Adesão às precauções padrão e infecção por SARS-CoV-2 em profissionais da saúde de hospitais universitários durante a pandemia de COVID-19

Abstract

The COVID-19 pandemic has imposed a new scenario on health services, increasing concern for the safety of professionals involved in caring for the population. Standard precautions are measures that include basic principles of infection control and represent an important protective measure in the care context. The literature points out as a gap in knowledge studies on SARS-CoV-2 infection among health professionals and its relationship with the use of protective equipment and other protective maeasures. The general objective is to analyze adherence to standard precautions and SARS-CoV-2 infection among health professionals in university hospitals during the COVID-19 pandemic. A multicenter study, with a mixed methodological approach with a concomitante incorporated strategy, carried out in five university hospitais in the southern region of Brasil, with nursing professionals, doctors and managers. Four instruments were used for data collection: the Sociodemographic and Occupational Characterization Questionnaire, applied to all participants; the Instrument of variables related to standard precautions and the Questionnaire of variables related to the COVID-19 pandemic, which were applied to healthcare professionals; and for the qualitative stage, the Questionnaire on protective measures during the COVID-19 pandemic was used, applied to care professionals and managers. The collection took place through na electronic form on the Google Forms platform. The sample was selected for convenience, reaching 559 participants. The analysis of quantitative data was performed using descriptive and inferential statistics. The association between the variables was performed using the tests: chi-square, one-way analysis of variance, Kruskal-Wallis and Mann-Whitney. The Poisson regression model was also used to estimate prevalence raios, considering a significance level of 5% (p<0,05). Qualitative analysis was performed using Bardin’s contente analysis, supported by the MAXQDA software. The combination of the data was made by incorporating the qualitative results to quantitative ones, in order to produce complementary information. Of the study participants, 132 reported testing positive for SARS-CoV-2 infection, representing 23,6% of the sample. Nursing professionals were the most affected. Adherence to standard precautions was observed with a median of 4.69 [4,38; 4,85]. The most adherent professionals had children (p=0.014); worked in áreas dealing with COVID-19 (p<0.001); received training in biosafety (p=0.018); and performed social distancing (p<0.001). There was no association between adherence and SARS-CoV-2 infection. The group of health professionals who tested positive for SARS-CoV-2 performed the “RT-PCR” test (p<0.001); worked in services that had care for COVID-19 patients (p=0.028); provided direct care to suspected or confirmed patients with COVID-19 (p=0.010); had symptoms suggestive of COVID-19 (p<0.001); Always performed social distancing recommended by the World Health Organization in other activities of their private life (p<0.001). Qualitative data resulted in three categories: “Difficulties faced to protect health professionals during the COVID-19 pandemic”; “Repercussions of the pandemic on adherence to standard precautions” and “Individual and institutional strategies to protect health professionals during the COVID19 pandemic”. The impacto f the COVID-19 pandemic and the high transmissibility of the SARS-CoV-2 virus, both in the community and in the hospital environment, indicates that high adherence to SP is not a suficiente isolated measure to prevent infection among health professional. In this sense, this thesis demonstrates that the protection of health professional during the pandemic was determined by diferente factors, which encompass both individual and organizational and public policy issues. The individual and institutional strategies created during this period can support the constuction of future interventions.