Considering the importance of hands in the chain of transmission of microorganisms, this observational research investigated the material infrastructure and compliance of hand hygiene in an intensive care unit in the south of Brazil in 2010. The data was collected by direct non-participant observation and through the use of self-administered questionnaires to be completed by the 39 participants, which was analyzed with the assistance of the chi2 Test, descriptive statistics and quantitative discourse analysis. Although health professionals overestimate compliance rates, recognize the practice as relevant to the prevention of infection and refer there are no impeding factors, of the 1,277 opportunities observed, compliance was 26% and significantly lower before patient contact and the use of aseptic procedures than after patient contact: infrastructure was shown to be deficient. The results indicate risk to patient safety, and thus, the planning of corrective actions to promote hand washing is relevant.

RESUMOA higienização das mãos está associada à prevenção de agravos à saúde e tem sido objeto de pesquisas. Este estudo de revisão bibliográfica de 20 anos das publicações disponíveis na base de dados PubMed teve por objetivo caracterizar os relatos científicos sobre higienização das Mãos e contextualizar divergências entre a prática e o ideal preconizado. Os resultados evidenciam a interferência do comportamento, do hábito, do ambiente e do contexto assistencial na baixa adesão a essa prática, bem como a necessidade de compreender e transformar a realidade, minimizando as divergências evidenciadas.Palavras-chave: higienização de mãos, adesão, comportamento, profissionais da saúde. ABSTRACThandwashing is related to the prevention of health hazards and has been a research issue. This retrospective, twenty-year literature review of publications -available at PubMed database-aimed to characterize scientific reports on handwashing (hW), and contextualize divergences between practice and theory. The results show behavior, habit and environment interference as well as care context explain the low adherence to this practice, besides the need to understand and transform reality, minimizing the evidenced divergences.Key words: handwashing, adherence, behavior, health professionals. RESUMENLa higienización de las manos está asociada a la prevención de daños a la salud y sigue siendo objeto de investigaciones. Este estudio de revisión bibliográfica de 20 años de las publicaciones disponibles en la base de datos PubMed tuvo por objetivo caracterizar los relatos científicos acerca de higienización de las manos y contextualizar divergencias entre la práctica y el ideal preconizado. Los resultados evidencian la interferencia del comportamiento, del hábito, del ambiente y del contexto asistencial en la pequeña adhesión a esa práctica, así como la necesidad de comprender y cambiar la realidad, minimizando las divergencias evidenciadas.Palabras claves: higienización de manos, adhesión, comportamiento, profesionales de la salud.

Objective:to develop, evaluate and validate a surgical safety checklist for patients in the pre and postoperative periods in surgical hospitalization units. Method:methodological research carried out in a large public teaching hospital in the South of Brazil, with application of the principles of the Safe Surgery Saves Lives Programme of the World Health Organization. The checklist was applied to 16 nurses of 8 surgical units and submitted for validation by a group of eight experts using the Delphi method online. Results:the instrument was validated and it was achieved a mean score ≥1, level of agreement ≥75% and Cronbach’s alpha >0.90. The final version included 97 safety indicators organized into six categories: identification, preoperative, immediate postoperative, immediate postoperative, other surgical complications, and hospital discharge. Conclusion:the Surgical Safety Checklist in the Pre and Postoperative periods is another strategy to promote patient safety, as it allows the monitoring of predictive signs and symptoms of surgical complications and the early detection of adverse events.

The results showed that the items on the checklist were verified nonverbally and there was no significant adherence to the instrument.

We concluded that the non-compliance of basic actions concerning patient safety exposes users to preventable adverse events and demands systematized actions to comply with government guidelines and promote quality of health assistance.