Conhecimento e adesão aos procedimentos de segurança do paciente pela equipe multiprofissional na assistência a pacientes colonizados por germes multirresistentes.

Abstract

Introduction: healthcare-associated infections (HAIs) result in high rates of complications, in addition to favoring the selection and dissemination of multidrug-resistant microorganisms (MDR). Materials and methods: cross-sectional cohort study, with a quantitative approach, data were collected in a ward for patients colonized by MDR bacteria in a military hospital in Rio de Janeiro, from April 1 to 30, 2022, through questionnaires: data demographics, knowledge of contact precautions, and adherence to contact precautions. The adherence rate was compared between shift, profession and education using the ANOVA test with Tukey's post-test or the Kruskal-Wallis test with Dunn's post-test, depending on normality. The significance level used was 5% and all data were evaluated using the statistical software IBM SPSS Statistics 20. Main objective: to analyze the level of knowledge and the adherence rate of the multidisciplinary team related to safe procedures in the care of patients colonized by bacteria multiresistant. Secondary: identify whether the multidisciplinary team's level of knowledge and adherence rate differs or not by gender; compare the level of knowledge and adherence rate among permanent and temporary professionals in the sector; promote strategies that contribute to the reduction of HAIs; and build a desired value stream map for caring for patients colonized by multidrug-resistant bacteria based on the Lean Healthcare methodology. Results: 75 professionals participated (50 temporary and 25 permanent); being 54/75-72% female. Considering knowledge about contact precautionary measures and the type of professional (permanent or temporary), there was only one significant association. In the association between knowledge and gender, there was no significance between the analyzed variables. In the association between knowledge and work shift, most people who work at night answered that they did not receive training on PPE and safe procedures (p-value = 0.001). With regard to adherence, permanent professionals showed greater adherence than temporary workers (p-value < 0.0001). No significant differences were observed when comparing adherence rate and sex; adherence rate and shift; and adherence rate and schooling. In addition, a future value stream map was made with the help of Lean Healthcare. Conclusion: the level of knowledge of professionals in the multidisciplinary team was high, and the rate of adherence to procedures was satisfactory. It was evidenced that there was no significant difference in the level of knowledge and adherence rate of the multidisciplinary team regarding gender. Knowledge was adequate in permanent and temporary professionals. The adherence rate was higher in fixed professionals when compared to mobile professionals.