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252 IMPLEMENTATION OF THE WORLD HEALTH ORGANIZATION (WHO) MULTIMODAL HAND HYGIENE IMPROVEMENT STRATEGY IN BRAZILIAN HOSPITALS

Friday, March 19, 2010
Grand Hall (Hyatt Regency Atlanta)
Heiko Thereza Santana, MD , National health surveillance agency, Brasília, Brazil
Fabiana Cristina Sousa , National Health Surveillance Agency, Brasília, Brazil
Julia Yaeko Kawagoe, PhD, MD , Albert Einstein Hospital, São Paulo, Brazil
Heder Murari Borba , National health surveillance agency, Brasília, Brazil
Magda Miranda , National Health Surveillance Agency, Brasília, Brazil
Suzie Marie Gomes, MD , National health surveillance agency, Brasília, Brazil
Edzel Ximenes , National health surveillance agency, Brasília, Brazil
André Carvalho , National health surveillance agency, Brasília, Brazil
Luci Correa, PhD, MD , Federal University of San Paulo, Sao Paulo, Sao Paulo, Brazil
Ester Racuia , Albert Einstein Hospital, São Paulo, Brazil
Aldaiza Ribeiro , Albert Sabin Hospital, Fortaleza, Brazil
Loriane Konkewicz, MD , Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Fernanda Chassot , Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Rodrigo Santos , Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Rogério Lima , Pan American Organization/Brazil, Brasília, Brazil
Jonathan Borges , National Health Surveillance Agency, Brasília, Brazil
Julival Ribeiro, PHD , Hospital de Base do Distrito Federal, Brasília, Brazil
Background: Hand hygiene compliance is challenging in both developed and developing countries.  In Brazil there are more than 179,000 thousand registered health services, from which 6,851 are hospitals, including private, public and philanthropic institutions. 

Objective: To describe a pilot project implementation of the WHO Multimodal Hand Hygiene Improvement Strategy in 5 Brazilian healthcare services in order to encourage interventions for the prevention of healthcare associated infections.

Methods: The (WHO)/Brazil/Pan American Organization (PAHO)/National Health surveillance Agency (Anvisa)/Hand Hygiene Project has been developed in 5 hospitals by National Coordination (ANVISA and Brazil-PAHO/WHO). The project was supported by the Brazilian government which formally signed an agreement in November 2007 to participate in the World Alliance for Patient Safety. Since then, ANVISA has been developing actions related to the First Global Patient Safety Challenge, specially regarding “Hand Hygiene in Health Care Services”. The 5 hospitals were selected by the Anvisa Sentinel Network; one hospital from each region in Brazil due to a partnership with PAHO/WHO and the hospitals. The hand hygiene compliance was monitored using direct observation: compliance (%) = actions/opportunities x 100. The program Epi Info 6 was used to analyze data.

Results: Currently, the hospitals are implementing step 5 of the WHO strategy and the partial results are: the total hand hygiene adherence by the health-care workers was of 51.9%; only 4.3% of the interviewees answered that they performed hand hygiene than 60% less than recommended; the highest adherence to hand hygiene was 59.3% for nurses and the lowest was 35.0% for technicians. Conclusions: This pilot project contributed to improve the hand hygiene awareness in the five hospitals through hand hygiene measurement. This strategy will be implemented in other hospitals by the National Coordination from Anvisa Sentinel Network.