Dissertations / Theses on the topic 'Standard precautions'

Introduction and background: Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) are among the top ten causes of death globally. To prevent the spread of these infections in a hospital setting, health care workers and students should apply a set of principles called “standard precautions”. However, student nurses were found not complying to the standard precautions for prevention of Tuberculosis and Human Immunodeficiency Virus when allocated for clinical practice in the Eswatini healthcare setting. Many studies from different countries have shown non-use of protective clothing and students' failure to adhere to standard precautions. The knowledge of student nurses on standard precautions and the factors affecting their compliance regarding standard precautions had not been determined in-depth in the past. Aim of the study: The aim of this study was to assess knowledge and factors affecting student nurses’ compliance to standard precautions with the intention of recommending measures that can be taken to facilitate this compliance among student nurses. Methodology: A non-experimental quantitative approach was used to conduct a survey on senior student nurses of Eswatini University using questionnaires. The total population of third, fourth- and fifth-year students was selected through census sampling method. A Statistical Package for Social Science version 26 software was used to analyze the data. Findings: Among the student nurses asked, 91% were found to have adequate knowledge on standard precautions but they did not comply on washing hands and wearing gloves, safety glasses and aprons. Factors which influence compliance among student nurses were found to be: adequate knowledge, students’ willingness to take measure, hospital support through training and infection control policies, supportive nurses, availability of the post- exposure prophylaxis, the university’s continuous support, lack of resources and poor role- modelling. Recommendations: The researcher recommends that TB and HIV prevention skills be demonstrated to student nurses in the skills laboratory and that clinical facilitators should accompany students in the clinical area. In the hospitals, ordering and monitoring of supplies should be done well to eliminate shortage of resources and preceptors should be exempted from other duties so that they can be able to supervise student nurses.
Dissertation (MCur)--University of Pretoria, 2020.

Thesis (MCurr)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: The aim of this study was to compare the impact of a four-day structured Basic Infection Prevention and Control course on the knowledge of, and adherence to, Standard Precautions in clinical nursing practice amongst nurses who had completed the course and those who did not. The specific precautionary measures of investigation included hand hygiene, personal protective equipment (PPE) and sharps management. The secondary aim of the study was to identify any personal and contextual factors that influenced the application of such Standard Precautions measures in public healthcare facilities within the Cape Winelands and Overberg District. Sixty eight students (those who had been trained) with a similar number of controls (who had not been trained) were enrolled in the study. Although both the participants and controls had the knowledge, their adherence to hand hygiene, PPE and sharps management in clinical nursing practice was poor. Staff attitude was found to be the main factor for non-adherence. The knowledge of the participants was good as they had answered most of the questions correctly. It seems as if there was retention of knowledge after the four-day Basic Infection Prevention and Control course. There were, however, no significant differences between the two groups. For both groups attitude and behavioural change must be addressed in order to improve adherence to hand hygiene, PPE and sharps management. The findings of the study will form recommendations towards improved infection prevention and control practices at public healthcare facility level in the Cape Winelands District.
AFRIKAANSE OPSOMMING: Die doel van die studie was om die impak van 'n 4-dag gestruktureerde Basiese Infeksiebeheerkursus op die kennis en toepassing van Standaard Voorsorgmaatreëls in kliniese praktyk in die Kaapse Wynland en Overberg Distrikte ondersoek, vergeleke met 'n groep wat nie die kursus bygewoon het nie. Die spesifieke Voorsorgmaatreëls wat ondersoek is, het handhigiëne, die gebruik van beskermende drag en die hantering en beheer van skerpvoorwerpe ingesluit. Die studie het ook gekyk na enige kontekstuele en persoonlike faktore wat die toepassing van Standaard Voorsorgmaatreëls in openbare gesondheidsorgfasiliteite beïnvloed. Agt en sestig verpleegkundiges het die 4-dag Basiese Infeksiebeheerkursus bygewoon en 'n gelyke aantal kontrole studente het nie die kursus bygewoon nie. Alhoewel beide groepe die kennis van handhigiëne, die dra van beskermende drag en die hantering van skerpvoorwerpe gehad het, was die toepassing van die Standaard Voorsorgmaatreëls in kliniese praktyk baie swak. Personeel se houding was die grootste faktor wat gelei het tot die nie-toepassing van Standaard Voorsorgmaatreëls. Die kennis van die kursusgangers was goed, want albei groepe het die meeste van die vrae korrek beantwoord. Die waarneming wat gemaak is, is dat die kursusgangers se kennis wel verbeter het na die bywoning van die 4-dag Basiese Infeksiebeheerkursus. Data weerspieël egter geen noemenswaardige verskille tussen die groepe nie. Beide groepe se houding en gedrag moet aangespreek word om die toepassing van handhigiëne, die dra van beskermende drag en die hantering van skerpvoorwerpe te verbeter. Die bevindinge van die studie sal gebruik word om aanbevelings te maak ten einde infeksiebeheerpraktyke in die Kaapse Wynland Distrik te verbeter.

INTRODUCTION Compliance with evidence-based Standard Precautions Guidelines (SPGs) among healthcare practitioners is essential to combat Healthcare Associated Infections (HCAI). However, it is widely understood that non-compliance with these precautions remains a common problem in paediatric nursing practice. Most existing studies into this problem have used quantitative methods. However, these studies have failed to explain noncompliant behaviour or address the issues that are specific to paediatric clinical areas. AIM This study is designed to investigate paediatric nurses' perceptions and experiences of infection control measures and to achieve a better understanding of the factors that influence nurses’ compliance with SPGs. METHODS This qualitative study used an adapted constructivist grounded theory approach. The study was conducted in five Jordanian hospitals. Thirty one (n=31) qualified paediatric nurses from different paediatric areas were reccruited to the study. Data were gathered using face-to-face semi-structured audio-taped interviews, which were transcribed and coded through constant comparative analysis. RESULTS This study identified causes of enduring failure by nurses to comply fully with SPGs. Four themes emerged (Children are different; Nurses are human first; Limited professional status; The challenges of the working environment). Paediatric nurses claim to be willing to comply with SPGs, but sometimes fail to achieve this. Risk of exposure to microorganisms was perceived as a major factor in compliance. Paediatric nursing practice was seen as different to adult practice and nurses construed the need for SPGs differently. DISCUSSION A key issue is the fact that nurses were reluctant to see themselves as change-agents to improve practice. This resulted in problems with SPGs being well understood but not acted on. Nurse’s prioritised compliance with the nursing culture in their specific clinical area, over more general principles of care, such as SPGs. Nurses did appreciate that compliance with SPGs was suboptimal and did sometimes criticise this situation. However, most nurses had a value system, which militated against the proper use of Standard Precautions and which served to diminish the influence of them. IMPLICATION The chief implication of this study is that infection control is unlikely to improve further until nurses feel empowered to initiate change. Nursing in this area of the world is essentially semi-professional in nature. Nursing needs to develop to become fully professional in its orientation so that nurses take full responsibility for their actions. Only when nurses see their actions and behaviour as fully their responsibility, will nursing issues such as this be properly addressed. Until this occurs, the imposition of rules and guidelines, documentation and policies, will not be sufficient to progress care in this important area of practice.

Occupational exposures of healthcare workers tend to occur because of inconsistent compliance with standard precautions. Also, incidence of occupational exposure is underreported among operating room personnel. The purpose of this project was to develop national estimates for compliance with standard precautions and occupational exposure reporting practices among operating room nurses in Australia. Data was obtained utilizing a 96-item self-report survey. The Standard Precautions and Occupational Exposure Reporting survey was distributed anonymously to 500 members of the Australian College of Operating Room Nurses. The Health Belief Model was the theoretical framework used to guide the analysis of data. Data was analysed to examine relationships between specific constructs of the Health Belief Model to identify factors that might influence the operating room nurse to undertake particular health behaviours to comply with standard precautions and occupational exposure reporting. Results of the study revealed compliance rates of 55.6% with double gloving, 59.1% with announcing sharps transfers, 71.9% with using a hands-free sharps pass technique, 81.9% with no needle recapping and 92.0% with adequate eye protection. Although 31.6% of respondents indicated receiving an occupational exposure in the past 12 months, only 82.6% of them reported their exposures. The results of this study provide national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia. These estimates can now be used as support for the development and implementation of measures to improve practices in order to reduce occupational exposures and, ultimately, disease transmission rates among this high-risk group.

Introdução: As precauções-padrão (PP) constituem um conjunto de medidas que têm como finalidade minimizar o risco de transmissão ocupacional de patógenos, sendo indispensável sua utilização por profissionais de saúde, sobretudo pelos enfermeiros. No entanto, a não adesão às PP constitui problemática amplamente discutida em todo o mundo. Embora haja diversos estudos brasileiros que visem avaliar a adesão às PP , ainda tem-se observado grande fragilidade no processo de construção e de validação dos instrumentos utilizados para avaliação deste construto. Objetivo: Realizar a adaptação cultural e validação da Compliance with Standard Precautions Scale (CSPS) para enfermeiros brasileiros. Metodologia: Trata-se de um estudo metodológico para a adaptação e validação da CSPS. Essa escala é composta por 20 itens com quatro opções de respostas, e destina-se a avaliar a adesão às PP. O processo de adaptação consistiu em Tradução, Consenso entre Juízes, Retrotradução e Validação Semântica. A primeira etapa foi a tradução do idioma original para o português do Brasil. Após foi realizado um comitê composto por sete juízes, a versão de consenso obtida na etapa anterior foi traduzida novamente para o idioma de origem. Foram avaliadas as propriedades psicométricas do instrumento, considerando-se as validades de face e de conteúdo, a validade de construto e a confiabilidade. A versão para o Português do Brasil da CSPS (CSPS-PB) foi aplicada em uma amostra de 300 enfermeiros que atuam na assistência a pacientes em um hospital localizado na cidade de São Paulo/SP. A confiabilidade foi avaliada por meio da consistência interna (alfa de Cronbach) e teste reteste (coeficiente de correlação intraclasse - ICC). Para a validação de construto, foi utilizada a comparação entre grupos diferentes, análise fatorial exploratória e análise fatorial confirmatória, segundo o Modelo de Equações Estruturais (SEM). Utilizou-se o software IBM® SPSS, 19.0. Para a análise fatorial confirmatória foi utilizado o módulo específico Analysis of Moment Structures (IBM® SPSS AMOS). Para a análise paralela utilizou-se o programa RanEigen Syntax. O nível de significância adotado foi ? = 0,05. Todos os aspectos éticos foram contemplados. Resultados: A tradução realizada por tradutores juramentados garantiu qualidade a esse processo. A validação de face e de conteúdo possibilitou a realização de modificações pertinentes e imperativas a fim de atender aos critérios de equivalências conceituais, idiomáticas, culturais e semânticas. Obteve-se ?=0,61 na avaliação da consistência interna, indicando confiabilidade satisfatória. O ICC indicou uma correlação de 0,87 quase perfeita para o teste reteste duas semanas após a primeira abordagem, conferindo estabilidade satisfatória. A validade de construto mostrou que a CSPS-PB foi capaz de discriminar as médias de adesão às PP entre grupos distintos referente à idade (F=5,15 p<=0,01), ao tempo de experiência clínica (F = 8,9 p<= 0,000) e a ter recebido treinamento (t = 2,48 p<=0,01). Na análise fatorial confirmatória, o modelo foi subidentificado. A análise fatorial exploratória indicou que todos os itens apresentaram cargas fatoriais adequadas (>=0,30), sendo identificados quatro fatores pela análise paralela. O total de variância explicada foi de 35,48%. Conclusão: A CSPS-PB, trata-se de um instrumento adequado, confiável e válido para medir a adesão às PP entre enfermeiros brasileiros
Introduction: Standard precautions (SP) are a set of measures that aim to minimize the risk of occupational transmission of pathogens, being essential their use by health professionals, especially nurses. However, the non-adhesion to SP is a widely discussed problem. Although there are several Brazilian studies aimed at evaluating adhesion to SP, a great weakness in the construction and validation process of the instruments used to assess this construct was observed. Objective: To conduct the cultural adaptation and validation of the Compliance with Standard Precautions Scale (CSPS) for Brazilian nurses. Methodology: This is a methodological study to adapt and validate the CSPS. This scale consists of 20 items with four response options to evaluate adhesion to standard precautions. The adaptation process consisted of Translation, Consensus among Judges, Back-translation and Semantic Validation. The first step was the translation of the original language to Brazilian Portuguese. After that, a committee composed of seven judges analyzed the translation; the consensus version obtained in the previous step was translated back into the original language. The psychometric properties of the instrument were evaluated considering the validity of face and content, construct validity and reliability. The version for Brazilian Portuguese of CSPS (CSPS-PB) was applied to a sample of 300 nurses who work in the care of patients in a hospital located in city of São Paulo. Reliability was evaluated by internal consistency (Cronbach\'s alpha) and test retest (intraclass correlation coefficient-ICC). For construct validation, it was used comparisons among different groups, exploratory factor analysis and confirmatory factor analysis, according to the Structural Equation Model (SEM). IBM® SPSS 19.0 was used. For the confirmatory factor analysis, it was used the specific module Analysis of Moment Structures (IBM® SPSS AMOS). For parallel analysis, it was used the RanEigen Syntax program. The significance level was ?=0.05. All ethical aspects were included. Results: The translation conducted by sworn translators assured quality to this process. Validation of face and content made possible the performance of relevant and imperative modifications in order to meet the criteria of conceptual, idiomatic, cultural and semantic equivalence. The evaluation of internal consistency obtained ?=0.61, indicating satisfactory reliability. The ICC indicated a near-perfect correlation of 0.87 for the test-retest two weeks after the first approach, giving satisfactory stability. Construct validity showed that the CSPS-PB was able to discriminate the average of adhesion to PP among different groups related to age (F=5.15 p<=0.01), to the time of clinical experience (F=8.9 p<=0.000) and to have received training (t=2.48 p<=0.01). In confirmatory factor analysis, the model was under identified. Exploratory factor analysis indicated that all items had adequate factor loadings (>=0.30), being identified four factors by parallel analysis. The total variance explained was 35.48%. Conclusion: CSPS-PB is an appropriate instrument, reliable and valid to measure adhesion to PP among Brazilian nurses

Occupational exposures of healthcare workers tend to occur because of inconsistent compliance with standard precautions. Also, incidence of occupational exposure is underreported among operating room personnel. The purpose of this project was to develop national estimates for compliance with standard precautions and occupational exposure reporting practices among operating room nurses in Australia. Data was obtained utilizing a 96-item self-report survey. The Standard Precautions and Occupational Exposure Reporting survey was distributed anonymously to 500 members of the Australian College of Operating Room Nurses. The Health Belief Model was the theoretical framework used to guide the analysis of data. Data was analysed to examine relationships between specific constructs of the Health Belief Model to identify factors that might influence the operating room nurse to undertake particular health behaviours to comply with standard precautions and occupational exposure reporting. Results of the study revealed compliance rates of 55.6% with double gloving, 59.1% with announcing sharps transfers, 71.9% with using a hands-free sharps pass technique, 81.9% with no needle recapping and 92.0% with adequate eye protection. Although 31.6% of respondents indicated receiving an occupational exposure in the past 12 months, only 82.6% of them reported their exposures. The results of this study provide national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia. These estimates can now be used as support for the development and implementation of measures to improve practices in order to reduce occupational exposures and, ultimately, disease transmission rates among this high-risk group.

Everyday thousands of nurses are rendering bedside nursing care in health care settings as a result they are exposed to blood, body fluids and sharp objects that are contaminated with Hepatitis B, Hepatitis C and HIV. Therefore they are at risk of getting infected. In 1996, standard precautions were implemented by the Centre of Disease Control to reduce the risk of transmission of micro-organisms from any source of infection in the hospital. In the year 2008, the three tertiary hospitals together in the Western Cape reported that they had 733 needle prick injuries. Therefore the aim of the study was to determine if nurses comply with and have adequate knowledge of standard precautions. A non-experimental design and a self administered questionnaire were used to collect the data for the study. The study was done at Tygerberg Hospital and the participants (n=143) that were involved in the study were all nursing categories (professional, enrolled nurse and auxiliary nurse). Stratified random sampling was used to ensure that there was a representation of all the nurses working in the different modules at Tygerberg Hospital. Therefore three wards were randomly selected from each module and all the nurses on duty working in the three selected wards were given a questionnaire by the Assistant Director of the specific module. After the data was collected it was analysed through the statistical package for social sciences. The findings of the study showed that nurses have inadequate knowledge regarding standard precautions and the mean score of the nurses overall self reported compliance of standard precautions was 87.5%. The results also showed that when patients are HIV positive nurses intend to over comply the use of personal protective equipment. No association was found between the nurses&rsquo
knowledge and compliance regarding standard precautions. It is therefore important that every nurse should be educated about the basic principles of standard precautions and also the policies and protocols of infection control in order to prevent each nurse from getting infected. Training needs to be implemented starting in the wards through the unit manager to improve all the nurses&rsquo
knowledge and practice.

As Unidades de Terapia Intensiva atendem pacientes críticos, que demandam cuidados de alta complexidade. Com isso, a freqüente realização de procedimentos invasivos favorece a exposição do profissional e dos pacientes a riscos biológicos. Para diminuir os riscos associados ao trabalho dos profissionais que atuam nessas unidades, é imprescindível utilizar medidas preventivas durante a assistência das quais destacamos as precauções-padrão. Objetivos: Avaliar os fatores individuais, relativos ao trabalho e organizacionais relacionados à adesão às precauções-padrão por profissionais de enfermagem que atuam em terapia intensiva em um hospital universitário do interior paulista. Metodologia: Trata-se de um estudo de corte transversal, desenvolvido no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, no período de dezembro de 2010 a junho de 2011. A população de estudo constituiu-se por 178 profissionais da equipe de enfermagem - enfermeiros, técnicos e auxiliares de enfermagem- que atuavam na assistência a pacientes em terapia intensiva, de duas unidades distintas da instituição. Os instrumentos para a coleta de dados foram escalas psicométricas do tipo Likert desenvolvidas por Gershon et al. (1995), traduzidas e validadas por Brevidelli e Cianciarullo (2009), somando 57 questões divididas em 10 escalas, que compreendem fatores individuais, do trabalho e organizacionais. A análise estatística foi feita por meio do software Statistical Package for Social Science (SPSS), versão 15.0., utilizando-se estatística descritiva e teste de correlação de Pearson. Resultados: A maior parte dos profissionais foi do sexo feminino 171 (79,2) com predomínio da categoria de auxiliar de enfermagem com 94 (52,8%). Obteve-se que 79 (44,4%) dos profissionais trabalhavam 50 horas ou mais durante a semana. Na escala de adesão às precauções-padrão obteve-se um escore de 4,45 (DP=0,27) classificado como intermediário para as duas unidades. Houve correlação quando comparada com fatores individuais, para Escala de Personalidade de Risco (r=- 0,169; p=0,024) e fatores relativos ao trabalho representada pela Escala de Obstáculos para Seguir as precauções-padrão (r=-0,359; p=0,000). Para a unidade B os fatores organizacionais com a Escala de Clima de Segurança (r=0,243; p=0,014) apresentaram correlação estatisticamente significante quando comparados com a Escala de Adesão. Conclusão: Para as unidades A e B de terapia intensiva, a adesão às PP foi intermediária entre enfermeiros, técnicos e auxiliares de enfermagem, ou seja, não ocorreu em sua totalidade. O comportamento individual, a identificação de obstáculos e a organização do trabalho são aspectos que devem ser revistos, pois fatores individuais, relativos ao trabalho e organizacionais influenciaram na adesão às precauções-padrão por profissionais que atuam em terapia intensiva.
Introduction: Intensive Care Units serve critically ill patients requiring highly complex care. Thus, frequent invasive procedures promote the professional and the patients exposure to biological hazards. To reduce the risks associated with the work of professionals working in these units, it is essential to use preventive measures for the assistance of which we highlight the standard precautions. Objectives: To assess the individual factors related to work-related and organizational adherence to standard precautions for nurses working in intensive care at a university hospital in the interior of São Paulo. Methodology: This is a cross-sectional study, developed at the Hospital das Clinicas of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo in the period of December 2010 to June 2011. The study population consisted of 178 professionals of the nursing staff - nurses, technicians and nursing assistants who worked in patient care in intensive care, two distinct units of the institution. The instruments for data collection were the psychometric Likert scales developed by Gershon et al. (1995), translated and validated by Brevidelli and Cianciarullo (2009), totaling 57 questions divided into 10 scales, which include individual factors, and organizational work. Statistical analysis was performed using the Statistical Package for Social Science (SPSS) version 15.0., Using descriptive statistics and Pearson correlation test. Results: Most professionals were 171 females (79.2) with a predominance of the category of nursing assistant with 94 (52.8%). It was found that 79 (44.4%) of the professionals were working 50 hours or more during the week. On a scale of adherence to standard precautions we obtained a score of 4.45 (SD = 0.27) classified as intermediate for the two units. There was a correlation when compared with individual factors to Risk Personality Scale (r =- 0.169, p = 0.024) and factors related to the work represented by the scale of Obstacles to follow the standard-precautions (r =- 0.359, p = 0.000). For the B unit the organizational factors with Safety Climate Scale (r = 0.243, p = 0.014) showed statistically significant when compared with the adherence scale. Conclusion: For the A and B intensive care units, adherence to SP was intermediate between nurses, technicians and nursing assistants, or did not occur in its entirety. The individual behavior, identification of obstacles and work organization must be reviewed because individual factors, related to work and organizational influence on adherence to standard precautions by professionals working in intensive care.

As precauções-padrão preconizadas pelo Centers for Disease Control and Prevention e ratificadas pelo Ministério da Saúde, são medidas que minimizam a exposição ocupacional a material biológico potencialmente contaminado e previnem as infecções relacionadas à assistência em saúde. No entanto, constata-se que a adesão a essas medidas é problema dentre os profissionais de enfermagem e instrumentos para estudar a adesão de enfermeiros a essas medidas foram construídos para apoiar intervenções. Considerando-se que a adaptação e validação de um instrumento utilizado em diferentes culturas garante a sua maior confiabilidade e validade e que a viabilidade de um instrumento fidedigno, para aferir conhecimento e adesão de enfermeiros às precauções-padrão, se faz necessário no contexto brasileiro, este estudo teve por objetivos adaptar para enfermeiros brasileiros e validar o questionário de adesão às precauções-padrão e o questionário de conhecimento sobre as precauções-padrão (Questionnaires for Knowledge and Compliance with Standard Precaution).Trata-se de estudo metodológico, cujo processo de adaptação dos questionários seguiu as etapas: tradução inicial; síntese e consenso das traduções; realização do comitê de especialistas; retrotradução; validação semântica e pré-teste da versão final. O processo de adaptação contou com uma amostra de 42 enfermeiros de uma unidade de emergência vinculada a um hospital de ensino do interior de São Paulo, sendo que 12 enfermeiros participaram da validação semântica e 30 do pré- teste. O processo de validação foi realizado com uma amostra aleatória de 121 enfermeiros, sendo 91 pertencentes a estabelecimentos de saúde de alta complexidade e 30 enfermeiros pertencentes a estabelecimentos de saúde de média complexidade de outro município do interior de São Paulo (sendo um hospital filantrópico, um hospital privado e uma unidade de pronto atendimento vinculada a um plano de saúde). Para o Questionário de Adesão às Precauções-Padrão, a consistência interna foi calculada pelo alfa de Cronbach e a estabilidade pelo Coeficiente de Correlação Intraclasse. A validade de construto convergente foi calculada pela correlação com a percepção de clima de segurança organizacional e a validade de construto divergente por meio da correlação com a menor percepção de obstáculos, para seguir as precauções-padrão. A validade de construto por grupos conhecidos foi calculada entre enfermeiros que relataram ter recebido e enfermeiros que relataram não ter recebido treinamento e entre as diferentes instituições estudadas. A presença de efeito máximo e mínimo (floor and ceiling) foi avaliada. Para o Questionário de Conhecimento sobre as Precauções-Padrão foi calculada a concordância pelo coeficiente Kappa e a estabilidade foi avaliada pelo Coeficiente de Correlação Intraclasse. A validade de construto entre grupos conhecidos foi calculada entre enfermeiros com maior e menor titulação e enfermeiros que receberam e que não receberam treinamento sobre as precauções-padrão. Os resultados obtidos mostram que os questionários estão compreensíveis, fáceis de responder e adequados ao português do Brasil. O pré-teste confirmou a versão obtida pela validação semântica. O questionário de adesão apresentou consistência interna de 0,80 e estabilidade de 0,97. A validade de construto convergente e divergente evidenciaram forte correlação com a maior percepção de clima de segurança (r=0,614) e com a menor percepção de obstáculos, (r=0-537). A validade de construto entre grupos conhecidos revelou maior adesão entre os enfermeiros que receberam treinamento (p=0,028) e que os participantes pertencentes aos estabelecimentos de alta complexidade apresentaram maior adesão quando comparados aos demais estabelecimentos (p=0,006). Foi verificado efeito máximo e mínimo no Questionário de Adesão às Precauções-Padrão, o que compromete a responsividade do instrumento; porém, auto-relatos de adesão são frequentemente superiores aos índices constatados em estudos observacionais. Com relação ao Questionário de Conhecimento sobre as Precauções-Padrão, as respostas dos enfermeiros se mostraram concordantes e a estabilidade foi de 0,91, o que confirma a capacidade do instrumento de detectar possíveis alterações em características na amostra estudada. A validade por grupos conhecidos não evidenciou diferença estatisticamente significante entre os enfermeiros pela titulação e presença de treinamento (p=0,706 e p=0,209, respectivamente). Os resultados evidenciam que o Questionário de Adesão às Precauções-Padrão obteve índices psicométricos satisfatórios, o que confirma a hipótese de que o instrumento afere o construto adesão. O Questionário de Conhecimento sobre as Precauções-Padrão revelou boa concordância e estabilidade. Conclui-se que os questionários adaptados e validados são fidedignos e podem ser utilizados para medir a adesão e o conhecimento de enfermeiros brasileiros às precauções-padrão e subsidiarão a proposição de medidas intervencionistas, visando a saúde do trabalhador e a segurança do paciente
The standard precautions, established by the Centers for Disease Control and Prevention and ratified by the Brazilian Ministry of Health, are measures that minimize the occupational exposure to potentially contaminated biological material and prevent healthcare-related infections. As verified, however, compliance with these measures is a problem among nursing professionals and tools to study the nurses\' compliance with these measures have been constructed to support interventions. Considering that the adaptation and validation of a tool used in different cultures guarantees its greater reliability and validity and that the feasibility of a reliable tool to verify nurses\' knowledge and compliance with the standard precautions is necessary in the Brazilian context, the objectives in this study were to adapt for Brazilian nurses and validate the Questionnaires for Knowledge and Compliance with Standard Precaution. In this methodological study, the adaptation process of the questionnaires followed a number of phases: initial translation; synthesis and consensus of the translations; expert committee; back translation; semantic validation and pretest of the final version. The adaptation process involved a sample of 42 nurses from the emergency service of a teaching hospital in a city from São Paulo state, 12 of whom participated in the semantic validation and 30 in the pretest. The validation process was accomplished with a random sample of 121 nurses, 91 were located in high complexity healthcare institutions and 30 from intermediate healthcare institutions in another city from São Paulo state (including one non-for-profit hospital, one private hospital and the emergency service of a health insurance). For the Questionnaire for Compliance with Standard Precaution, the internal consistency was calculated using Cronbach\'s alpha and the stability using the Intraclass Correlation Coefficient. The convergent construct validity was calculated through the correlation with the perceived organizational safety climate and the divergent construct validity through the correlation with the lesser perception of obstacles to compliance with the standard precautions. The construct validity using the known-groups method was calculated among nurses who indicated they had received and nurses who indicated they had not received training and among the different institutions under analysis. The presence of floor and ceiling effects was assessed. For the Questionnaire for Knowledge about Standard Precaution, the agreement was calculated using the Kappa coefficient and stability was assessed through the Intraclass Correlation Coeficient. The construct validity among known groups was calculated between nurses with higher and lower degrees and nurses who did and did not receive training about the standard precautions. The obtained results show that the questionnaires are understandable, easy to answer and appropriate to Brazilian Portuguese. The pretest confirmed the version obtained in the semantic validation procedure. The internal consistency of the compliance questionnaire equaled 0.80 and the stability 0.97. The convergent and divergent construct validity showed a strong correlation with a greater perceived safety climate (r=0.614) and a lesser perception of obstacles (r=0-537). The construct validity among known groups revealed greater compliance among the nurses who received training (p=0.028) and that the subjects at the high complexity healthcare institutions showed higher compliance levels when compared to the other institutions (p=0.006). Floor and ceiling effects were found in the Questionnaire for Compliance with Standard Precaution, which compromises the responsiveness of the tool; nevertheless, self-reported compliance levels are frequently higher than the indices found in observation studies. As regards the Questionnaire for Knowledge about Standard Precaution, the nurses\' answers demonstrated agreement and the stability corresponded to 0.91, which confirms that tool\'s ability to detect possible alterations in characteristics of the study sample. The validity among known groups did not show a statistically significant difference among the nurses according to the degree and presence of training (p=0.706 and p=0.209, respectively). The results show that the Questionnaires for Compliance with Standard Precautions obtained satisfactory psychometric coefficients, which confirms the hypothesis that the tool verifies the compliance construct. The Questionnaire for Knowledge about Standard Precaution revealed good agreement and stability coefficients. In conclusion, the adapted and validated questionnaires are reliable and can be used to measure the compliance and knowledge of Brazilian nurses about the standard precaution and will support the proposal of intervention measures directed at occupational health and patient safety

The purpose of the study The purpose of this research project was to develop and test an educational program for preparing Taiwanese nursing students for clinical practice. Study background The SARS outbreak revealed that health care professionals were ill-prepared for coping with the disease epidemic in terms of the rapid transmission of the infection, the high mortality and morbidity rate among health care workers, and the significant impacts on the public and health care personnel. Frontline nurses were the group at highest risk of becoming infected, as they are the health care personally that provide direct health care to infected patients. However, to date the ability of Taiwanese frontline nurses to respond to such a disease epidemic has not been examined. Study design This research project incorporated a three phase design, presented in the form of two separate studies. A small qualitative exploratory study was undertaken to validate the assumptions emerging from international literature regarding the preparedness nurses in managing an infection outbreak. The information gained was used to construct an infection control education program (Study I). A quasi-experimental design, using pre- and post-tests and experimental and control groups was then used to test the effectiveness of the education intervention (Study II). Participants A purposive sampling technique was used in the qualitative exploratory study, whereby six Taiwanese nurses who had provided direct nursing care to patients with SARS were interviewed. A convenience sampling approach was utilised in the quantitative study, which aimed to test the effectiveness of educational intervention. This, second study, had 175 participants in total, 80 in the experimental group and 95 in the control group. All participants were enrolled in the first semester of their fourth year in a five-year nursing program in two selected junior nursing colleges. The education intervention The purpose-designed standard and additional precautions (SnAP) program was the intervention. The experimental group received a SnAP program which consisted of 16 hours of classes over 16 weeks. The control group received a conventional education program. Data collection and instrument Data were collected at three time points during the study (baseline, four months, six month) using validated instrument. The reliability and validity of the instrument was established in a pilot study with a Taiwanese population prior to the present study. Data analysis t-tests and chi-square analyses were performed to assess any differences across demographic variables and baseline outcome variables between the experimental and control groups. Two-way repeated measures ANOVAs were used to examine the scores of the intervention and control groups across three time points. Results The data revealed that, at six months following the education program, there was a statistically significant improvement in the knowledge (F [2,180] =13.53, p=0.001) and confidence (F [2,94] =4.88, p= 0.01) of infection precautions in the intervention group compared to the control group. Also, the means of knowledge and confidence in intervention group showed a consistently increased across three time points; whereas, the mean of confidence relating infection control management in the control group resulted a drop at time 3. Although the application skills relating to infection control procedures did not show a statistically significant change during this period (F [2, 174] = 2.54, p=0.081), there were minor improvements in these scores at the six-month follow-up assessment. Conclusion The SnAP program had a positive impact on Taiwanese nursing students' readiness for clinical placement and potential outbreak of disease epidemics. Participation increased their knowledge about infection control precautions, their ability to properly use these specific precautions, and their confidence in solving infection-related issues in clinical practice.

The purpose of the study The purpose of this research project was to develop and test an educational program for preparing Taiwanese nursing students for clinical practice. Study background The SARS outbreak revealed that health care professionals were ill-prepared for coping with the disease epidemic in terms of the rapid transmission of the infection, the high mortality and morbidity rate among health care workers, and the significant impacts on the public and health care personnel. Frontline nurses were the group at highest risk of becoming infected, as they are the health care personally that provide direct health care to infected patients. However, to date the ability of Taiwanese frontline nurses to respond to such a disease epidemic has not been examined. Study design This research project incorporated a three phase design, presented in the form of two separate studies. A small qualitative exploratory study was undertaken to validate the assumptions emerging from international literature regarding the preparedness nurses in managing an infection outbreak. The information gained was used to construct an infection control education program (Study I). A quasi-experimental design, using pre- and post-tests and experimental and control groups was then used to test the effectiveness of the education intervention (Study II). Participants A purposive sampling technique was used in the qualitative exploratory study, whereby six Taiwanese nurses who had provided direct nursing care to patients with SARS were interviewed. A convenience sampling approach was utilised in the quantitative study, which aimed to test the effectiveness of educational intervention. This, second study, had 175 participants in total, 80 in the experimental group and 95 in the control group. All participants were enrolled in the first semester of their fourth year in a five-year nursing program in two selected junior nursing colleges. The education intervention The purpose-designed standard and additional precautions (SnAP) program was the intervention. The experimental group received a SnAP program which consisted of 16 hours of classes over 16 weeks. The control group received a conventional education program. Data collection and instrument Data were collected at three time points during the study (baseline, four months, six month) using validated instrument. The reliability and validity of the instrument was established in a pilot study with a Taiwanese population prior to the present study. Data analysis t-tests and chi-square analyses were performed to assess any differences across demographic variables and baseline outcome variables between the experimental and control groups. Two-way repeated measures ANOVAs were used to examine the scores of the intervention and control groups across three time points. Results The data revealed that, at six months following the education program, there was a statistically significant improvement in the knowledge (F [2,180] =13.53, p=0.001) and confidence (F [2,94] =4.88, p= 0.01) of infection precautions in the intervention group compared to the control group. Also, the means of knowledge and confidence in intervention group showed a consistently increased across three time points; whereas, the mean of confidence relating infection control management in the control group resulted a drop at time 3. Although the application skills relating to infection control procedures did not show a statistically significant change during this period (F [2, 174] = 2.54, p=0.081), there were minor improvements in these scores at the six-month follow-up assessment. Conclusion The SnAP program had a positive impact on Taiwanese nursing students' readiness for clinical placement and potential outbreak of disease epidemics. Participation increased their knowledge about infection control precautions, their ability to properly use these specific precautions, and their confidence in solving infection-related issues in clinical practice.

Syftet med denna litteraturstudie var att beskriva sjuksköterskestuderandes kunskaper om och följsamhet till basala hygienrutiner. Vidare var syftet att beskriva faktorer som bidrar till sjuksköterskestuderandes följsamhet respektive oföljsamhet avseende basala hygienrutiner. Metoden var en deskriptiv litteraturstudie. Artikelsökningen har skett via databaserna Medline via Pubmed och Cinahl, sökning har även skett manuellt. Huvudresultatet visade att sjuksköterskestudenter har generellt goda teoretiska kunskaper om vårdhygien och basala hygienrutiner. Dock finns faktorer som minskar följsamheten till vårdhygien och basala hygienrutiner. Sjusköterskestudenterna har få positiva förebilder som utför korrekta basala hygienrutiner. Hög arbetsbelastning och stress minskar utförandet av basala hygienrutiner. Ytterligare faktorer som bidrar till minskad följsamhet var studenternas vilja att bli accepterade som en i vårdlaget och rädslan att relationen mellan student och handledare försämras. Goda förebilder för sjuksköterskestudenterna kan öka följsamheten till basala hygienrutiner, samt lärarledda målinriktade utbildningar inom vårdhygien och basala hygienrutiner. Slutsatsen av studien är att sjuksköterskestudenter har generellt goda teoretiska kunskaper om vårdhygien och basala hygienrutiner, dock att följsamheten till detta inte alltid följs på grund av olika faktorer. Samt att det behövs mer utbildning om basala hygienrutiner för sjuksköterskestudenter.
The aim of this literature review was to describe nursing students’ knowledge about standard precautions and infection control. Furthermore the aim was to describe contributing factors to nursing student’s compliance and noncompliance to standard precautions and infection control. The chosen method for this study was a descriptive review. Scientific articles were searched in the databases Pubmed and Cinahl. Manual search was also conducted.  The main results of the study showed that nursing students generally have good theoretical knowledge about standard precautions and infection control. There are however factors that reduce the compliance to standard precautions and infection control. Nursing students have few positive role models that perform correct standard precautions. Heavy workload and stress reduce the performance of standard precautions. Additional factors that reduce the compliance are the students’ intentions to become accepted as members of the nursing team, and the fear of the relationship between the student and the mentor would deteriorate. Good role models and teacher-led targeted education interventions for the students can increase the compliance to standard precautions. The conclusion of this study is that nursing students’ generally have good theoretical knowledge about standard precautions and infection control, there are however factors that reduce the compliance. More educations about hygiene are necessary for nursing students.

As Precauções- Padrão (PP) são medidas fundamentais para proteger pacientes e profissionais da área da saúde (PAS) da aquisição de microorganismos patogênicos. Entretanto, a adesão às PP é insatisfatória e vários motivos são descritos para essa baixa adesão. OBJETIVO: Analisar os fatores individuais, laborais e organizacionais associados com a adesão às PP de profissionais de enfermagem de uma instituição privada localizada na cidade de São Paulo. MÉTODO: Estudo transversal realizado com uma amostra de 291 profissionais de enfermagem, distribuídos proporcionalmente entre enfermeiros, técnicos e auxiliares que trabalhavam em setores críticos, semi-críticos e emergência. Os dados foram coletados no período de outubro de 2010 a janeiro de 2011. Para a coleta de dados, utilizou-se um instrumento com questões socio demográficas e escalas de Likert com 5 opções de respostas, segundo o referencial teórico Modelo Explicativo da Adesão às Precauções- Padrão. RESULTADO: 78,0% (226/291) dos profissionais de enfermagem responderam usar as PP na assistência a todos os pacientes. A análise multivariada mostrou que a adesão às PP foi associada a fatores individuais, expressa por profissionais mais jovens; fatores laborais, expressa por menor percepção de obstáculos e ter recebido treinamento; e fatores organizacionais, expressa por maior percepção de clima de segurança institucional. CONCLUSÕES: As intervenções planejadas para a melhoria da adesão às PP devem ser voltadas não somente para treinamentos em serviço, mas também para ações de redução de barreiras e melhoria do clima de segurança institucional.
Standard Precautions (SP) are key measures to protect patients and health professionals (HP) from the acquisition of pathogenic microorganisms. However, adherence to the SP is unsatisfactory and several reasons are described for this low adherence. OBJECTIVE: To analyze individual, organizational and labor factors associated with adherence to the SP of nursing professionals from a private institution located in the city of São Paulo. METHOD: Cross-sectional study carried out with a sample of 291 nursing professionals, proportionally distributed among nurses, nursing technicians and nursing auxiliaries who work in critical, semi-critical and emergency care areas. Data were collected between October 2010 and January 2011. For data collection an instrument with sociodemographic questions and Likert-type scales with 5 response options was used, according to the theoretical framework of the Explanatory Model of Adherence to Standard Precautions. RESULT: 78.0% (226/291) of the nursing professionals answered using the SP in the care to all patients. Multivariate analysis showed that adherence to SP was associated with individual factors, expressed by younger professionals; labor factors, expressed by lower perception of obstacles and having received training; and organizational factors, expressed by a greater perception of institutional safety climate. CONCLUSIONS: Interventions designed to improve the adherence to SP should target not only in-service training, but also actions to reduce barriers and improve the institutional safety climate.

Background Hospital-acquired infections are significant cause of morbidity and mortality among hospitalized patients worldwide. Healthcare workers during job are exposed to blood borne pathogens through contact with infected body parts, blood and body fluids. World health organization (WHO) estimated that globally about 2.5% of HIV and 40% of hepatitis viral infected cases are among health workers due to exposures. The most important mechanism of spread of these pathogens is through contaminated hands of the healthcare workers. Standard precautions measures are essential to prevent and control healthcare associated infection among healthcare workers and patients. In developing countries despite the development of detailed guideline for infection control the knowledge of standard precautions is low and not properly applied. The aim of this study is to assess the knowledge and practice of health care workers regarding standard precautions and hand hygiene to infectious disease control.  Aim The aim of this study was to assess the knowledge and practice of health care workers regarding hand wash and standard precautions to control infectious diseases in BMCH. In addition create awareness among participants and encourage them to practice regularly hand hygiene and standard precautions to control or reduce nosocomial infections in health care facilities Methods The study design is cross-sectional evaluation of healthcare worker knowledge and practices about standard precautions and hand hygiene for infectious disease control. A questionnaire administered to health care workers (doctors and nurses). The questionnaire was divided in two parts and the first part concerns demographic information, asking knowledge and practice. The second part asked opinions about risk and prevention of HAIs. The questionnaire was developed with consultation of other studies of the same kind. It has been pre tested and is finalized for survey. The ethical approval was given by hospital superintendent and informs consent from all study participants. Statistic analysis was done on Excel and statistical software SPSS version 20. Data was described in numbers, percentages and Chi Square test done for association among categorical variables, significant level was considered P= <0.05. Results Two hundred questionnaires were distributed to HCWs in BMCH and 169 completely fill questionnaire were returned. The male gender respondents were 42% and female respondents were 58%. The basic questions about knowledge of hand hygiene and standard precautions were answered well in both categories; about 73% were with sufficient knowledge. The practice of hand hygiene and standard precautions was not satisfactory among both categories; about 47% found with good practice. Differences found in sub groups, young age none trained doctors and nurses answered wrong and shown lack of knowledge. This study found an association of age, profession and job experience with knowledge and practice regarding hand hygiene and standard precautions. Open handed questions described well the major issue regarding HAIs and participants emphasized on risk and prevention methods.  Conclusions The respondents were HCWs (doctors and nurses) of both sex and this study found that majority of HCWs have good knowledge and practice about control of HAIs but difference were found in age groups, sex and profession. Above half of the HCWs were not trained for infection control in health facilities, thus getting training of infection control is important but more important is implementation of it during practice.

Introdução: Staphylococcus aureus é um importante patógeno responsável por diversas infecções no ambiente hospitalar com elevada morbi-mortalidade. Os profissionais de saúde, sobretudo os de enfermagem, apresentam elevado risco de colonização por meio do contato direto com indivíduos suscetíveis ou pelo contato com fômites em suas atividades laborais. Com isso, esses profissionais podem disseminar esses microrganismos tanto no ambiente hospitalar como na comunidade. Objetivo: Avaliar a colonização por Staphylococcus aureus em profissionais de enfermagem e a adesão às precauções-padrão. Metodologia: Trata-se de um estudo transversal realizado em clínica médica e em unidades especializadas em prestação de cuidados a pessoas com HIV/aids de um hospital escola do município de Ribeirão Preto. A população foi composta por 100 profissionais de enfermagem que prestam cuidados direto aos pacientes dessas unidades. Foram coletadas amostras de saliva, de secreção nasal e um swab do telefone celular dos profissionais. A coleta ocorreu no período de abril de 2014 a fevereiro de 2015, em três momentos, nos meses zero, quatro e oito. A obtenção dos dados demográficos, profissionais e individuais foi feita por meio de um questionário estruturado. Para avaliar a adesão dos profissionais às precauções-padrão, foram aplicadas dez escalas psicométricas do tipo Likert, já traduzidas e validadas para o português. As amostras coletadas foram encaminhadas e processadas pelo Laboratório de Microbiologia e Sorologia do referido hospital. Resultados: Dos 100 profissionais de enfermagem, 43,0% estavam colonizados por Staphylococcus aureus nas amostras de saliva e/ou de secreção nasal; 36,0% eram Staphylococcus aureus sensível à oxacilina e 7,0% resistente à oxacilina. A prevalência foi de 32,0% na secreção nasal, 1,0%, na saliva e 11,0%, nas amostras de saliva e de secreção nasal. Observou-se que 93,0% dos Staphylococcus aureus apresentaram resistência à penicilina, 43,0%, à eritromicina e 39,5%, à clindamicina. Nenhuma das amostras coletadas da base do telefone celular dos profissionais apresentou Staphylococcus aureus. Os profissionais apresentaram escores médios altos para a Escala de Adesão às Precauções-padrão e Escala de Personalidade de Risco. Não houve diferença significante ao comparar a média dos escores das escalas entre o grupo de colonizados e não colonizados. Armazenamento da escova dental em compartimento fechado/protegido (RP=2,07; IC95%=1,07-3,80) foi um fator de risco para a colonização. Enquanto que, o conhecimento sobre as PP (RP=0,53; IC95%=0,44-0,64) e participação em treinamento sobre as PP (RP=0,52; IC95%=0,43-0,64) apresentaram-se como um fator de proteção para a não colonização. Conclusão: A cavidade nasal foi um importante sítio de colonização quando comparada à cavidade oral, sendo um sítio relevante e indicado para a coleta em estudos que investigam a prevalência de colonização por Staphylococcus aureus. O conhecimento sobre precauções-padrão e a participação em treinamentos foram fatores associados à proteção para a não colonização. No entanto, um dos fatores determinantes para a adesão às precauções-padrão é a percepção de suscetibilidade do profissional de adquirir e disseminar esses microrganismos
Introduction: Staphylococcus aureus is an important pathogen responsible for several infections in hospitals with high morbidity and mortality rates. Health professionals, especially nurses, are at increased risk of colonization through direct contact with susceptible individuals or by contact with fomites in their work activities. As a consequence, these professionals can disseminate these microorganisms both in the hospital and in the community. Objective: To assess colonization by Staphylococcus aureus in nursing professionals and the adherence to standard precautions. Methods: This cross-sectional study was carried out in an outpatient clinic and in specialized units that provide care to people with HIV/Aids, in a teaching hospital of Ribeirão Preto. The population consisted of 100 nursing professionals who provide direct care to patients of these units. Samples of saliva, nasal secretions and a swab from the mobile phone of professionals were collected. The collection took place from April 2014 to February 2015 on three occasions, in months zero, four and eight. A structured questionnaire was used to obtain demographic, occupational and personal data. To assess the adherence of professionals to standard precautions, ten Likert-type psychometric scales, translated and validated for Portuguese, were applied. The collected samples were forwarded to and processed by the Microbiology and Serology Laboratory of the hospital. Results: Of the 100 nursing professionals, 43% were colonized with Staphylococcus aureus in saliva samples and/or nasal secretions; 36% were oxacillin-sensitive Staphylococcus aureus and 7.0% oxacillin-resistant. The prevalence was 32% in nasal secretion, 1% in saliva and 11% in saliva samples and nasal discharge. It was observed that 93% of Staphylococcus aureus were penicillin-resistant strains, 43% resistant to erythromycin and 39.5% to clindamycin. None of the samples collected from the base of the mobile phone of the professionals presented Staphylococcus aureus. Professionals had high mean scores for the Compliance with Standard Precautions Scale and the Risk Personality Scale. There was no significant difference when comparing the average scores of scales between the colonized and non-colonized groups. Storing the toothbrush in a closed/protected space (PR=2.07; CI95%=1.07-3.80) was a risk factor for colonization. Knowledge of the SP (PR=0.53, CI95%=0.44-0.64) and participation in training on SP (PR=0.52, CI95%=0.43-0.64) were a protective factor for non- colonization. Conclusion: The nasal cavity was an important colonization site compared to the oral cavity, the nasal site is relevant and recommended for collection in studies investigating the prevalence of colonization for Staphylococcus aureus. Knowledge of the standard precautions and participation in training on standard precautions were protective factors for non-colonization. However, one of the determining factors for adherence to standard precautions is the perceived susceptibility of professional to acquire and disseminate these microorganisms

The aim of the present study was to examine both the individual and organizational level factors contributing to the safety related behaviours of nurses. Effects of the individual level factors on safety behaviour of nurses were analyzed within the theoretical framework of Ajzen&rsquo
s (1991) Theory of Planned Behaviour (TPB) and effects of the organizational level factors were analyzed through safety climate perceptions of the nurses. Data were collected from nurses (N=274) of two different private hospitals located in Ankara and their first line supervisors (N=34).Participants filled out the questionnaires including scales of TPB (i.e., subjective norm, attitude toward the behaviour, perceived behavioural control, and intention), safety climate perceptions and compliance to Standard Safety Precautions. The outcome variable was the compliance to the Standard Safety Precautions as rated by the first line supervisors of the nurses. Subjective norm was found to be the only significant predictor of the nurses&rsquo
intention to adhere to the Standard Safety Precautions. Contrary to the hypothesized relationships, intention and perceived behavioural control did not contribute significantly to the prediction of safety behaviour rated by the first line supervisors. Furthermore, teamwork dimension of safety climate perceptions was found to be the only significant predictor of compliance to the Standard Safety Precautions. The results are discussed with practical implications of the findings.Contributions of the study are presented followed by the limitations and some future research suggestions.

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This was a qualitative study done in a big-sized general public hospital in the city of Goiânia Goiás The aims was to analyze nurses´ adherence to standard precautions according to Rosenstock´s health belief model (HBM) (1974) Data were collected using a semi-structured interview guide based on principles of Critical Incidence Technique (CIT) The instrument was validated by judges and was then pre-tested The ethical-legal research principles were observed Among 90 nurses selected to participate in the study 82 agreed to take part in this study Inclusion criteria were nurses who were either in direct contact with patients or in supervisory positions in the hospital cleaning, laundry or sterilization services Data were analyzed in accordance with CIT The analysis categories were constructed using the dimensions of the HBM A total of 139 critical incidents were identified of which 66 were considered positive and 73 negative HBM dimensions were identified within 131 situations: 74 (56,5%) related to perceived susceptibility; 17 (13,0%) to perceived benefits and 40 (30,5%) to perceived barriers The majority of the reported critical incidents related to situations of occupational exposure to biological materials Among the Standard Precautions (SP) use of protective barriers was most frequently utilized Denial of susceptibility was indicated by the lack of use of protective barriers improper management of sharp objects and non-adherence to SP related to patients with multi-resistant pathogens Moderate perceived susceptibility was associated with partial adherence to SP in cases of patients requiring more complex levels of care; in situations following occupational exposure; and when patients needs took priority over personal protection High perceived susceptibility was observed in situations of caring for patients suspected or diagnosed with infections due to pathogens of epidemiological importance and those related to nurses responsibility Perceived seriousness was evident in behaviors and consequences related to critical incidences after occupational exposure in moments when nurses expressed feelings experienced psychosomatic symptoms and were diagnosed with an infection. Perceived benefits emerged above all from positive critical incidente with focus on protective barriers understood as protection strategies which lead to safety while procedures are executed Perceived barriers were: lack of personnel preparation lack of material resources insufficient personnel improper physical structure patient emergencies psychosocial factors lack of personnel policies for cases of exposure to biological material These barriers contribute to lower adherence of SP but they could be addressed by the Health Care Facilities since nurses have demonstrated adequate perception of susceptibility and benefits HBM dimensions were associated with nurses adherence to SP suggesting that plans should be developed to improve the nurses actions and decision-making in day-to-day nursing cars prioritizing the safety of those individuals involved in this process
Estudo qualitativo desenvolvido em um hospital público geral de grande porte de Goiânia-Go Teve como objetivo analisar a adesão dos enfermeiros às precauções padrão (PP) à luz do modelo de crenças em saúde (MCS) de Rosenstock (1974) Os dados foram coletados por meio de entrevista com roteiro semi-estruturado e conforme preconizado pela técnica de incidentes críticos (TIC) O instrumento foi validado por juizes seguido do pré-teste Foram observados os aspectos ético-legais da pesquisa Fizeram parte do estudo 82 enfermeiros dos 90 eleitos que estavam em atividade assistencial direta ao paciente ou atuavam nos setores: de higienização hospitalar reprocessamento de roupas e materiais odonto-médico-hospitalares Procedemos a análise de conteúdo dos dados conforme a TIC As dimensões do MCS foram utilizadas como categorias prévias de análise Obtivemos 139 incidentes críticos sendo que 66 foram positivos e 73 negativos de acordo com a polaridade referida Destes 131 situações remetiam às dimensões do modelo de crenças em saúde: 74 (56,5%) eram relacionadas à suscetibilidade percebida; 17 (13,0%) aos benefícios percebidos e 40 (30,5%) às barreiras percebidas Os incidentes críticos relatados predominantemente relacionavam-se às situações de exposição ocupacional a material biológico O uso de barreiras protetoras foi a PP que obteve maior freqüência de indicação A negação da suscetibilidade foi observada pelo não uso das barreiras protetoras no manuseio inadequado de perfurocortante e não adesão às PP relacionadas ao paciente portador de patógeno multi-resistente A moderada suscetibilidade percebida associou-se à adesão parcial às PP no atendimento a pacientes com maior complexidade nos cuidados assistenciais Estes comportamentos adotados sinalizam limitada percepção da necessidade de intervenção nos cuidados pós-exposição ocupacional priorizando o atendimento às necessidades dos pacientes A alta suscetibilidade percebida foi observada nas situações de atendimento ao paciente sob suspeita ou com diagnóstico de infecção por patógenos de importância epidemiológica e àquelas relacionadas à responsabilidade do enfermeiro nesta particularidade da assistência A severidade percebida foi evidenciada somente nos comportamentos e conseqüências dos incidentes críticos relatados nos momentos de pós-exposição ocupacional expressa em sentimentos alterações psicossomáticas e experiência de infecção Os benefícios percebidos emergiram sobretudo dos incidentes críticos positivos com enfoque no uso das barreiras protetoras que foram compreendidas como estratégia de proteção ratificando a segurança na execução dos procedimentos As barreiras percebidas foram: falta de preparo do profissional falta de material de consumo e permanente número insuficiente de profissionais estrutura física inadequada atendimento a pacientes em situações de urgência/emergência fatores psicossociais e falta de fluxo para o atendimento ao profissional em situação de pós-exposição a material biológico; que poderiam ser minimizadas com a organização do Serviço de Assistência à Saúde pois se constituíram em impedimentos para a adesão às precauções padrão embora os enfermeiros apresentassem adequada percepção da suscetibilidade e benefícios Verificamos que as dimensões do modelo de crenças em saúde elucidaram a adesão dos enfermeiros às PP sugerindo que empreendimentos devam ser feitos para melhor instrumentalizá-los para a tomada e modalidade de ação no cotidiano da assistência que priorize a segurança dos sujeitos envolvidos nesse processo

Orientador: Ione Corrêa
Resumo: Introdução: Estima-se que mais de quatro milhões de pacientes na Europa e 1,7 milhões nos Estados Unidos desenvolvam uma infecção a cada ano, com maior prevalência nos países em desenvolvimento. A taxa de incidência de letalidade devida às infecções hospitalares foi de 27,88% no Brasil. A propagação de micro-organismos de um paciente para outro, por meio das mãos dos profissionais de saúde, contaminados pode ser interrompida com a higienização das mãos, com água e sabão, ou a higiene das mãos à base de álcool etílico a 70% e pelo uso de luvas. O uso de paramentação diminui a transmissão de micro-organismos veiculados nos uniformes dos trabalhadores de saúde. O sistema de precaução padrão e/ou baseada nas vias de transmissão de micro-organismos tem sido adotado em todo o mundo, com atualizações periódicas desde sua primeira publicação. Sendo necessário transmitir o conhecimento sobre os mecanismos de disseminação e o uso das precauções de isolamento preconizadas pelo Centers for Disease Control. Objetivo: Avaliar a efetividade de diferentes intervenções para aumentar a adesão ao uso das medidas de precauções padrão e/ou baseado na via de transmissão de micro-organismos no cuidado ao paciente. Método: Revisão sistemática de ensaios clínicos randomizados e não randomizados, séries temporais e estudos controlados antes e depois avaliando a efetividade de diferentes intervenções para aumentar a adesão ao uso das medidas de precauções padrão e/ou baseado na via de transmissão de mi... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Introduction: It is estimated that more than four million patients in Europe and 1.7 million in the United States develop an infection each year, with a higher prevalence in developing countries. The case fatality rate due to the incidence of nosocomial infections was 27.88% in Brazil. The spread of microorganisms from one patient to another via the hands of healthcare workers, contaminated may be interrupted with hand hygiene with soap and water, or hand hygiene to ethyl alcohol based 70% and when using gloves. The use of scrub decreases the transmission of microorganisms served in the uniforms of health workers. The standard precaution system and / or based on microorganisms routes of transmission have been adopted worldwide, with periodic updates from its first publication. It is necessary to transmit knowledge of the dissemination mechanisms and the use of isolation precautions recommended by the Centers for Disease Control. Objective: To evaluate the effectiveness of different interventions to improve adherence to the use of standard precautions and / or based on the route of transmission of microorganisms in patient care. Methods: Systematic review of randomized controlled trials and non-randomized, time series and controlled studies before and after evaluating the effectiveness of different interventions to improve adherence to the use of standard precautions and / or based on the path of microorganisms transmission in patient care. Relevant studies were identified thr... (Complete abstract click electronic access below)
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Não recebi financiamento
Introdução: Estima-se que mais de quatro milhões de pacientes na Europa e 1,7 milhões nos Estados Unidos desenvolvam uma infecção a cada ano, com maior prevalência nos países em desenvolvimento. A taxa de incidência de letalidade devida às infecções hospitalares foi de 27,88% no Brasil. A propagação de micro-organismos de um paciente para outro, por meio das mãos dos profissionais de saúde, contaminados pode ser interrompida com a higienização das mãos, com água e sabão, ou a higiene das mãos à base de álcool etílico a 70% e pelo uso de luvas. O uso de paramentação diminui a transmissão de micro-organismos veiculados nos uniformes dos trabalhadores de saúde. O sistema de precaução padrão e/ou baseada nas vias de transmissão de micro-organismos tem sido adotado em todo o mundo, com atualizações periódicas desde sua primeira publicação. Sendo necessário transmitir o conhecimento sobre os mecanismos de disseminação e o uso das precauções de isolamento preconizadas pelo Centers for Disease Control. Objetivo: Avaliar a efetividade de diferentes intervenções para aumentar a adesão ao uso das medidas de precauções padrão e/ou baseado na via de transmissão de micro-organismos no cuidado ao paciente. Método: Revisão sistemática de ensaios clínicos randomizados e não randomizados, séries temporais e estudos controlados antes e depois avaliando a efetividade de diferentes intervenções para aumentar a adesão ao uso das medidas de precauções padrão e/ou baseado na via de transmissão de micro-organismos no cuidado ao paciente. Estudos relevantes foram identificados por meio de bases de dados MEDLINE, EMBASE, CINAHL, Cochrane Controlled Trials Register (CENTRAL). Para extração de dados foram utilizados formulários retirados do Cochrane. Resultados e Discussões: 10 estudos preencheram os critérios de inclusão. Verificou-se que houve predomínio dos estudos do tipo ensaios clínicos randomizados (ECRs) com cinco artigos, equivalendo a 50% das publicações, seguido pelos estudos ECR por cluster e estudos do tipo ensaios clínicos controlados não randomizados, com dois artigos (20%), respectivamente, e do tipo controlado antes e depois (CBA) com um artigo. Foi possível realizar uma metanálise comparando intervenção educacional versus não intervenção em relação ao desfecho mudança nas taxas de adesão às precauções padrão e/ou precauções baseadas em transmissão de micro-organismos, na qual, houve uma diferença estatisticamente significante favorecendo estratégia educacional. Conclusões: Há moderadas evidências demonstrando que a intervenção educacional é mais eficaz quando comparada a nenhuma intervenção nas taxas de adesão às precauções padrão e/ou precauções baseadas em transmissão de micro-organismos.
Introduction: It is estimated that more than four million patients in Europe and 1.7 million in the United States develop an infection each year, with a higher prevalence in developing countries. The case fatality rate due to the incidence of nosocomial infections was 27.88% in Brazil. The spread of microorganisms from one patient to another via the hands of healthcare workers, contaminated may be interrupted with hand hygiene with soap and water, or hand hygiene to ethyl alcohol based 70% and when using gloves. The use of scrub decreases the transmission of microorganisms served in the uniforms of health workers. The standard precaution system and / or based on microorganisms routes of transmission have been adopted worldwide, with periodic updates from its first publication. It is necessary to transmit knowledge of the dissemination mechanisms and the use of isolation precautions recommended by the Centers for Disease Control. Objective: To evaluate the effectiveness of different interventions to improve adherence to the use of standard precautions and / or based on the route of transmission of microorganisms in patient care. Methods: Systematic review of randomized controlled trials and non-randomized, time series and controlled studies before and after evaluating the effectiveness of different interventions to improve adherence to the use of standard precautions and / or based on the path of microorganisms transmission in patient care. Relevant studies were identified through MEDLINE, EMBASE, CINAHL, Cochrane Controlled Trials Register (CENTRAL). For data extraction taken from the Cochrane forms were used. Results and discuss: 10 studies met the inclusion criteria. It was found that there was a predominance of type randomized clinical trial trials (RCTs) with five articles, equivalent to 50% of the publications, followed by ECR studies by cluster and studies type clinical trials no randomized controlled with two articles (20%) respectively, and the type controlled before and after (CBA) in an article. It was possible to perform a meta-analysis comparing educational intervention versus non-intervention in relation to the outcome change in rates of adherence to standard precautions and / or precautions based on transmission of microorganisms, in which there was a statistically significant difference favoring educational strategy. Conclusions: There is moderate evidence showing that the educational intervention is more effective when compared to no intervention on rates of adherence to standard precautions and / or precautions based on transmission of microorganisms.

Les entreprises sont aujourd’hui au coeur des échanges économiques mondiaux. Ces échanges se traduisent par la mise en place de relations commerciales desquelles peuvent émerger des structures souvent complexes et difficilement saisissables par le droit : les entreprises transnationales. Aucune réponse juridique satisfaisante n’a encore été trouvée pour les encadrer, alors que paradoxalement, la RSE donne naissance à des normes, des outils et des instruments pour les responsabiliser. L’étude de la responsabilité sociétale des entreprises transnationales à travers le prisme du droit révèle en réalité l’émergence d’un cadre de régulation hybride : les normes de RSE s’immiscent dans le droit, conduisant celui-ci à s’emparer de ces normes à son tour. Cet échange permet d’aborder l’entreprise transnationale à travers une approche nouvelle, tirée des normes de RSE, c’est-à-dire à travers son organisation et ses fonctions. Les relations de l’entreprise avec ses partenaires commerciaux deviennent alors une assise potentielle pour le droit, davantage que son statut ou que sa structure juridique, à partir desquelles peuvent être imputées des obligations, aujourd’hui inexistantes. Une fois l’entreprise transnationale saisie, c’est un cadre juridique adapté à son organisation complexe qui peut être mis à jour. L’étude des normes de RSE dévoile un enrichissement des règles applicables à l’entreprise transnationale et un renforcement potentiel de sa responsabilité juridique, fondée sur une approche préventive mais également solidaire du droit de la responsabilité. Passant outre les problèmes posés par l’absence de statut juridique, la RSE permet de saisir les entreprises transnationales par le biais de leurs relations commerciales, et d’envisager la conception d’un nouveau standard juridique de conduite sociétale, générateur d’une responsabilité individuelle et collective fondée sur une obligation de vigilance
Companies are now at the heart of global trade. These economic exchanges result in the establishment of commercial relationships, from which may emerge structures that are often complex and difficult to grapple with under the law: transnational corporations. While no satisfactory legal framework has yet been established to frame their work, paradoxically CSR gives rise to standards, tools and instruments to ensure their accountability. The study of the social responsibility of transnational corporations through the prism of the law actually reveals the emergence of a hybrid framework of regulation: CSR standards influence the law, forcing the law in turn to take note of these standards. This exchange allows us to handle a transnational business through a new approach derived from CSR standards, essentially through its organisation and functions. The relationship between a company and its business partners then becomes a potential basis for the law, rather than its status or its legal structure, from which can be derived responsibilities. Once a transnational corporation is seized, a legal framework adapted to its complex structure can come to light. The study of CSR standards reveals an enrichment of the rules applicable to transnational corporations and a potential strengthening of their legal liability, based on a preventive and joint and several approach of the law of responsibility. Ignoring the problems posed by the lack of legal status, CSR allows for the regulation of transnational enterprises through their commercial relations and provides a basis for the development of a new legal standard of social conduct, giving rise to individual and collective liability based on a duty of care

A research report submitted to the Faculty of Health Science, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Nursing Johannesburg, 2018.
The purpose of this study was to explore the opinions of nurses as to why there was a low adherence to standard precautions (SP) of infection control , ways in which adherence might be improved and to make some suggestions to the Infection Prevention and Control policies and practice at an academic hospital. This study used a qualitative exploratory design. The population comprised of all Registered nurses (RNs) and Enrolled nurses working in the postnatal ward, general paediatric ward, medical ward, general surgical ward and general wards. Purposive sampling was used and the sample size was 28 (n = 28) .The self-administered narrative sketches were used as the data collection tool. This study employed directed content analysis in which the findings of the study were grouped independently and compared to findings of previous studies. The participants reaffirmed poor basic training, risk behaviours, inadequate provision of equipment and protective equipment and inappropriate work conditions as reasons for low adherence to Standard Precautions among nurses. Lack of skills and knowledge regarding standard precautions can lead to non-adherence. Behavioural and cognitive skills of individuals were associated with the low adherence to Standard Precautions. The study found that insufficient supply of resources, use of uncomfortable personal protective equipment, excessive workload, lack of time, high numbers of patients and shortage of nurses, all contribute to non-adherence to standard precautions among nurses. The findings of the study do not support unawareness of the importance of standard precautions as a reason for low adherence to SPs. Most participants felt that the level of adherence to standard precautions among nurses was satisfactory. Nurses recommended continuous education, regular audits, motivation, increasing numbers continuous support visits and use of reminders. Recommendations to the policies of Infection Control at the hospital include continuing professional development/education, regular supply of Personal Protective Equipment, Institutional strategies to change risk behaviours, management support. Further research should be conducted to examine strategies to address barriers found in this study.
LG2018

Standard precautions are a set of guidelines that aim to protect health care workers from infections from blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes while providing care to patients. However, compliance to the standard precautions is often low in low-income countries in spite of the greater risk of infection. This study examined the knowledge and practice of standard precautions among health care workers in public secondary health facilities in Abuja, the Federal Capital Territory of Nigeria. A quantitative descriptive survey was conducted with 83 doctors and 194 nurses using a structured questionnaire. Findings show suboptimal knowledge and practice of the standard precautions among the health care workers. Knowledge of post-exposure prophylaxis for HIV was low as well as hepatitis B immunization among the respondents. A lack or irregular supply of essential materials, such as personal protective equipment, was the main reason the respondents did not comply to the precautions. This report recommends the development and implementation of a comprehensive infection prevention and control program in health facilities in order to ensure compliance to the standard precautions by health care workers.
Public Health
M.A. (Public Health)

This study aimed to provide evidence on knowledge of attitudes toward standard precautions (SPs) and its practice of Healthcare Workers (HCWs) in government and private hospitals in Botswana. It utilised descriptive cross-sectional methodology. A range of significant findings were revealed. Good practice of SPs was noted more amongst the HCWs in government than in private hospitals. Knowledge of SPs amongst HCWs in government hospital was significantly and positively correlated to good practice of SPs. Registered Nurses (RNs) had better knowledge of SPs than HealthcareAssistants (HCAs).There was no significant difference between RNs and HCAs practice of SPS and attitudes toward the same. No significant difference in the knowledge, attitudes and practice of SPs was noted between General Practitioners (GPs) and RNs. No significant difference in the knowledge, attitudes and practice of SPs was observed between GPs and HCAs. The study findings have implications for the application of SPs in practice
Health Studies
M.A. (Public Health)

Sendo o objecto deste estudo “A adesão dos enfermeiros na adopção das medidas de Precaução Padrão quanto ao uso dos Equipamentos de protecção individual”, procurámos saber quais as razões da adesão ou não adesão subjacentes às práticas dos prestadores de cuidados, reveladoras numa primeira instância dos motivos da existência deste projecto. Tratou-se de um estudo descritivo e transversal inserido numa abordagem quantitativa, situado no contexto hospitalar, onde os participantes foram enfermeiros prestadores de cuidados de todos os serviços, que se caracterizaram por ser maioritariamente mulheres, com uma média de idades de 35 anos, com a licenciatura como habilitação literária e a categoria profissional de enfermeiro graduado, com uma média de 15 anos de tempo de exercício profissional. Foi utilizado o Questionário como técnica de colheita de dados, tendo sido elaborado e testado através de pré-teste, e posteriormente aplicado à população referida entre os meses de Junho e Setembro de 2010. Os dados foram submetidos ao programa informático Statistical Package for Social Science (versão 17.0) e a posterior tratamento estatístico e análise. Como principais conclusões destacamos: - A quase totalidade dos enfermeiros (98,9%) refere conhecer as Precauções Padrão quanto ao uso dos equipamentos de protecção individual, mas pouco mais de metade (59,9%) viu contemplada na sua formação inicial formação em Precauções Padrão quanto ao uso dos equipamentos de protecção individual, assim como os que participaram em formação nesta área no decorrer do percurso profissional (63,2%); - Grande parte (87,4%) assume que considera que ter formação aumenta muito a adesão às Precauções Padrão quanto ao uso dos equipamentos de protecção individual; - Um número elevado de enfermeiros apresenta mais de 5 anos de exercício profissional (275), e destes mais de metade (183) refere que a adesão às Precauções Padrão quanto ao uso dos equipamentos de protecção individual se alterou muito ao longo do seu exercício profissional mas sempre num sentido positivo; - A maioria (82,5%) assume adoptar as Precauções Padrão quanto ao uso dos equipamentos de protecção individual no seu quotidiano, mas não em presença de todos os doentes independentemente do seu diagnóstico (apenas 48,7%), e sim consoante o nível de cuidados a prestar (84,0%); - Os enfermeiros consideram as luvas, o avental e a máscara os equipamentos mais utilizados, com os óculos a aparecerem só em 7º lugar de frequência de uso;- As principais razões da adesão às Precauções Padrão quanto ao uso dos equipamentos de protecção individual, são para protecção individual (87,9%), evitar a transmissão cruzada (84,9%) e transmitir segurança na realização das actividades (51,4%); - As principais razões da não adesão às Precauções Padrão quanto ao uso dos equipamentos de protecção individual, foram a não disponibilidade dos equipamentos de protecção individual (47,4%), o esquecimento (35%), considerar que não há necessidade (29,5%), não ser prático (24,2%) e a colocação dos equipamentos de protecção individual consumir muito tempo (19,3%).
Being the subject of this study "The adhesion of nurses in adopting the standard precautions measures regarding the use of Personal protection equipment," which sought to know the reasons for adherence or no adherence to the underlying practices of care providers, revealing in the first instance the reasons for the existence of this project. This was a cross-sectional and descriptive study inserted in a quantitative approach, located in the hospital context, where participants were nurses care providers from all services, which are characterized for being mainly women, with an average age of 35 years, with a university degree and the professional category of graduate nurse and an average of 15 years of professional time. The questionnaire was used as the technique for collecting data, having been developed and tested trough pre-test, and later applied to the population referred to between June and September 2010. Data were submitted to Statistical Package for Social Science (version 17.0) software and subsequent statistical treatment and analysis. The main findings highlighted that: - Almost all nurses (98.9%) reported knowing the standard precautions, this regarding the use of personal protection equipment, but just over half (59.9%) saw it covered in its initial training in the use of standard precautions on the use of personal protection equipment, as well as those who participated in training in this area during the career (63.2%); - The majority (87.4%) considered to have assumed that training increases the adhesion to standard precautions and the use of personal protection equipment; - A high number of nurses has more than 5 years of professional practice (275), and more than half of these (183) reported that adherence to the standard precautions and the use of personal protection equipment has altered greatly over their professional practice but always in a positive sense; - Most (82.5%) assumes to adopt the standard precautions and the use of personal protection equipment in their daily life, but not in the presence of all the patients regardless of their diagnosis (only 48.7%), but according to the level of care provided (84.0%); - The nurses see the gloves, apron and mask equipment more widely used, with the glasses to appear only in 7th place of frequency of use; - The main reasons for joining the standard precautions and the use of personal protection equipment were for personal protection (87.9%), to prevent cross transmission (84.9%) and providing security in carrying out activities (51.4%); - The main reasons for non-adherence to standard precautions and the use of personal protection equipment were the unavailability of personal protection equipment (47.4%), forgetfulness (35%) consider that there is no need (29.5%), not practical (24.2%) and the placement of the personal protection equipment is a time-consuming (19.3%).

The purpose of this study was to describe factors associated with noncompliance to hand hygiene standards among nurses in one public hospital in Windhoek, Namibia. A quantitative, descriptive, cross-sectional research design was employed using a stratified sample comprising three categories of nurses (registered, enrolled and auxiliary nurses). Data collection was done using a structured questionnaire. Based on the results, there were more institutional than individual factors associated with noncompliance to hand hygiene. Compliance to hand hygiene was found to be lowest when nurses provide care for patients in non-isolation rooms, when the perceived risk of acquiring infection from patients was low and following brief encounters with patients. Dryness of the skin caused by hand hygiene agents and lack of active participation in hand hygiene promotion at individual level contributed to noncompliance to hand hygiene among nurses. In addition, the results showed that, institutionally there were no rewards/encouragement for hand hygiene, no sanctions for non-compliers and no workshops, seminars and continuing educational courses on hand hygiene. The study produced interesting insights into the vital role that good leadership plays in the implementation of hand hygiene policy guidelines. The key recommendations for this study included development of good leadership, characterized by dedication for hygiene standards to encourage staff to maintain hygiene practice and to ensure that there are adequate resources for the implementation of hand hygiene policy as well as rewards/incentives for compliers and sanctions for noncompliers
Health Studies
M.A. (Nursing Science)