Hand hygiene management among nurses: collective health challenges.OBJECTIVE
 To describe the determining factors in hand hygiene management among nurses and identify associated collective health challenges.


 Cross-sectional descriptive study.  Data were collected using a questionnaire that was applied in four internal medicine units of a hospital of reference in Portugal.


 The sample was composed of 50 nurses aged 26 to 55 years (mean age of 34.88 years); 80% were women, 58% had a Bachelor's degree, and had 5-30 years of nursing practice (X̄ =11.94;±5.92).  The vast majority of nurses (90%) reported complying with the existing recommendations on hand hygiene in pre-established moments.  However, none of the nurses were able to identify all the moments for hand hygiene using water and soap or alcohol-based handrub.


 CONCLUSION
 This study shows that continuous training, adequate materials/structures in the units, and redesigned administration/supervision practices are determining factors to achieve higher levels of adherence to hand hygiene among nurses, as well as increased quality and safety in care delivery, which is a current collective health challenge.
C