[Intervening factors in attention flow of professionals injured by biological material]. / Fatores intervenientes no fluxo de atendimento ao profissional acidentado com material biológico.

OBJECTIVE: To describe the barriers and facilitator factors to follow the attention flow of professionals injured by biological material in the worker perspective. METHOD: Qualitative descriptive study with data collected through individual interviews with 18 injured workers, assisted in reference public units in the city of Goiânia. The content analysis was carried out with assistance of the ATLAS.ti 6.2 software, under the work organization and subjective perspectives. RESULTS: From the interviews regarding the barriers and facilitator factors emerged the categories: organizational structure, Support from close people, and Knowledge influence. CONCLUSION: The organized services have enabled more qualified consultations and the workers follow-up, which caused a satisfaction feeling in relation to the working environment.

Reprocessing safety issues associated with complex-design orthopaedic loaned surgical instruments and implants.

BACKGROUND: The acquisition of reusable surgical instruments (RSIs) through loaner system is a worldwide phenomenon, particularly in orthopaedic surgeries. Loaner sets contain high-complex design RSIs, which are very difficult to clean, and also include single use implants, such as screws, that remain in the surgical tray and are subjected to multiple reprocessing until they are implanted. Inadequate cleaning of SI and various exposures of single-use implants to physical, chemical and biological agents can compromise their quality/safety and promote biofilm formation. The difficulty in cleaning is compounded in middle and low-income countries where automated cleaning infrastructure at sterilizing service units is often unavailable, and thus manual cleaning only is performed. Thus, we aimed to determine the condition of orthopaedic loaned sets when delivered to the hospital, assess the quality of complex-design RSIs reprocessed by manual cleaning, and evaluate the effect of multiple reprocessing on single-use implant (screw). METHODS: Flexible medullary reamers (FMRs), depth gauges and screws used for femur intramedullary nailing, in clinical use for >1 year, were obtained from three Brazilian loaner companies and assessed for residual ATP, protein, bacterial contamination, endotoxin and/or biofilm at delivery at the hospital, following cleaning and steam sterilisation. RESULTS: Before cleaning, blood was visible on a RSIs tray, and RSIs/screws were contaminated with high amounts of ATP, protein and bacteria. Visible soil was released during brushing of a FMR lumen and, following cleaning, the inner layer of 34/40 were visible soiled, and over 5/8 were protein test positive. Following sterilisation, biofilm and soil, including fragments appearing to be bone, were detected by scanning electron microscopy on RSIs/screws. A sterilised FMR revealed visible soil on the inner layer. Endotoxin tests were negative. CONCLUSION: The contaminated condition of loaned-complex-designed RSIs/screws upon arrival at the hospital and after reprocessing points to the insufficiency of manual reprocessing and management practices related to this instruments/implants. A multidisciplinary approach involving expert in design/manufacture, regulating, managing, reprocessing and surgeons is suggested to improve RSIs manufacture that enables complete decontamination and maintain the surgical patient safety.

[Accident with biological material at the prehospital mobile care: reality for health and non-healthcare workers]. / Acidente com material biológico no atendimento pré-hospitalar móvel: realidade para trabalhadores da saúde e não saúde.

Analytical transversal study that was conducted with the objectives of identifying the prevalence and characterizing the accidents with biological material among professionals in pre-hospital service (PHS) and comparing the risk behaviors adopted by healthcare and non-healthcare groups that can affect the occurrence and seriousness of such accidents. Data were obtained by questionnaire applied to all PHS workers in Goiânia-GO. The study revealed a high prevalence of accidents involving biological material which, although higher for the healthcare group, also affected the non-healthcare group. There were significant (p < 0.05) risk behaviors for these accidents in both groups: not using gloves, masks or eye protectors; inappropriate disposal of sharps; inadequate dress; re-capping of needles; and a lack of immunization against hepatitis B. The results underscore the importance of both groups in adhering to preventive measures, and further point to the need to structure and implement vigilance and control system for this type of accident.

Intervening factors in attention flow of professionals injured by biological material / Fatores intervenientes no fluxo de atendimento ao profissional acidentado com material biológico / Factores que intervienen en el flujo de atención al profesional accidentado con material biológico

Objective: To describe the barriers and facilitator factors to follow the attention flow of professionals injured by biological material in the worker perspective. Method: Qualitative descriptive study with data collected through individual interviews with 18 injured workers, assisted in reference public units in the city of Goiânia. The content analysis was carried out with assistance of the ATLAS.ti 6.2 software, under the work organization and subjective perspectives. Results: From the interviews regarding the barriers and facilitator factors emerged the categories: organizational structure, Support from close people, and Knowledge influence. Conclusion: The organized services have enabled more qualified consultations and the workers follow-up, which caused a satisfaction feeling in relation to the working environment.
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Objetivo: Describir los factores que facilitan y dificultan el cumplimiento del flujo de atención del profesional accidentado con material biológico, desde la perspectiva de los trabajadores. Método: Estudio cualitativo, descriptivo, cuyos datos fueron recolectados por medio de entrevistas individuales a 18 profesionales accidentados, atendidos en las unidades públicas de referencia del municipio de Goiânia. El análisis de contenido fue realizado con ayuda del software ATLAS.ti 6.2, bajo la perspectiva de la organización del trabajo y la subjetividad. Resultados: De los testimonios referidos a factores que facilitan y dificultan, emergieron las categorías: Estructura organizacional, Apoyo de personas cercanas e Influencia del conocimiento. Conclusión: Los servicios organizados realizaron de manera más calificada las consultas y los seguimiento de los profesionales, lo que provocó en los trabajadores un sentimiento de satisfacción en relación al ambiente laboral. 
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Objetivo: Construir um modelo teórico que configure a vivência do apoio da rede social pelas pessoas envolvidas no cuidado domiciliário. Método: Pesquisa de abordagem qualitativa, com a utilização do método Teoria Fundamentada nos Dados. A coleta e análise concomitante dos dados viabilizou a interpretação do significado do fenômeno A vivência do apoio da rede social pelas pessoas envolvidas no cuidado domiciliário. Resultados: Destacou-se a postura passiva da população na construção de seu bem-estar. Reconhece-se que deve existir uma responsabilização compartilhada entre as partes envolvidas, população e Estado. Conclusão: Sugere-se que os enfermeiros sejam estimulados a ampliar o cuidado que realizam no domicílio para atender demandas dos cuidadores; e que novos estudos sejam elaborados com populações diferentes, a fim de validar ou complementar o modelo teórico proposto.
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Acidente com material biológico no atendimento pré-hospitalar móvel: realidade para trabalhadores da saúde e não saúde / Accident with biological material at the prehospital mobile care: reality for health and non-healthcare workers / Accidente con material biológico en la atención pre hospitalario móvil: realidad para trabajadores de salud y no-salud

Estudo analítico transversal, com objetivos de identificar a prevalência e caracterizar os acidentes com material biológico entre profissionais do Atendimento Pré-Hospitalar (APH) e comparar os comportamentos de risco adotados entre os grupos saúde e não saúde que podem influenciar na ocorrência e na gravidade destes acidentes. Dados foram obtidos por meio de questionário aplicado a todos os trabalhadores do APH de Goiânia - GO. Verificou-se alta prevalência de acidentes envolvendo material biológico que, apesar de maior no grupo saúde, também acometeu o grupo não saúde. Comportamentos de risco, estatisticamente significativos (p<0,05), para ocorrência de acidentes em ambos os grupos: não uso de luvas, máscara e óculos de proteção, descarte inapropriado de perfuro-cortante, vestimenta incompleta, reencape de agulhas e não imunização contra hepatite B. Os dados evidenciaram a importância da adesão às medidas preventivas por ambos os grupos e a necessidade de estruturação e implementação de um sistema de vigilância e controle deste tipo de acidente.

Analytical transversal study that was conducted with the objectives of identifying the prevalence and characterizing the accidents with biological material among professionals in pre-hospital service (PHS) and comparing the risk behaviors adopted by healthcare and non-healthcare groups that can affect the occurrence and seriousness of such accidents. Data were obtained by questionnaire applied to all PHS workers in Goiânia-GO. The study revealed a high prevalence of accidents involving biological material which, although higher for the healthcare group, also affected the non-healthcare group. There were significant (p < 0.05) risk behaviors for these accidents in both groups: not using gloves, masks or eye protectors; inappropriate disposal of sharps; inadequate dress; re-capping of needles; and a lack of immunization against hepatitis B. The results underscore the importance of both groups in adhering to preventive measures, and further point to the need to structure and implement vigilance and control system for this type of accident.

Estudio transversal analítico con objetivos de identificar y caracterizar la prevalencia de accidentes con material biológico entre profesionales de la atención pre hospitalaria (APS) y comparar los comportamientos de riesgo adoptados entre los grupos salud y no-salud que pueden influir en la aparición y gravedad de estos accidentes. Los datos fueron recolectados con cuestionario aplicado a todos los trabajadores de la APS de Goiânia - GO. Hubo alta prevalencia de accidentes con material biológico que, aunque mayor en el grupo salud, también ocurrió en no-salud. Las conductas de riesgo, estadísticamente significativas (p <0,05), para accidentes en ambos los grupos: sin uso de guantes, máscara y gafas de protección, descarte inadecuado de objetos punzocortantes, ropa incompleta, tapar agujas y no vacunación para hepatitis B. Los datos mostraron la importancia de ambos grupos adherir a las medidas preventivas y la necesidad de estructurar e implementar un sistema para monitorear y controlar este tipo de accidentes.