Uso da simulação clínica no conhecimento de cuidadores de crianças sobre ações de prevenção de infecções: estudo piloto

Abstract

Healthcare-Associated Infections (HAIs) are considered preventable adverse events (AEs) that compromise patient safety and the quality of healthcare services. In the pediatric context, HAIs lead to consequences beyond clinical complications, affecting the well-being of the hospitalized child and their family unit, prolonging hospital stays, and increasing indirect costs. The presence of caregivers in the pediatric environment acts as a barrier that promotes patient well-being and safety, also contributing to the prevention of AEs, especially HAIs. Thus, enhancing their knowledge about these infections becomes relevant, and clinical simulation emerges as an educational strategy that can expand the development of skills and competencies in this group, minimizing exposure to risks during teaching and promoting learning in a safe environment. This study aimed to evaluate the effect of an intervention with clinical simulation on the knowledge of caregivers of hospitalized children regarding the prevention and control of healthcare-associated infections. It is a quasi-experimental, beforeand-after study conducted in a large public hospital in Belo Horizonte. The population consisted of 47 caregivers of children hospitalized in the pediatric inpatient unit during February and March 2024. The study was developed in four phases: 1) development of the simulated scenario and the knowledge assessment instrument, both evaluated by experts; 2) assessment of participants' knowledge before the intervention; 3) intervention with clinical simulation; and 4) assessment of knowledge after the intervention. Data were subjected to statistical analysis using SPSS version 21.0. In all analyses, a significance level of 0.05 and a confidence interval of 95% were adopted. Regarding sociodemographic and economic data, it was observed that in 76,9% (n=36) of cases, parents were the primary caregivers. The majority of participants were female 73,1% (n=34), and 55,8% (n=29) were over 30 years old. The predominant age group was over 30 years 53,8% (n=25), and 48,1% (n=23) had completed high school. Additionally, 71,8% (n=28) of the caregivers were employed, although 52,9% (n=25) of families lived on less than one minimum wage. Regarding sociodemographic and economic variables, no significant association was demonstrated between their categories (p>0.05), indicating that the intervention can be effectively applied to the studied population, except for the family income category (p=0.03). Regarding the knowledge acquired after the intervention, a significant improvement was observed in caregivers' knowledge (p<0.001) concerning hand hygiene, contact precautions, and microorganism transmission. The number of caregivers who showed better results increased from 13.5% to 86.5%. In the individual analysis of the knowledge test questions, all questions showed significant improvement (p<0.05), except for the question about toy sharing, which did not show a statistically significant difference (p=0.56). The total frequency of correct answers in the evaluated questions increased from 46% to 75.8% (p<0.001). Given the findings, it is evident that the educational intervention through clinical simulation in the Pediatric Unit had a significant impact on increasing the knowledge of caregivers of hospitalized children, especially in some items, but not in its entirety. This suggests that, despite being a strategy still under evaluation, the intervention through clinical simulation for caregivers of hospitalized children was effective. Thus, the importance of developing educational interventions aimed at educating patients, families, and caregivers during hospitalization is highlighted, seeking to contribute to the reduction, prevention, and control of HAIs.