HEALTHCARE PROFESSIONALS’ ADHERENCE TO HAND HYGIENE AND PREVENTION OF HEALTHCARE-ASSOCIATED INFECTIONS IN ADULT INTENSIVE CARE UNITS: AN INTEGRATIVE REVIEW

Abstract

This article aimed to analyze the factors influencing healthcare professionals’ adherence to hand hygiene practices in intensive care units and their implications for the prevention of healthcare-associated infections. An integrative literature review was conducted using articles published between 2015 and 2025, in Portuguese and English, retrieved from SciELO, the Virtual Health Library, LILACS, BDENF, journal portals, and complementary academic searches. The eligibility criteria included thematic relevance, availability of the full text, and discussion of adherence, barriers, or improvement strategies. After four duplicate records were removed, 17 studies were included in the synthesis. The results showed that observational studies reported heterogeneous and often insufficient adherence, with lower compliance before patient contact and before aseptic procedures. High levels of knowledge did not necessarily ensure proper practice. Work overload, time pressure, infrastructure shortcomings, availability of supplies, organizational culture, leadership influence, and risk perception were identified as factors affecting professional behavior. Continuing education, individualized feedback, monitoring, leadership engagement, and multimodal interventions contributed to improved adherence to proper hand hygiene practices. Based on the review, it was concluded that hand hygiene depends on both individual and systemic conditions. Therefore, isolated educational initiatives are insufficient without organizational support, accessible resources, adequate staffing, and continuous monitoring.