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O envelhecimento demográfico é um fenómeno atual e, o crescente aumento do número de idosos conduz ao incremento da dependência de cuidados de saúde (Anderson & Durstine, 2019). A pessoa com dependência recorre a diversas respostas sociais, ocorrendo em muitas situações a sua institucionalização em Estruturas Residenciais para Pessoas Idosas (ERPI) (Instituto de Segurança Social, 2007). Estas instituições, são um local propício para a transmissão de Infeções Associadas aos Cuidados de Saúde (IACS), as quais constituem um problema de saúde pública em crescimento (DGS, 2017). Este projeto de intervenção foi desenvolvido numa ERPI e a população alvo selecionada foram as Ajudantes de Ação Direta (AAD). Foi suportado pela metodologia do planeamento da saúde de Imperatori e Giraldes (1993) e pelo modelo de promoção de saúde de Nola Pender (2019). Para o diagnóstico de situação realizaram-se reuniões com peritos, pesquisou-se evidência científica atual e recorreu-se à utilização do questionário “Perceção e conhecimento dos profissionais de saúde sobre a higiene das mãos e suas implicações na IACS”, o qual permitiu recolher dados, sendo estes analisados e interpretados através da estatística descritiva. Os diagnósticos de enfermagem identificados direcionaram-se para o conhecimento e a perceção comprometida das AAD relativamente à prevenção e controlo das IACS, favorecendo o risco de infeção cruzada nas pessoas institucionalizadas. Os problemas foram priorizados de acordo com a grelha de análise, sendo estabelecidos objetivos, metas e indicadores de impacto e atividades. Definiu-se como objetivo geral “contribuir para a diminuição das IACS na ERPI X através da capacitação das AAD” quanto à prevenção das infeções, promovendo a saúde e prevenindo a doença e, a estratégia de intervenção foi principalmente, a educacional. As atividades planeadas foram executadas e os indicadores de atividade foram atingidos. Devido ao critério temporal, não foi possível avaliar os indicadores de resultado do projeto, propondo-se a avaliação posterior pela equipa de enfermagem da ERPI X, a qual permitirá avaliar o seu impacto, analisar modificações na intervenção assistencial das AAD e, observar a existência de alterações na incidência de diagnósticos de IACS na ERPI X, após um ano. Foram adquiridas e desenvolvidas as competências de mestre e especialista em enfermagem comunitária e de saúde pública.
Demographic aging is a current phenomenon and the increasing number of elderly individuals leads to an increase in healthcare dependency (Anderson & Durstine, 2019). People with dependency rely on various social responses, often resulting in institutionalization in Residential Structures for Elderly People (RSEP) (Instituto de Segurança Social, 2007). These institutions are a conducive place for the transmission of Healthcare-Associated Infections (HAI), which are a growing public health problem (DGS, 2017). This intervention project was developed in an RSEP, and the target population selected were Direct Action Aides (DAA). It was supported by the health planning methodology of Imperatori and Giraldes (1993) and the health promotion model of Nola Pender (2019). For the situation diagnosis, meetings were held with experts, current scientific evidence was researched, and the "Perception and knowledge of healthcare professionals about hand hygiene and its implications in HAI" questionnaire was used to collect data, which was analyzed and interpreted through descriptive statistics. Nursing diagnoses were identified as compromised knowledge and perception of DAA regarding the prevention and control of HAI, favoring the risk of cross-infection in institutionalized individuals. Problems were prioritized according to the analysis grid, and objectives, goals, impact indicators, and activities were established. The overall objective was to "contribute to the reduction of HAI in RSEP X by empowering DAA" in infection prevention, promoting health, and preventing disease, with the main intervention strategy being educational. The planned activities were executed, and the activity indicators were achieved. Due to time constraints, it was not possible to evaluate the project's outcome indicators, proposing subsequent evaluation by the nursing team of RSEP X, which will allow for the assessment of its impact, analyze changes in DAA's care intervention, and observe changes in the incidence of HAI diagnoses in RSEP X after one year. The competencies of a community nursing specialist and public health nurse were acquired and developed.
Demographic aging is a current phenomenon and the increasing number of elderly individuals leads to an increase in healthcare dependency (Anderson & Durstine, 2019). People with dependency rely on various social responses, often resulting in institutionalization in Residential Structures for Elderly People (RSEP) (Instituto de Segurança Social, 2007). These institutions are a conducive place for the transmission of Healthcare-Associated Infections (HAI), which are a growing public health problem (DGS, 2017). This intervention project was developed in an RSEP, and the target population selected were Direct Action Aides (DAA). It was supported by the health planning methodology of Imperatori and Giraldes (1993) and the health promotion model of Nola Pender (2019). For the situation diagnosis, meetings were held with experts, current scientific evidence was researched, and the "Perception and knowledge of healthcare professionals about hand hygiene and its implications in HAI" questionnaire was used to collect data, which was analyzed and interpreted through descriptive statistics. Nursing diagnoses were identified as compromised knowledge and perception of DAA regarding the prevention and control of HAI, favoring the risk of cross-infection in institutionalized individuals. Problems were prioritized according to the analysis grid, and objectives, goals, impact indicators, and activities were established. The overall objective was to "contribute to the reduction of HAI in RSEP X by empowering DAA" in infection prevention, promoting health, and preventing disease, with the main intervention strategy being educational. The planned activities were executed, and the activity indicators were achieved. Due to time constraints, it was not possible to evaluate the project's outcome indicators, proposing subsequent evaluation by the nursing team of RSEP X, which will allow for the assessment of its impact, analyze changes in DAA's care intervention, and observe changes in the incidence of HAI diagnoses in RSEP X after one year. The competencies of a community nursing specialist and public health nurse were acquired and developed.
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Envelhecimento Dependência IACS ERPI AAD Enfermagem de saúde pública Aging Dependency HAI RSEP DAA Public health nursing