Subject(s)
Rural Population , Sanitary Engineering , Waste Disposal, Fluid , Rural Population/statistics & numerical data , Waste Disposal, Fluid/methods , Wastewater/chemistry , Water Purification , Sanitary Engineering/methods , Sanitary Engineering/trends , Bathroom Equipment/supply & distributionSubject(s)
Bathroom Equipment , COVID-19 , Neoplasms , Public Health , Wastewater-Based Epidemiological Monitoring , Humans , Air Pollution/adverse effects , COVID-19/epidemiology , COVID-19/virology , Drug Resistance, Microbial , Neoplasms/epidemiology , Neoplasms/genetics , Opioid Epidemic , Public Health/methods , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purificationABSTRACT
In hospital environments, droplets generated by urination within shared toilets may represent a route of dissemination for bacteria such as vancomycin-resistant Enterococcus faecium (VREfm), which contributes significantly to the burden of hospital-acquired infections. We investigated the potential activity of a foam in preventing the generation of droplets containing Enterococcus spp. during urination. A uniform layer of foam was deposited in the inner walls and at the bottom of an experimental toilet contaminated with suspensions of Enterococcus strains (including a VREfm strain). Human urination was simulated, and colonies of Enterococcus were recovered through a toilet lid where agar plates had been placed. Results showed that the foam was able to suppress production of droplets containing Enterococcus spp. generated by a liquid hitting inner toilet walls. Conversely, Enterococcus colonies were recovered in absence of foam. Moreover, the foam did not show antibacterial activity. We propose a new non-antimicrobial approach aimed at limiting transmission of multidrug-resistant bacteria, particularly in healthcare settings.
Subject(s)
Bathroom Equipment , Enterococcus faecium , Vancomycin-Resistant Enterococci , Humans , Vancomycin/pharmacology , AgarABSTRACT
Coastal regions, home to more than half of the global population and contributing over 50% to the global economy, possess vast renewable resources, such as seawater and solar energy. The effective utilization of these resources, through the seawater-cooled district cooling system (SWDCS), seawater toilet flushing (SWTF), and rooftop solar photovoltaic system (RTPV), has the potential to significantly reduce carbon emissions. However, implementing these technologies in different geographic contexts to achieve the desired carbon and economic outcomes at the city level lacks a clear roadmap. To address this challenge, we comprehensively analyzed 12 coastal megacities worldwide by integrating geospatial building data. Our study evaluated the potential energy savings, carbon mitigation, and levelized carbon abatement costs (LCACs) from a life cycle perspective. The results revealed that using seawater and solar energy within urban boundaries can reduce electricity consumption from 1 to 24% across these cities. The spatial distribution of the LCAC for seawater-based systems exhibited more variation compared to the RTPV. By applying specific LCAC thresholds ranging from 0 to 225 USD/tCO2e, all cities could achieve both carbon reductions and economic benefits. These thresholds resulted in up to 80 million tonnes of carbon emission reductions and 5 billion USD of economic benefits, respectively. Our study provides valuable insights into integrating renewable resource systems, enabling coastal cities to achieve carbon and economic advantages at the city scale simultaneously.
Subject(s)
Bathroom Equipment , Solar Energy , Cities , Carbon , SeawaterABSTRACT
ABSTRACT: Substantial evidence demonstrates that plumes from uncovered toilets potentially expose nurses and other health care workers to aerosols containing infectious agents and hazardous drugs, including antineoplastic drugs. Most hospitals in the United States utilize flushometer-type toilets, which operate under high pressure and do not have a permanently attached closure or lid, which is known to reduce the aerosols generated by flushing. This article aims to raise awareness among nurses of the potential exposure risks associated with toilet plume aerosols, so they can educate other health care workers and take part in initiatives to address these risks.
Subject(s)
Bathroom Equipment , Humans , United States , Toilet Facilities , Hospitals , AerosolsABSTRACT
Safe and hygienic management of human waste is essential in humanitarian settings. Urine-diverting dry toilets (UDDTs) can enable this management in some humanitarian emergency settings. A seeded, longitudinal environmental study was conducted in Hiloweyn refugee camp, Dollo Ado, Ethiopia, to measure Escherichia coli and Ascaris suum ova inactivation within closed UDDT vaults and to document environmental conditions (temperature, moisture content, and pH) that could influence inactivation. Hiloweyn camp represented an optimal location for a desiccation-based sanitation technology such as the UDDT. E. coli and Ascaris ova inactivation was observed in UDDTs under warm, dry, alkaline conditions at 6, 9, and 12 months of storage; UDDTs with samples containing <1000 E. coli/g total solids increased from 30 % to 95 % over 12 months, and a >2.8-log10 reduction in Ascaris ova viability was observed after 6 months. Additional laboratory-based studies were conducted to provide insights into the field study findings and study the impact of hydrated lime on E. coli and Ascaris ova inactivation. Results suggest that adding hydrated lime to elevate pH > 12 may increase inactivation and decrease storage time. Overall, UDDTs could contribute to the safe and hygienic management of human waste in comparable warm and dry humanitarian settings.
Subject(s)
Bathroom Equipment , Escherichia coli , Oxides , Animals , Humans , Ethiopia , Calcium Compounds/chemistry , Ascaris/physiologyABSTRACT
Bioaerosols generated during toilet flushing can contribute to the spread of airborne pathogens and cross-contamination in indoor environments. This presents an increased risk of fomite-mediated or aerosol disease transmission. This study systematically investigated the factors contributing to increased bioaerosol exposure following toilet flushing and developed an empirical model for predicting the exposure-relevant bioaerosol concentration. Air in a toilet cubicle was sampled by impaction after seeding with Clostridium difficile spores. Design of Experiments (DoE) main effects screening and full factorial design approaches were then employed to investigate the significant factors that heighten the risk of exposure to bioaerosols post-flush. Our findings reveal that the inoculated bacterial concentration (C), time elapsed after flushing (t), lateral distance (d), and mechanical ventilation (v) are significant predictors of bioaerosol concentration, with p-values < 0.05. The interaction term, C × d showed a marked increase in bioaerosol concentration up to 232 CFU/m3 at the closest proximity and highest pathogen load. The interplay of C and t (C × t) demonstrated a time-dependent attenuation of bioaerosol viability, with concentrations peaking at 241 CFU/m3 immediately post-flush and notably diminishing over time. The lateral distance and time post-flush (d × t) interaction also revealed a gradual decrease in bioaerosol concentration, highlighting the effectiveness of spatial and temporal dilution in mitigating bioaerosol exposure risks. Furthermore, there is an immediate rise in relative humidity levels post-flush, impacting the air quality in the toilet environment. This study not only advances our understanding of exposure pathways in determining bioaerosol exposure, but also offers pivotal insights for designing targeted interventions to reduce bioaerosol exposure. Recommendations include designing public toilets with antimicrobial surfaces, optimizing ventilation, and initiating timely disinfection protocols to prioritise surfaces closest to the toilet bowl during peak exposure periods, thereby promoting healthier indoor environments and safeguarding public health in high-traffic toilet settings.
Subject(s)
Aerosols , Air Microbiology , Clostridioides difficile , Toilet Facilities , Aerosols/analysis , Humans , Air Pollution, Indoor/analysis , Bathroom Equipment/microbiologyABSTRACT
INTRODUCTION: Immunocompromised patients are at an increased risk of severe legionella infections. We present the results of an outbreak investigation initiated following a fatal case of hospital-acquired legionellosis linked to contaminated water from a toilet-flushing cistern. Additionally, we provide experimental data on the growth of Legionella spp. in flushing cisterns and propose a straightforward protocol for prevention. METHODS: We monitored the growth of Legionella spp. in the building's hot- and cold-water systems using quantitative bacterial culture on selective agar. Molecular typing of Legionella pneumophila isolates from the infected patient and the water system was conducted through core-genome multi-locus sequence typing (cgMLST). RESULTS: Legionella contamination in the hospital building's cold-water system was significantly higher than in the hot-water system and significantly higher in toilet flushing cistern's water compared with cold water from bathroom sinks and showers. Isolates from the patient and from the flushing cistern of the patient's bathroom were identical by cgMLST. In an experimental setting, daily toilet flushing for a period of 21 days resulted in a 67% reduction in the growth of Legionella spp. in the water of toilet flushing cisterns. Moreover, a one-time disinfection of cisterns with peracetic acid, followed by daily flushing, decreased legionella growth to less than 1% over a period of at least seven weeks in these setting. CONCLUSIONS: One-time disinfection of highly contaminated cisterns with peracetic acid and daily toilet flushing as short-term measure can significantly reduce legionella contamination in flushing cisterns. These measures may aid in preventing legionella infection among immunocompromised patients.
Subject(s)
Bathroom Equipment , Legionella pneumophila , Legionella , Legionellosis , Humans , Legionellosis/prevention & control , Multilocus Sequence Typing , Peracetic Acid , Water , Water Microbiology , Water Supply , GermanyABSTRACT
BACKGROUND: Because of the relationship between independent living and activities of daily living, care teams spend significant time managing assisted living residents' toileting problems. Recently, the TrueLoo was developed as a connected toilet seat to automatically log and monitor toileting sessions. OBJECTIVE: This study aimed to demonstrate the validity of the TrueLoo to (1) record and identify toileting sessions with regard to stool and urine events; (2) compare the results with the person-reported, standard-of-care methods; and (3) establish metrics of user acceptability and ease of use in a assisted living facility population. METHODS: We used two phases: (1) initial development of the TrueLoo algorithms to accurately identify urine and stool events and (2) evaluation of the algorithms against person-reported, standard-of-care methods commonly used in assisted living facilities. Phase 2 analyzed data over a 3-day period from 52 devices. Participants' age ranged from 63 to 101 (mean 84, SD 9.35) years. Acceptability and ease-of-use data were also collected. RESULTS: Regarding the development of the TrueLoo algorithm for urine assessment, sensitivity and specificity of 96% and 85% were observed when evaluating a gold-standard labeled data set, respectively (F1-score=0.95). For stool, sensitivity and specificity of 90% and 79% were observed, respectively (F1-score=0.85). Regarding the TrueLoo algorithm in assisted living settings, classification performance statistics for urine assessment revealed sensitivity and specificity of 84% and 94%, respectively (F1-score=0.90), and for stool, 92% and 98%, respectively (F1-score=0.91). Throughout the study, 46 person-reported instances of urine were documented, compared with 630 recorded by the TrueLoo. For stool events, 116 person-reported events were reported, compared with 153 by the TrueLoo. This indicates that person-reported events were captured 7% (46/630) of the time for urine and 76% (116/153) of the time for stool. Overall, 45% (32/71) of participants said that the new toilet seat was better than their previous one, 84% (60/71) reported that using the TrueLoo was easy, and 99% (69/71) said that they believed the system could help aging adults. Over 98% (69/71) of participants reported that they would find alerts related to their health valuable and would be willing to share this information with their doctor. When asked about sharing information with caregivers, 66% (46/71) reported that they would prefer the TrueLoo to send information and alerts to their caregiver, as opposed to the participant having to personally communicate those details. CONCLUSIONS: The TrueLoo accurately recorded toileting sessions compared with standard-of-care methods, successfully establishing metrics of user acceptability and ease of use in assisted living populations. While additional validation studies are warranted, data presented in this paper support the use of the TrueLoo in assisted living settings as a model of event monitoring during toileting.
Subject(s)
Activities of Daily Living , Humans , Aged , Female , Male , Aged, 80 and over , Retrospective Studies , Middle Aged , Bathroom Equipment , Algorithms , Assisted Living Facilities , Urination/physiology , Reproducibility of ResultsABSTRACT
The building's toilet drainage system has been identified as a potential route for the transmission of SARS-CoV-2 during outbreaks. This study employed agar-fluorescein sodium semi-solid as trace particles to investigate the possibility of vertical transmission of the SARS-CoV-2 in drainage system. In both scenarios, where floor drains were all properly sealed or dried out, simulated faeces containing fluorescein sodium were flushed into the toilet bowl. Air sampling was conducted in each restroom, and differential pressure measurements at the floor drain locations were taken. The experimental results showed that when all floor drains were properly sealed, the differential pressure at each floor drain was 0. The fluorescein sodium-traced aerosol did not transmit through the drainage system to various floors, which significantly reduced the risk of infection for users through this route. However, when all floor drains dried out, toilet users above the neutral pressure layer (NPL) were at a high risk of virus infection. Due to the increasing maximum negative pressure at the floor drain above the NPL with ascending floor levels, users on each floor above the NPL faced an elevated infection risk in restrooms. Specifically, users on the top floor were exposed to infectious aerosols roughly 1.6 times that of the first floor above the NPL. Conversely, owing to the increasing maximum positive pressure at the floor drain below the NPL with descending floor levels, users below the NPL experienced a comparatively lower infection risk. This finding has important implications for understanding the vertical transmission dynamics of SARS-CoV-2 in residential or public building and can inform the development of effective control measures.
Subject(s)
Bathroom Equipment , Fluorescein , Respiratory Aerosols and Droplets , SARS-CoV-2 , AerosolsABSTRACT
Separation of domestic effluents at the source and the utilization of low-flush toilets offer alternative approaches for developing efficient wastewater treatment systems while promoting energy generation through anaerobic digestion. This study focused on assessing toilet usage in Mexico and exploring the potential of anaerobic co-digestion of brown water (feces) and toilet paper as influential factors in wastewater treatment systems. A survey was conducted on a representative sample of Mexicans to gather information on toilet usage frequency, toilet paper use and disposal practices, as well as the type and quantity of commercial disinfectants and pharmaceutical compounds they use or consume. The survey revealed that per capita toilet paper consumption is 2.9 kg annually, that 58 % of respondents do not dispose used paper in the toilet, and that about 47 % use two to three cleaning and disinfection products. Notably, 97 % of the sampled Mexican population expressed a willingness to transition to more eco-friendly toilet options. Subsequently, in a second step, the anaerobic co-digestion of brown water with toilet paper was evaluated, demonstrating a relatively high production of volatile fatty acids but low methane production. This suggests an efficient hydrolysis/acidogenesis process coupled with restrained methanogenesis, probably due to pH decrease caused by acidogenesis. This study underscores that toilet paper and brown water are potential suitable substrates for anaerobic co-digestion. Furthermore, it sheds light on the behaviors of Mexican society regarding bathroom use and cleaning, contributing to the establishment of foundations for wastewater treatment systems with effluent separation at the source.
Subject(s)
Bathroom Equipment , North American People , Sewage , Humans , Anaerobiosis , Sewage/chemistry , Waste Disposal, Fluid , Mexico , Feasibility Studies , Surveys and Questionnaires , Methane , BioreactorsABSTRACT
Catheter-associated urinary tract infections (CAUTI) are among the most common bacterial infections associated with prolonged hospitalization and increased healthcare expenditures. Despite recent advances in the prevention and treatment of these infections, there are still many challenges remaining, among them the creation of a durable catheter coating, which prevents bacterial biofilm formation. The current work reports on a method of protecting medical tubing endowed with antibiofilm properties. Silicone catheters coated sonochemically with ZnO nanoparticles (NPs) demonstrated excellent antibiofilm effects. Toward approval by the European Medicines Agency, it was realized that the ZnO coating would not withstand the regulatory requirements of avoiding dissolution for 14 days in artificial urine examination. Namely, after exposure to urine for 14 days, the coating amount was reduced by 90%. Additional coatings with either carbon or silica maintained antibiofilm activity against Staphylococcus aureus while resisting dissolution in artificial urine for 14 days (C- or SiO2-protected catheters exhibited only 29% reduction). HR-SEM images of the protected catheters indicate the presence of the ZnO coating as well as the protective layer. Antibiofilm activity of all catheters was evaluated both before and after exposure to artificial urine. It was shown that before artificial urine exposure, all coated catheters showed high antibiofilm properties compared to the uncoated control. Exposure of ZnO-coated catheters, without the protective layer, to artificial urine had a significant effect exhibited by the decrease in antibiofilm activity by almost 2 orders of magnitude, compared to unexposed catheters. Toxicity studies performed using a reconstructed human epidermis demonstrated the safety of the improved coating. Exposure of the epidermis to ZnO catheter extracts in artificial urine affects tissue viability compared with control samples, which was not observed in the case of ZnO NPs coating with SiO2 or C. We suggest that silica and carbon coatings confer some protection against zinc ions release, improving ZnO coating safety.
Subject(s)
Bathroom Equipment , Zinc Oxide , Humans , Zinc Oxide/pharmacology , Silicon Dioxide/pharmacology , Biofilms , Anti-Bacterial Agents/pharmacology , Catheters , CarbonABSTRACT
BACKGROUND/AIMS: Diverticulosis coli is a common disorder of the colon, and a luminal pressure increase in the colon is a proposed mechanism in disease pathogenesis. Toilet types used around the world can be fundamentally categorized into 2 categories: sitting toilets and squatting toilets. Squatting toilets are shown to lead to better puborectalis muscle relaxation, wider anorectal angle, and require less straining compared to sitting toilets. Stemming from this knowledge, we hypothesized that toilet type would play a role in the complex pathogenesis of diverticulosis and that squatting toilets would lower the risk of diverticula formation. MATERIALS AND METHODS: This study was conducted at Antalya Training and Research Hospital between January 2023 and July 2023. A 1-page questionnaire consisting of demographic data and bowel habits as well as diverticulosis-related parameters was prepared to gather the study data. Colonoscopy results were matched with corresponding questionnaires. RESULTS: The study population consisted of 929 patients. Advanced age was found to be a risk factor for diverticulosis. Sitting toilet was also found to be a risk factor for diverticulosis in multivariate logistic regression analysis with an odds ratio of 3.36 (95% CI: 1.684-6.705) (P = .001). CONCLUSION: The results of this study revealed that toilet type is a determining factor in diverticulosis development, as was hypothesized during the conceptualization of the study. Revealing the potential contribution of the toilet type used to the development of a relatively common and impactful disorder like diverticulosis will lay the bedrock for future studies on the topic.
Subject(s)
Diverticulosis, Colonic , Humans , Female , Male , Middle Aged , Risk Factors , Aged , Surveys and Questionnaires , Diverticulosis, Colonic/etiology , Sitting Position , Adult , Bathroom Equipment , Age Factors , Colonoscopy , Toilet Facilities , Logistic Models , Aged, 80 and overABSTRACT
INTRODUCCIÓN: Enterobacterales productores de carbapenemasas (EPC) son una importante causa de infecciones asociadas a la atención en salud (IAAS). El principal reservorio de EPC lo constituyen pacientes infectados y colonizados, sin embargo, también se han identificado reservorios ambientales. OBJETIVO: Detectar la presencia de EPC en los sifones de lavamanos de la unidad de cuidados críticos de pacientes quemados adultos (UPC QMD) y unidad de cuidados críticos de pacientes pediátricos crónicos (UCEP). MÉTODO: Se recolectaron cuatro muestras de sifones de los lavamanos ubicados en el interior de las unidades de pacientes en UCEP y 10 de UPC QMD. A las muestras se les realizó estudio fenotípico y molecular para detección de carbapenemasas en el Instituto de Salud Pública de Chile. RESULTADOS: En los sifones estudiados de UCEP no se aislaron cepas de EPC. En UPC QMD, 50% de los sifones estudiados se aislaron cepas de EPC. CONCLUSIONES: En UPC QMD se objetivó la presencia de EPC en una alta proporción de los sifones de lavamanos testeados, lo que demuestra un reservorio ambiental de bacterias multi-resistentes.
INTRODUCTION: Carbapenemase-producing Enterobacterales (CPE) are an important cause of health care associated infections (HAI). The main reservoir is constituted by infected and colonized patients; however, environmental reservoirs have also been identified. OBJECTIVE: To detect the presence of CPE in the sink traps of the critical care unit for adult burn patients (UPC QMD) and the critical care unit for chronic pediatric patients (UCEP). MATERIAL AND METHOD: Four samples of trap were collected from the sinks located inside the patient units at PICU and 10 at UPC QMD. The samples underwent a phenotypic and molecular study for the detection of carbapenemases at the Institute of Public Health of Chile. RESULTS: In the UCEP no EPC strains were isolated. In UPC QMD, CPE was detected in 50% of the traps. CONCLUSIONS: In UPC QMD, the presence of CPE was observed in a high proportion of the tested sinks traps, which shows an environmental reservoir of multi-resistant bacteria.
Subject(s)
Humans , Child , Bathroom Equipment/microbiology , Enterobacteriaceae Infections , Carbapenem-Resistant Enterobacteriaceae/isolation & purification , Bacterial Proteins , beta-Lactamases , Disease Reservoirs , Plumbing Accessories , Critical Care , Hand HygieneABSTRACT
La rápida propagación mundial de la infección por SARS-CoV-2 (COVID-19) ha generado una crisis de salud de gran magnitud.[1] [2] El enfoque ha sido el uso de los recursos sanitarios a la atención de pacientes COVID-19 en el escenario de urgencias, hospitalización y cuidado intensivo.[3] De otro lado, se han cancelado las consultas presenciales y los procedimientos electivos en la gran mayoría de las instituciones hospitalarias generando un impacto en la atención de los pacientes.[4] Con excepción de las cirugías de oncología urológica, la mayoría de las cirugías electivas en urología pueden retrasarse sin un impacto negativo para el paciente.
The rapid global spread of SARS-CoV-2 (COVID-19) infection has created a major health crisis.[1] [2] The focus has been on the use of healthcare resources to care for COVID-19 patients in the emergency, inpatient and intensive care setting.[3] On the other hand, face-to-face consultations and elective procedures have been cancelled in the vast majority of hospital institutions, impacting patient care.[4] With the exception of urologic oncology surgeries, most elective surgeries in urology can be delayed without negative impact on patient care.[5] The majority of elective surgeries in urology, with the exception of urologic oncology surgeries, can be delayed without negative patient impact. With the exception of urologic oncology surgeries, most elective surgeries in urology can be delayed without a negative impact on the patient.
Subject(s)
Humans , Delivery of Health Care , COVID-19 , Medical Oncology , Bathroom Equipment , Critical Care , SARS-CoV-2 , Hospitalization , InpatientsABSTRACT
Objective: to compare the mean development time of the techniques of direct laryngoscopy and insertion of supraglottic devices; and to evaluate the success rate in the first attempt of these techniques, considering health professionals wearing specific personal protective equipment (waterproof overalls; gloves; boots; eye protection; mask). Method: meta-analysis with studies from LILACS, MEDLINE, CINAHL, Cochrane, Scopus and Web of Science. The keywords were the following: personal protective equipment; airway management; intubation; laryngeal masks. Results: in the "reduction of the time of the procedures" outcome, the general analysis of the supraglottic devices in comparison with the orotracheal tube initially presented high heterogeneity of the data (I2= 97%). Subgroup analysis had an impact on reducing heterogeneity among the data. The "laryngeal mask as a guide for orotracheal intubation" subgroup showed moderate heterogeneity (I2= 74%). The "2ndgeneration supraglottic devices" subgroup showed homogeneity (I2= 0%). All the meta-analyses favored supraglottic devices. In the "success in the first attempt" outcome, moderate homogeneity was found (I2= 52%), showing a higher proportion of correct answers for supraglottic devices. Conclusion: in the context of chemical, biological or radiological disaster, the insertion of the supraglottic device proved to be faster and more likely to be successful by health professionals. PROSPERO record (CRD42019136139).
Objetivo: comparar o tempo médio do desenvolvimento das técnicas de laringoscopia direta e de inserção de dispositivos supraglóticos e avaliar a taxa de sucesso na primeira tentativa dessas técnicas, considerando a utilização de equipamentos de proteção individual específicos (macacão impermeável; luvas; botas; proteção ocular; máscara) pelos profissionais de saúde. Método: metanálise com estudos das bases LILACS, MEDLINE, CINAHL, Cochrane, Scopus e Web of Science. As palavras-chave foram: personal protective equipment; airway management; intubation; laryngeal masks. Resultados: no desfecho redução "do tempo dos procedimentos" a análise geral dos dispositivos supraglóticos em comparação com o tubo orotraqueal apresentou inicialmente alta heterogeneidade dos dados (I2 = 97%). A análise por subgrupos impactou na redução da heterogeneidade entre os dados. O subgrupo "máscara laríngea como guia para intubação orotraqueal" demonstrou heterogeneidade moderada (I2 = 74%). O subgrupo "dispositivos supraglóticos de 2ª geração" evidenciou homogeneidade (I2 = 0%). Todas as metanálises foram favoráveis aos dispositivos supraglóticos. No desfecho "êxito na primeira tentativa" foi encontrada homogeneidade moderada (I2 = 52%), demonstrando maior proporção de acerto para dispositivos supraglóticos. Conclusão: no contexto do desastre químico, biológico ou radiológico, a inserção do dispositivo supraglótico revelou ser mais rápida e apresentar maior chance de acerto por profissionais de saúde. Registro PROSPERO (CRD42019136139).
Objetivo: comparar el tiempo medio de desarrollo de las técnicas de laringoscopia directa y de inserción de dispositivos supraglóticos y evaluar la tasa de éxito obtenida en el primer intento de dichas técnicas con profesionales sanitarios provistos de equipos de protección individual específicos (mono impermeable, guantes, botas, protección ocular, mascarilla). Método: meta-análisis con estudio de las bases de datos LILACS, MEDLINE, CINAHL, Cochrane, Scopus y Web of Science. Las palabras clave fueron las siguientes: personal protective equipment; airway management; intubation; laryngeal masks. Resultados: en el resultado "reducción del tiempo de los procedimientos", el análisis general de los dispositivos supraglóticos en comparación con el tubo orotraqueal presentó, inicialmente, una alta heterogeneidad de los datos (I2= 97%). El análisis por subgrupos dio como resultado una reducción de la heterogeneidad entre los datos. El subgrupo "mascarilla laríngea como guía para la intubación orotraqueal" mostró una heterogeneidad moderada (I2= 74%). El subgrupo "dispositivos supraglóticos de 2ª generación" mostró homogeneidad (I2= 0%). Todos los meta-análisis fueron favorables a los dispositivos supraglóticos. En el resultado "éxito en el primer intento" se halló una homogeneidad moderada (I2= 52%), obteniendo una mayor proporción de aciertos con el uso de dispositivos supraglóticos. Conclusión: en el contexto de un desastre químico, biológico o radiológico, se ha demostrado que la inserción del dispositivo supraglótico es más rápida y que los profesionales sanitarios obtienen una mayor probabilidad de acierto. Registro PROSPERO (CRD42019136139).
Subject(s)
Protective Devices , Bathroom Equipment , Incidence , Laryngeal Masks , Meta-Analysis , Disasters , Airway Management , Personal Protective Equipment , Equipment and Supplies Utilization , Intubation , LaryngoscopyABSTRACT
ABSTRACT Objective: to describe the development of a device to prevent falling for seniors when using the toilet. Method: we sought in literature and in the hospital market for a device to prevent falling, without success. Geriatric nurses, in partnership with the hospital engineering team, elaborated a prototype and, after several analysis, looked for a partner for its production. Results: the device, named "Safe Embrace", installed and tested in an apartment of the Geriatric ward, was positively evaluated by the health team, patients and caregivers. Conclusion: for the benefit obtained and considering the safety and privacy during use, Safe Embrace was patented so that other institutions could use it.
RESUMEN Objetivo: describir la elaboración del dispositivo de prevención de caídas para ancianos durante el uso del baño. Método: se buscó en la literatura y mercado del área hospitalaria un dispositivo para prevenir caída, sin éxito. Las enfermeras de la geriatría, en asociación con el equipo de ingeniería del hospital, elaboraron un prototipo y, tras varios análisis, buscaron un socio para su producción. Resultados: el dispositivo, denominado "Abrazo Seguro", instalado en un apartamento de la geriatría para la prueba, fue evaluado positivamente por el equipo de salud, pacientes y cuidadores. Conclusión: por el beneficio obtenido, y considerando la seguridad y privacidad durante el uso, el Abrazo Seguro fue patentado para que otras instituciones lo disfruten.
RESUMO Objetivo: descrever a elaboração do dispositivo de prevenção de quedas para idosos durante o uso do sanitário. Método: buscou-se na literatura e mercado da área hospitalar um dispositivo para prevenir queda, sem sucesso. Enfermeiras da geriatria, em parceria com a equipe de engenharia do hospital, elaboraram um protótipo e, após várias análises, procuraram um parceiro para sua produção. Resultados: o dispositivo, nominado "Abraço Seguro", instalado em um apartamento da geriatria para teste, foi avaliado positivamente pela equipe de saúde, pacientes e cuidadores. Conclusão: pelo benefício obtido e considerando a segurança e privacidade durante o uso, o Abraço Seguro foi patenteado para que outras instituições desfrutassem dele.
Subject(s)
Humans , Aged , Aged, 80 and over , Bathroom Equipment/standards , Patient Safety/standards , Inventions , Accidental Falls/prevention & control , Frail ElderlyABSTRACT
Resumen Introducción: Actualmente, la calidad de servicio es un pilar fundamental en los sistemas sanitarios, ya que permite garantizar a los usuarios externos un conjunto de condiciones mínimas en las prestaciones de salud. Objetivo: Evaluar las percepciones y expectativas del usuario externo respecto a la calidad del servicio del Hospital Comunitario de Salud Familiar de Quirihue. Material y Método: Estudio descriptivo comparativo, transversal, basado en modelo SERVQUAL. Las variables sociodemográficas fueron analizadas mediante estadística descriptiva, las brechas se calcularon mediante la diferencia existente entre las percepciones y expectativas, las que se analizaron con las pruebas T pareada y Wilcoxon. Resultados: La variable con mayor insatisfacción en Atención Abierta (AA) fue "difícil acceso a horas médicas o de otro profesional"; en Atención Cerrada (AC) "personal no orienta ni explica de manera clara y adecuada la atención durante la hospitalización"; y en Atención de Urgencia "demora en la atención en el box de admisión". Conclusión: El tipo de atención con menor calidad de servicio fue la AA, le sigue AU y finalmente la AC. En la AA los mayores problemas se presentaron en la obtención de horas para atenderse con médico y también en el NO cumplimiento de los horarios programados. En la AU los usuarios refieren mayor insatisfacción en la atención inmediata a su llegada al servicio. En la AC los pacientes señalan que los funcionarios NO brindan el tiempo necesario para contestar las dudas o preguntas sobre el problema de salud por el cual se encuentran hospitalizados.
Abstract Introduction: Currently, quality of service is fundamental in healthcare systems, since it allows external users to be guaranteed a set of minimum conditions in health services. Objective: To evaluate the perceptions and expectations of the external user regarding the quality of the service of the Community Health Family Hospital of Quirihue. Material and Method: Cross-sectional descriptive study, based on the SERVQUAL model. The sociodemographic variables were analyzed by means of descriptive statistics, the gaps were calculated by means of the difference between perceptions and expectations, and those were tested with paired T and Wilcoxon. Results: The variable with the greatest dissatisfaction in Open Care (OC) it was "difficult access to medical or other profesional appointment "; in Closed Care (CC) "personnel without orientation or explanation in a clear and adequate manner during hospitalization"; and in Emergency Care (EC) "delay in attention in the admission box". Conclusion: The type of care with the lowest quality of service was OC, followed by EC and finally CC. In the OC, the greatest problems arise in obtaining an appointment to be seen by the doctor and also in the NO fulfillment with the scheduled appointments. In the EC, users refer to great discontent with the immediate attention to their arrival at the service. In the CC, the patients pointed out that the staff DO NOT provide the necessary time to answer the questions or clarify doubts about the health problem for which they are hospitalized.