The Value of the Hospital Infection Control Service (Scih) in Continuous Hand Hygiene Training. Effects of an Intervention in Critical Care Units of a Tertiary Hospital

Hand hygiene (HH) is a mandatory topic in training and auditing processes in health services, especially in critical care units of tertiary hospitals. The objective of this work is to describe an intervention carried out in intensive care units of a tertiary hospital, with evaluation before and after training, and its impact across different professional categories. A confidential assessment of healthcare professionals was conducted using the hand hygiene observation form of the Agência Nacional de Vigilância Sanitária, before and after on-site team training, providing guidance on key HH points, with data comparison. A total of 402 HH opportunities were evaluated (237 pre-guidance and 165 post-guidance) among 96 healthcare professionals (physicians, resident physicians, medical students, nurses, nursing technicians, hemodialysis nursing technicians, and physical therapists), based on the WHO Five Moments for Hand Hygiene. The average number of HH opportunities per employee was 4.2, and missed opportunities accounted for 79.48%, with 58.3% showing complete loss of opportunities. More frequent use of alcohol-based solution for HH was observed, and the more HH opportunities a professional had, the lower the likelihood of HH. When evaluating opportunities that were performed, there was a 280% increase after SCIH guidance. Among the five HH moments, the moments “before touching a patient” (43.3%) and “after touching a patient” (42.5%) were the most prevalent. For these moments, there was a gain of 300% and 275% after the training period, respectively. When categorizing professionals, being a nursing technician increased the chance of HH with an alcohol-based product by 19% (RR 1.19; p = 0.043), being a resident physician increased it by 16% using alcohol or soap (RR 1.16; p = 0.044 and p = 0.040), whereas being a nurse reduced the chance of HH by 5% (RR 0.95; p = 0.001). Training should be prioritized for teams with more patient contact, given the risk of lower adherence to HH measures. The most prevalent reasons for missed opportunities include exhausting routines, an excessive number of patients, and lack of training. There was a marked increase in HH after SCIH training. HH measures are effective, should occur through continuous training, and different tools should be used to improve teams.