As infecções relacionadas à assistência à saúde (IRAS) desafiam constantemente a qualidade da assistência prestada no sistema de saúde como um todo. Apesar do conhecimento acerca do conceito de infecção hospitalar, suas origens, fatores relacionados e principalmente as medidas gerais de prevenção e controle das IRAS, o que normalmente se verifica, é a baixa adesão dos PAS às medidas preventivas. Existem várias medidas fortemente embasadas em evidências científicas, porém, a utilização dessas medidas, por profissionais de saúde, permanece um grande desafio. Estudos mencionam que o não cumprimento das diretrizes é um problema universal, e para desenvolver intervenções bem-sucedidas, são necessárias mais pesquisas sobre os determinantes comportamentais. Diante disso este estudo teve como objetivos avaliar a adesão às práticas de prevenção e controle de infecção dos (PAS) que atuam em UTI, tais como: cuidados de manipulação e curativo de cateteres venosos centrais (CVC) e manipulação direta do paciente e de seu ambiente próximo e investigar uma possível correlação entre a adesão dos PAS e o desempenho de seus testes psicológicos que avaliaram seus Estilos de pensamento, Autoestima, Qualidade de vida, Estresse e Personalidade. Realizou-se um estudo observacional, prospectivo, no período de julho de 2012 a dezembro de 2013 em quatro Unidades de Terapia Intensiva em um grande hospital escola. Foram realizadas 7.572 observações distribuídas entre as práticas selecionadas de 248 profissionais que atuaram em quatro UTIs, constituídos por médicos e enfermeiros (auxiliares de enfermagem, técnicos de enfermagem e enfermeiros). Para a equipe de enfermagem a proporção de adesão para o procedimento de cuidados com a manipulação variou entre 13% e 95%, ficando com a menor adesão as etapas que envolveram a higienização das mãos (HM) antes de manipular o cateter e a desinfecção da conexão do CVC. Para o procedimento de cuidados com o curativo do CVC a proporção de adesão variou entre 14% e 99%, ficando com a menor adesão novamente as etapas que envolveram a HM antes de iniciar a troca do curativo do CVC. Para avaliação da equipe médica foi observada a adesão à HM das mãos nos cinco momentos propostos pela OMS. A proporção de adesão variou entre 10% e 98%. Observou-se menor taxa de adesão para os momentos \"Antes do contato direto com o paciente\", \"Após contato com ambiente próximo ao paciente\" e \"Antes de procedimentos assépticos\". Utilizou-se um modelo de regressão logística ajustado para avaliar a associação entre à adesão às práticas de controle de infecção e os testes psicológicos dos profissionais de saúde e apenas a autoestima e aspectos de personalidade (agressão, assistência, deferência, afago e afiliação) obtiveram associação com a adesão às práticas de controle de infecção. Conhecer fatores biopsicossociais (características de personalidade e autoestima) capazes de gerar comportamentos que influenciam o ato de adesão dos PAS às práticas de controle de infecção, pode ser um passo importante para projetar estratégias de intervenção mais eficientes para modificar o comportamento dos profissionais de saúde e aumentar as boas práticas / Health care-associated infections (HAI) consistently challenge the quality of care provided in the health system as a whole. Despite knowledge about hospital infection, its origins, associated factors and the general measures of prevention and control, usually a low adherence of healthcare professional to preventive measures is observed. There are several scientifically-based preventive measures, however the use of these guidelines by health professionals remains a major challenge. Studies point out that failure to comply with the guidelines is a universal problem and for successful interventions to be developed further research on behavioral determinants is needed. The objective of this study was: -to evaluate the adherence to the prevention and infection control practices by healthcare professionals working in ICUs, during procedures such as handling and dressing of central venous catheters (CVC), and direct manipulation of the patient and the close environment to the patient; and -to investigate a possible correlation between adherence of healthcare professionals and their performance in psychological tests (Styles of Thought, Self Esteem, Quality of Life, Stress and Personality). An observational, prospective study was carried out from July 2012 to December 2013 in four Intensive Care Units in a large teaching hospital. A total of 7,572 observations was made, for 248 healthcare professionals who worked in four ICUs. These were doctors and nurses (nurse assistants, nurse technicians and registered nurses). For the nursing team the proportion of adherence to adequate procedures involving CVC manipulation varied between 13% and 95%. The steps with smaller adhesion were: hand hygiene (HM) before beginning the CVC manipulation and disinfection of the CVC hub. For the CVC dressing, adherence varied between 14% and 99%. Lowest adherence was observed for HM before beginning the dressing. For doctors, hand hygiene was observed during the five moments proposed by the WHO. Compliance varied between 10% and 98%. Lowest compliance was observed for the moments: \" Before direct contact with the patient \",\" After contact with environment close to the patient \"and\" Before aseptic procedure \". An adjusted regression logistics model was used to evaluate the correlation between adherence to infection control practices by the healthcare professionals and their psychological tests. Self-esteem and aspects of personality (aggression, attendance, affiliation and cuddle) were associated with compliance. We believe that knowing biopsychosocial factors (personality traits and self-esteem) that may influence adherence of healthcare professionals to infection control practices can be an important step to develop more efficient intervention strategies to modify behavior and increase quality of care for patients

Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing CLABSI in NICUs. Methods: A systematic literature search was conducted using CINAHL Plus with Text, Cochrane Database of Systematic Reviews and MEDLINE from January 2008 up to 2018. There were multiple search terms used and these included "neonate OR newborn OR infant", "CLABSI OR central line-associated bloodstream infection", "intervention OR prevention" and "bundle". The search solely focused on the outcome of infant patients. Therefore studies were excluded for the following criteria: being non-peer reviewed, being published before 2008, and being a case in which CLABSI was assessed in patients outside the NICU. See Table 4 and 5 for further information. Results: Eight articles were eligible for inclusion all of which CDC's guidelines were implemented in their strategy of intervention. The systematic review showed that adherence to care bundles decreases infection rates drastically. All eight articles reported a significant decrease in CLABSI rates following the implementation of the bundle set by CDC with two studies achieving a CLABSI rate of zero. Author's Conclusion: Implementation of care bundles showed a success in reducing CLABSI rates in the NICUs; however none of the studies endorsed a specific bundle application utilized to achieve its intended goal. Some practices adopted CDC's guidelines more than others and those showed a greater decrease in infection rate. In addition, it is evident that nurses deliver the best care when preventing an infection. Further research is needed to assess the effectiveness of a specific bundle element.