[Evolution of adherence to hand hygiene in health care professionals in a third level hospital in relation to the SARS-CoV-2 pandemic]. / Evaluación de la adherencia a la higiene de manos en profesionales sanitarios en un hospital de tercer nivel en relación con la pandemia de SARS-CoV-2.

OBJECTIVE: Proper hand hygiene is the main measure in the prevention and control of infection associated with healthcare. It describes how the pandemic period of 2020 has influenced the evolution of the degree of compliance with hand hygiene practices in health professionals at the Hospital Universitario Insular de Gran Canaria with respect to previous years. METHODS: Descriptive cross-sectional study of direct observation on compliance with the five moments of hand hygiene in the 2018-2020 period. Adherence is described with the frequency distribution of the different moments in which it was indicated. RESULTS: Total adherence has increased from 42.5% in 2018, to 47.6% in 2019, and 59.2% in 2020 (p <0.05). Total adherence was greater in the moments after contact with the patient (67%) than in the moments before contact (48%). The area with the highest adherence was dialysis (83%). There is a greater adherence in open areas than in hospitalization areas (65% vs 56%). Higher adherence was determined in physicians (73%) and nurses (74%), than in nursing assistants (50%) (p<0.05). CONCLUSIONS: In 2020 there was an increase in adherence to hand hygiene compared to previous years. A higher percentage of adherence was determined in physicians and nurses than in nursing assistants. We consider that the current SARS-CoV-2 pandemic has played a relevant role in this increase in adherence.

[Prospective study of the incidence density of multi-resistant microorganisms and Clostridioides difficile during the period 2012- 2019 in the Canary Islands]. / Estudio prospectivo de la densidad de incidencia de microorganismos multirresistentes y Clostridioides difficile durante el periodo 2012-2019 en la Comunidad Autónoma de Canarias.

OBJECTIVE: In 2012, the Canary Islands Health Service implemented a new surveillance system for nosocomial infections caused by multi-resistant microorganisms and Clostridioides difficile. This system will make it possible to know the incidence rates of these pathogens, periodically contrast them to monitor their trend and compare them with those of other national and European health institutions. METHODS: Observational, prospective study of the density of incidence of multi-resistant pathogens and Clostridioides difficile in the healthcare centers of the Canary Islands Health Service from 2012 to 2019. RESULTS: The incidence density of methicillin-resistant Staphylococcus aureus infections for 2012 was 1.96 cases per 10,000 stays and decreased to 0.80 in 2019, reaching the lowest figure in the surveillance period. Infections due to carbapenemase-producing Enterobacterales (CPE) showed an upward trend, 0.47 (2014) and 2.35 (2019). The slight upward trend in imipenem-resistant Acinetobacter baumannii infections in observed bacteraemias 0.17 (2012) and 0.09 (2019) has been corrected. No cases of infection with vancomycin-resistant enterococci were observed. With regard to C. difficile, an upward trend that began in 2012 has consolidated, producing an increase of 216% in the number of cases detected at the end of the study period. CONCLUSIONS: The most relevant problem detected today is the CPE. The data analyzed in this period showed an evident change in the trend of the multi-resistant pathogens studied. This fact must be confirmed in the future.

[Evaluation of training on the programs to optimize antimicrobial use in medical residents of the province of Las Palmas]. / Evaluación de la formación sobre el programa de optimización del uso de antimicrobianos en médicos residentes de la provincia de Las Palmas.

OBJECTIVE: Antibiotic resistance is a threat to global public health. This situation makes essential to establish programs to optimize antimicrobial use (PROA). Training needs are identified in the PROA of resident physicians and the results of the analysis of the associations between study variables and training in the rational and prudent use of antibiotics are presented in this analysis. METHODS: Cross-sectional and analytical study through a self-administered questionnaire to a group of 506 medical residents of the province of Las Palmas. The association between resident's characteristics and PROA training was calculated through logistic regression. RESULTS: The associations between response variance and speciality were observed in most of the core component analysis (opportunity p=0.003, training p=0.007, motivation p=0.055 and hand hygiene p=0.044), followed by variance according to sex (capacity p=0.028, theoretical knowledge p=0.013, hand hygiene p=0.002). Very few differences were associated with age (capacity p=0.051 and hand hygiene p=0.054) or the year of expertise (hand hygiene p=0.032). CONCLUSIONS: The main training needs of resident physicians include one health, motivation, training, hand hygiene and information. The type of speciality followed by sex are the most important determinants on antibiotic use and resistance for resident physicians.

[Perceptions of intensive care professionals about hand hygiene compared with observational studies]. / Percepciones de los profesionales de cuidados intensivos sobre la higiene de manos en comparación con estudios observacionales.

OBJETIVE: To identify perceptions and knowledge about the adherence to hand hygiene of the healthcare staff of an intensive care unit, correlating them with compliance data on adherence to hand hygiene through observational studies MATERIAL AND METHOD: A quantitative methodology has been combined, based on the completion of a personal survey, and a qualitative methodology based on direct observation. Units of Intensive Care of Adults (A-ICU) and Pediatrics (P-ICU) of a tertiary hospital. There were 187 health professionals. Personal and work data of the professionals were collected, as well as questions related to their knowledge and perceptions about the hand hygiene. RESULTS: Those 187 professionals, 75,9% from A-ICU, represented more than 80% of the study population, and 91.4% had received previous training on hand hygiene. Regarding knowledge, 35% of the A-ICU professionals and almost 50% from the P-ICU consider that hand washing is more effective than hand friction with alcohol-based solutions for the elimination of microorganisms. They have a better perception that they correctly perform the hand washing (89.32% ICU-P and 82.93% ICU-A), than when we compare them to the adherence rates obtained by direct observation (ICU-P 73.8% and ICU-A 51.4%, P=0.0001). CONCLUSIONS: Despite having previous training on hand hygiene, they have incomplete knowledge and, although they overestimate the problem of the healthcare-associated infections, they have a perception that does not fit with reality.