BackgroundHealth care associated infections (HAIs) are a source of concern worldwide. No health service in any country can be considered HAI risk-free. However, there is scarcity of data on the risks to which both patients and health workers are subject in non-hospital settings. The aim of this study was to identify issues that determine the adherence of professionals to precautions for preventing transmission of microorganisms in primary health care.MethodThis was a qualitative study, using focus groups of primary health care staff, in two Brazilian municipalities. The data were analysed using content analysis.ResultsFour focus groups were conducted with 20 professionals (11 community health workers, 5 nursing assistants and 4 nurses), and the analysed content was organized into four thematic categories. These categories are: low risk perception, weaknesses in knowledge, insufficient in-service training and infrastructure limitations.Participants expressed their weaknesses in knowledge of standard and transmission based precautions, mainly for hand hygiene and tuberculosis. A lack of appropriate resources and standardization in sharps disposal management was also highlighted by the participants.ConclusionThe study points out the need to provide in-service training for professionals on the transmission of microorganisms in primary health care to ensure adequate level of risk perception and knowledge. Further recommendations include investment to improve infrastructure to facilitate adherence to precautions and to minimize the risk of disease transmission for both patients and health care workers.

This prospective, exploratory study was performed using a quantitative approach with the objective of characterizing the healthcare tasks that involved biological risk for professionals working with the Home Care Service of the São Carlos Municipal Hospital (São Carlos, SP, Brazil). We followed 159 visits from June 2008 to January 2009. A total of 347 procedures were considered to present risks for biological exposure, categorized as follows: dressings (31.1%), capillary blood glucose monitoring (14.4%); and vascular access (3.1%). Of all subjects, 21.5% complied with hand cleansing prior to performing a procedure, 66.3% wore gloves and 83.5% disposed of sharps appropriately. In conclusion, these professionals are subject to biological risks similar to those found in the hospital environment, because they are also exposed to blood and sharps often and have a poor adherence to the standard preventive measures. Further studies to evaluate the influence of the features of the household on the referred risk should be encouraged.

Objetivou identificar a concepção da equipe de odontologia da Atenção Primária em Saúde (APS) quanto às precauções padrão (PP), os obstáculos para seu uso e a segurança do local de trabalho. Estudo exploratório-descritivo, com abordagem quantitativa, realizado com 70,27% da equipe de odontologia da APS de município paulista, utilizando-se Escalas de Fatores Psicossociais e Organizacionais que Influenciam a Adesão às Precauções-Padrão. Os domínios da escala obtiveram escores intermediários e o valor geral do Coeficiente Alfa de Cronbach foi aceitável. No domínio “Clima de Segurança”, os profissionais destacaram fragilidades diante dos riscos ocupacionais, consideram o acúmulo de atividades e a falta de tempo obstáculos para a adesão às PP, além de reconhecerem a importância da educação continuada sobre a temática. Conclui-se que essa realidade compromete a prática clínica e a segurança, do profissional e do usuário, sendo necessária ampliação das discussões sobre biossegurança tanto na formação como no ambiente de trabalho.