Although with a high percentage of accuracy, with regard to the moments that required hand hygiene, this frequency was 97.5%. Gloves are always used for intramuscular or subcutaneous injection by 67.5% of professionals, but 17.5% still consider it unnecessary to wear disposable caps and surgical shoe covers. The use of sharps, handling and reporting of occupational accidents were not performed as expected.

Conclusion:

gaps were identified in relation to the knowledge and adherence of nurses in units that provide care to critical patients of a university hospital with regard to standard precautions.

DESCRIPTORS
Intensive care units; Nurses; Universal precautions; Training; Health knowledge, attitudes, practice

Socio-demographic and occupational variables	N	%
Age
≤ 30 years	22	55.0
> 30	18	45.0
Gender
female	30	75.0
male	10	25.0
Time of training
up to 5 years	13	32.5
over 5 years	27	67.5
Work shift
6 hours daytime	10	25.0
12 hours daytime	14	35.0
12 hours nighttime	16	40.0
Number of jobs
one	25	62.5
two	12	30.0
three or more	3	7.5
Working time at the institution*
Up to 1 year	14	35.9
greater than 1 and less than 3 years	22	56.4
3 years or more	3	7.7
Working time in Intensive Care Unit/Critical Care Unit (ICU/CCU)
up to one year	9	23.7
greater than one and less than three years	17	44.7
three years or more	12	31.6
Working time at the Intensive Care Unit/Critical Care Unit 173. (ICU/CCU) investigated†
up to one year	16	42.1
greater than one and less than three years	20	52.6
three years or more	2	5.3

Questions*	True	False	Do not know
Questions*	n(%)	n(%)	n(%)
You know what standard precautions are†	39(100.0)	0.0	0.0
Standard precautions should only be used in patients diagnosed with infection or patients who are in the incubation period for a given infection†	2(5.1)	37(94.9)	0.0
Adherence to standard precautionary measures is primarily aimed at protecting health staff.	27(67.5)	13(32.5)	0.0
When in contact with blood or other potentially contaminated materials should wash your hands immediately.	40(100.0)	0.0	0.0
Hand hygiene should be performed while providing care to different patients†	36(92.3)	2(5.1)	1(2.6)
Since the use of gloves can prevent contamination of hands, it is not necessary to sanitize the hands after removing the gloves.	1(2.5)	39(97.5)	0.0
Contact with objects, materials, equipment, clothing and individuals with contaminated Personal Protective Equipment should be avoided.	36(90.0)	3(7.5)	1(2.5)
The use of Personal Protective Equipment should not be shared.	36(90.0)	2(5.0)	2(5.0)
When performing oral care procedures or other procedures that may involve contact with mucous membranes of the patient, the use of gloves is not mandatory.	0.0	40(100.0)	0.0
In blood collection or venipuncture procedures, the use of gloves is necessary.	39(97.5)	0(0)	1(2.5)
In the procedures in which there are possibilities of contact of the hands with secretion or excretion of patients, the use of the gloves is necessary.	38(95.0)	1(2.5)	1(2.5)
Gloves should be replaced when providing care to different patients.	39(97.5)	1(2.5)	0.0
In procedures where there are possibilities of blood splatters, body fluid, secretion or excretion, protective mask or facial protector should be used.	39(97.5)	1(2.5)	0.0
In procedures where blood splatters, body fluid, secretion or excretion are likely to occur, it should be weared personal protective glasses or face shields.	40(100.0)	0.0	0.0
In procedures where blood splatters, body fluid, secretion or excretion are likely to occur, the protective apron should be used.	39(97.5)	1(2.5)	0.0
16. In situations where blood splatters, body fluid, secretion or excretion are likely to occur, disposable hats and surgical shoe should be used.	33(82.5)	6(15.0)	1(2.5)
It is forbidden to bend, twist, or perform the active encapsulation of needles. When necessary, perform the passive encapsulation with only one hand. Containers for disposal should be near the handling area.	31(77.5)	8(20.0)	1(2.5)
When providing nursing care to patients with hepatitis C or syphilis, it is necessary to adopt only the standard precautionary measures.	34(85.0)	6(15.0)	0.0
When providing nursing care to patients with active tuberculosis or chickenpox, standard precautions should be taken in addition to precautionary measures for droplets.†	13(33.3)	26(66.7)	0.0
When providing nursing care to patients with intestinal infections or skin infections, it is necessary to adopt the standard precautionary measures in addition to the contact precautionary measures.	34(85.0)	5(12.5)	1(2.5)

Variable*	Always	Frequently	Some times	Rarely	Never
Variable*	N (%)	N (%)	N (%)	N (%)	N (%)
1. I perform hand hygiene in the interval between providing care to different patients.	32 (80.0)	8 (20.0)	0.0	0.0	0.0
2. I perform hand hygiene after removing the gloves.	36 (90.0)	4 (10.0)	0.0	0.0	0.0
3. I wash hands immediately after contact with potentially contaminated biological materials.	40 (100.0)	0.0	0.0	0.0	0.0
Frequency of glove use in procedures where there is a possibility of contact with potentially contaminated biological materials:
4. Blood collection	39 (97.5)	1 (2.5)	0.0	0.0	0.0
5. Procedures involving the possibility of contact with urine or feces	39 (97.5)	1 (2.5)	0.0	0.0	0.0
6. Procedures involving the possibility of contact with the patient's non-integral skin	39 (97.5)	1 (2.5)	0.0	0.0	0.0
7. Procedures involving the possibility of contact with the patient's mucosa	38 (95.0)	2 (5.0)	0.0	0.0	0.0
8. Procedures involving the possibility of contact with secretions of the airway of patient	39 (97.5)	1 (2.5)	0.0	0.0	0.0
9. Intramuscular or subcutaneous injection	27 (67.5)	6 (15.0)	6 (15.0)	1 (2.5)	0.0
10. Dressing	39 (97.5)	1 (2.5)	0.0	0.0	0.0
11. Cleaning for blood removal	39 (97.5)	1 (2.5)	0.0	0.0	0.0
12. Venous puncture	36 (90.0)	4 (10.0)	0.0	0.0	0.0
13. Contact with blood samples	35 (87.5)	3 (7.5)	2 (5.0)	0.0	0.0
14. I use protective mask when there is possibility of contact with blood splash, body fluid, secretion or excretion	34 (85.0)	4 (10.0)	1 (2.5)	1 (2.5)	0.0
15. I wear protective glasses when there is a possibility of contact with blood splash, body fluid, secretion or excretion	12 (30.0)	11 (27.5)	13 (32.5)	4 (10.0)	0.0
16. I use protective apron when there is possibility of contact with blood splash, body fluid, secretion or excretion	18 (45.0)	15 (37.5)	4 (10.0)	3 (7.5)	0.0
17. I use disposable hats and surgical shoe when there is the possibility of contact with blood splash, body fluid, secretion or excretion	11 (27.5)	14 (35.0)	8 (20.0)	4 (10.0)	3 (7.5)
18. I do not perform active encapsulation of used needles or perform passive encapsulation of needles with only one hand	19 (47.5)	9 (22.5)	2 (5.0)	6 (15.0)	4 (10.0)
19. Discard needles, blades and other sharps materials in specific waste containers	40 (100.0)	0.0	0.0	0.0	0.0
20. After work accidents with potentially contaminated sharping materials, immediately squeeze the site, then perform the antisepsis and put on a dressing†	22 (56.4)	4 (10.3)	1 (2.6)	2 (5.1)	10 (25.6)

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] CORRESPONDENCE AUTHOR:
Keila Cristianne Trindade da Cruz keilactc@unb.br