Broad Diversity of Fungi in Hospital Water.

INTRODUCTION: Some studies have reported the occurrence of microorganisms isolated from water. Considering these microorganisms, fungi are known to occur ubiquitously in the environment, including water, and some are pathogenic and may cause health problems, especially in immunocompromised individuals. The aim of this study was to identify fungi in hospital water samples and to correlate their presence with the concentration of free residual chlorine. METHODS: Water samples (100 mL) were collected from taps (n = 74) and water purifiers (n = 14) in different locations in a university hospital. Samples were filtered through a nitrocellulose membrane and placed on Sabouraud dextrose agar and incubated for 24 hours at 30°C. Fungi were identified according to established methods based on macroscopic and microscopic characteristics (filamentous) and physiological tests (yeasts). Free chlorine residual content was measured at the time of sample collection. RESULTS: Seventy species of fungi were identified in the water samples and about 56% of the water samples contained culturable fungi. Cladosporium oxysporum, Penicillium spinulosum, and Aspergillus fumigatus were the most common filamentous fungi. Aureobasidium pullulans and Candida parapsilosis were the most common yeasts. Chemical analyses revealed that free residual chlorine was present in 81.8% of the samples within recommended concentrations. Among samples from water purifiers, 92.9% showed low levels of free residual chlorine (<0.2 mg/L). There was no significant association between chlorine concentrations (either within or outside the recommended range) and the presence of filamentous fungi and yeasts. CONCLUSIONS: This study showed that hospital water can be a reservoir for fungi, some of which are potentially harmful to immunocompromised patients. Free residual chlorine was ineffective in some samples.

Evaluation of disinfection of surfaces at an outpatient unit before and after an intervention program.

BACKGROUND: Cleaning and disinfection processes must be improved so that there is a reduction in environmental contamination of frequent-contact surfaces. The objective of this study was to evaluate cleaning and disinfection of surfaces at a specialized healthcare unit after an intervention program. METHODS: Exploratory, longitudinal, and correlational study carried out in a medium-complexity clinic. Two hundred and forty samples from five surfaces were collected during three phases: diagnosis; implementation of an intervention program; and evaluation of immediate and long-term effects. In total, 720 evaluations were made, performed through three monitoring methods: visual inspection; adenosine triphosphate bioluminescence assay (ATP); and aerobic colony count (ACC). The Wilcoxon, Mann-Whitney, and Fisher's Exact tests were run to analyze data statistically. RESULTS: Cleaning and disinfection of surfaces were not being performed properly in most cases. Failure rates of surfaces reached 37.5 and 100% when the ATP and ACC procedures were used, respectively. However, after an intervention program, an improvement occurred. Success rates increased by 43.96% (ATP) and 12.46% (ACC) in phase I, by 70.6% (ATP) and 82.3% (ACC) immediately after interventions, and by 76.52% (ATP) and 85.76% (ACC) two months after the changes, showing that the program was effective. CONCLUSION: The present study reveals that implementing intervention actions with a cleaning and healthcare team brings benefits to prevent the spread of pathogenic agents through frequently touched hospital surfaces.

Hospital infection control programs: assessment of process and structure indicators. / Programas de Controle de Infecção Hospitalar: avaliação de indicadores de estrutura e processo.

OBJECTIVE: To assess hospital infection control committees in relation to structure and process indicators of hospital infection control programs. METHOD: Descriptive, cross-sectional study conducted with hospital committees registered in the National Registry of Healthcare Facilities. Primary and secondary data collection was conducted through structured interview using validated instruments and verification of documents, respectively. RESULTS: Fourteen committees participated in the research. Mean values of conformity of 80.58% were evidenced for the technical-operational structure assessment indicator, 60.77% for the infection control and prevention operational guidelines indicator, 81.59% for the epidemiological surveillance system assessment indicator, and 63.44% for hospital infection control and prevention activities assessment indicator. CONCLUSION: Among the four instruments applied to assess hospital infection control programs, only two presented results with more than 80.0% of conformity: those related to the epidemiological surveillance and technical-operational structure assessments.

Effectiveness of ATP bioluminescence assay for presumptive identification of microorganisms in hospital water sources.

BACKGROUND: Laboratory analysis of organisms in water include arduous methods, such as the multiple tube and membrane filter. The ATP bioluminescence system, proposes a new way of measuring cellular material in water by measuring adenosine triphosphate (ATP) levels, which are expressed in relative light units (RLU). The ATP bioluminescence assay has been increasingly used to assess the microbiological safety of the hospital environment. However, there are few studies investigating the use of this methodology to evaluate the microbiological quality of water. The objective of the present study was to verify whether ATP, as measured by the 3 M™ Clean-Trace Water™ ATP test, can be used as an alternative tool for presumptive testing for the presence of microorganisms in hospital water. METHODS: Water samples (N = 88) were collected from faucets (74) and water purifiers (14) in a university hospital. The sample were filtered by the membrane filter technique (100 mL for bacterial analysis and 100 mL for fungal analysis) and then submitted to ATP bioluminescence assay to the determine quantity of RLU in each sample. In order to compare RLU and the presence of microorganisms, a receiver operating characteristic (ROC) curve was used to calculate sensitivity and specificity (levels higher than 90% were considered significant). In addition, control tests were conducted to compare RLU to the quantities of bacterial and fungal organisms added to distilled water (ANOVA and Tukey's tests; p ≤ 0.05). This inoculum was compared to RLU emission, and the data were analyzed by calculating the Pearson's correlation coefficient, with a 95% confidence interval. RESULTS: In the present study, 94.3% of the water samples presented bacterial growth. Of these, 15.6% showed heterotrophic bacteria above recommended levels and fungal contamination was detected in 55.6% of samples. Sensitivity and specificity of the samples were not significant (< 90%), and the correlation between ATP and the presence of these microorganisms in the samples (hospital water) was not significant, whereas, in distilled water, the results revealed a significant difference (p < 0.0001). CONCLUSIONS: These results demonstrated that the ATP test cannot be used as an alternative tool for presumptive assessment of the presence of microorganisms in water.

[Collection of tracheal aspirate: safety and microbiological concordance between two techniques]. / Colheita de aspirado traqueal: segurança e concordâcia microbiológica entre duas técnicas.

OBJECTIVE: To evaluate the safety of the performance of the traditional and protected collection techniques of tracheal aspirate and to identify qualitative and quantitative agreement of the results of microbiological cultures between the techniques. METHOD: Clinical, prospective, comparative, single-blind research. The sample was composed of 54 patients of >18 years of age, undergoing invasive mechanical ventilation for a period of ≥ 48 hours and with suspected Ventilator Associated Pneumonia. The two techniques were implemented in the same patient, one immediately after the other, with an order of random execution, according to randomization by specialized software. RESULTS: No significant events occurred oxygen desaturation, hemodynamic instability or tracheobronchial hemorrhage (p<0.05) and, although there were differences in some strains, there was qualitative and quantitative agreement between the techniques (p<0.001). CONCLUSION: Utilization of the protected technique provided no advantage over the traditional and execution of both techniques was safe for the patient.

Effect of ozone gas on cultures of Candida albicans and Aspergillus fumigatus: evaluation of two ozonation devices.

INTRODUCTION: Candida albicans and Aspergillus fumigatus are two important agents of Healthcare-associated infections. This study aimed to evaluate the antifungal activity of ozone (O3) gas produced by two commercial devices against cultures of these two species. METHODOLOGY: Sterile plastic plates were inoculated with C. albicans and A. fumigatus and placed on a countertop at three distances (30 cm, 1 m, and 2 m) and three positions in relation to the wall (near, middle, and away), considering the source of O3. Plates were exposed to O3 for one hour and incubated. After incubation, the counting of colony-forming units was performed. As a control, an inoculated plate was incubated, without being exposed to O3. Tests were carried out with two different devices (namely, Mod.I and Mod.II), with the air conditioner on and off, in triplicate. RESULTS: Both devices showed antifungal activity. Mod. I presented better results, due to a higher flow rate. The best activity was on plates at 30 cm, middle position. Contrarily, on plates at 2m, near the wall, the inhibition activity was lower. The best results were obtained with the air conditioner off. Candida albicans was more sensitive to O3 than A. fumigatus. CONCLUSIONS: This method of decontamination by O3 gas shows potential due to its fast and easy execution. The establishment of new protocols for hygiene and hospital disinfection using this approach should be considered, which may reduce environmental contamination by fungi and, consequently, the burden of fungal infections.

Contamination of equipment and surfaces in the operating room anesthesia workspace: a cross-sectional study.

BACKGROUND: Contamination of the breathing circuit and medication preparation surface of an anesthesia machine can increase the risk of cross-infection. OBJECTIVE: To evaluate the contamination of the anesthetic medication preparation surface, respiratory circuits, and devices used in general anesthesia with assisted mechanical ventilation. DESIGN AND SETTING: Cross-sectional, quantitative study conducted at the surgical center of a philanthropic hospital, of medium complexity located in the municipality of Três Lagoas, in the eastern region of the State of Mato Grosso do Sul. METHODS: Eighty-two microbiological samples were collected from the breathing circuits. After repeating the samples in different culture media, 328 analyses were performed. RESULTS: A higher occurrence of E. coli, Enterobacter spp., Pseudomonas spp., Staphylococcus aureus, and Streptococcus pneumoniae (P < 0.001) were observed. Variations were observed depending on the culture medium and sample collection site. CONCLUSION: The study findings underscore the inadequate disinfection of the inspiratory and expiratory branches, highlighting the importance of stringent cleaning and disinfection of high-touch surfaces.

Impact of water quality on reprocessing equipment: Assessment of neurosurgical instruments cleaning and biofilm formation in hospital pipes.

Background: The presence of contamination and microorganisms at any stage of processing renders a method unsafe, leading to a high risk of cross-transmission and cross-infection. Objective: The objective of this study was to assess the cleaning quality of aspirator instruments used in neurosurgical procedures. Methods: The experimental study was conducted at the materials and sterilization center, as well as the microbiology laboratory, of a philanthropic hospital in Brazil. A study protocol was implemented, which involved the analysis of 10 samples of Yasargil aspirators with varying dimensions. The samples were subjected to protein tests to detect the presence of organic matter and microbiological analysis. Descriptive statistics were used to analyze the data. Results: The results indicated that 40% of the instruments tested positive for protein after manual cleaning. Furthermore, after automated cleaning, samples showed an increased microbiological load, with Escherichia coli accounting for 20% and Klebsiella aerogenes for 10% of the identified microorganisms. Conclusion: This study provides evidence of failures in the cleaning process of healthcare products and highlights the presence of biofilm in the pipes, thereby compromising the drinking water quality standard.

[The use of fatty acids in wound care: an integrative review of the Brazilian literature]. / Utilização dos ácidos graxos no tratamento de feridas: uma revisão integrativa da literatura nacional.

The objective of this study was to characterize the Brazilian scientific production on the topical use of fatty acids in wound care, and to describe the effects of its administration in this process. This integrative literature review included articles indexed in Lilacs and BEDENF databases. Data collection was carried out in December 2010 using controlled descriptors and without publication date limitations. The sample consisted of nine articles, mostly concerning animal models and the use of different fatty acids mixtures. Due to the lack of randomized clinical trials in human beings and the limitations of this review, it is not possible to generalize that essential fatty acids have a positive effect on the healing process or have antimicrobial effects on wound healing. Therefore, it is necessary to conduct studies of higher methodological rigor, comparing the different formulas available with fatty acids and their effects on the healing process.

[Egg crater mattresses: a deposit of methicillin-resistant staphylococcus aureus?]. / Colchões do tipo caixa de ovo: um reservatório de Staphylococcus aureus resistente à meticilina?

The purpose of this study was to evaluate the microbiological conditions of the egg crater mattress in hospital use to identify the presence of Staphylococcus aureus and its methicillin-resistance phenotype (MRSA). Petrifilm plates were used to collect the microbiological data from the mattresses, in pre-established positions. A total 180 plates were collected in 15 mattresses, 139 (72.2%) of which were positive for Staphylococcus aureus. Of the positive plates, 77 (55.4%) were collected before and 62 (44.6%) after washing the mattresses. There was a significant reduction (p=0.023) in Colony Forming Units (CFU); however, regarding the resistance profile, 8 (53.3%) mattresses with MRSA were identified. Results show the risk of these mattresses acting as a secondary deposit in the infection chain, especially regarding the presence of MRSA.

Influencing factors of hand hygiene in critical sections of a brazilian hospital.

INTRODUCTION: The aim of this study was to monitor adherence to hand hygiene by health professionals working in critical sections and to assess the factors that influenced adherence, such as physical structure of the units, use of procedure gloves, employment bond of the worker, and perception of patient safety climate. METHODOLOGY: Observational and correlational study carried out in critical areas of a university hospital in the Midwest region of Brazil. RESULTS: The overall hand hygiene adherence rate was 46.2% (n = 3,025). Adherence was higher among nurses 59.8% (n = 607) than among nursing technicians (p < 0.001), and the section with the greatest adherence was the neonatal Intensive Care Unit 62.9% (n = 947) (p < 0.001). Unlike the neonatal unit, in the adult unit the dispensers of alcohol-based handrubs were poorly located, without arms reach, and the taps were manual. In this section, a greater frequency of procedure glove use was also observed, 90.6% (n = 536), as compared to the other sections (p < 0.001). Regarding safety climate perception, temporary employees had higher means as compared to regular employees (p = 0.0375). CONCLUSIONS: Hand hygiene adherence was affected and/or influenced by the physical structure, use of procedure gloves, work regime, and patient safety climate.

Effectiveness of clinical surface cleaning and disinfection: evaluation methods.

OBJECTIVE: To discuss the methods employed to evaluate the effectiveness of clinical surface cleaning and disinfection (C&D). METHOD: This is a theoretical reflection based on scientific studies and the experience of the authors. Knowledge and current gaps, the need for further studies, and practical application of the methods were approached. RESULTS: There are four main methods used to evaluate the effectiveness of clinical surface C&D: visual inspection, fluorescent markers, microbiological cultures, and adenosine triphosphate (ATP) bioluminescence. The first two are used to evaluate the process and to predict adherence to protocols by the staff, and the last two are employed to evaluate the results, therefore being the most relevant to assess the risk of infection. FINAL CONSIDERATIONS: The ideal method was not found, because all of them showed limitations. There is a need for strategies to optimize the precision of these methods.

Wide diversity of fungal species found in wellwater for human consumption: an analytical cross-sectional study.

BACKGROUND: Fungi are ubiquitous in the environment. They are able to grow in water and many of them may be opportunistic pathogens. OBJECTIVE: The aims were to identify fungi in registered wells (RWs) and nonregistered wells (NRWs) that tap into groundwater; and to correlate the results from physicochemical assays on this water (free residual chlorine and pH) with the presence of fungi. DATA AND SETTING: Analytical cross-sectional quantitative study on groundwater wells in São José do Rio Preto, São Paulo, Brazil. METHODS: 52 samples of 500 ml of water were collected from RWs and 107 from NRWs. These were sent to a microbiology laboratory to identify any fungi that were present. In addition, free residual chlorine and pH were measured immediately after sample collection. Several statistical analysis tests were used. RESULTS: Fungal contamination was present in 78.8% of the samples from RWs and 81.3% from NRWs. Filamentous fungi were more prevalent than yeast in both types of wells. There was no significant difference in presence of fungi according to whether chloride and pH were within recommended levels in RWs; or according to whether pH was within recommended levels in NRWs. Furthermore, there was no statistical difference in the levels of fungal contamination between RWs and NRWs. CONCLUSION: Both RWs and NRWs are potential reservoirs for many types of fungi. Many of these may become opportunistic pathogens if they infect immunosuppressed individuals. Furthermore, this study confirms that fungi are able to grow even when chlorine and pH parameters are within the standards recommended.

Contamination of equipment and surfaces in the operating room anesthesia workspace: a cross-sectional study

ABSTRACT BACKGROUND: Contamination of the breathing circuit and medication preparation surface of an anesthesia machine can increase the risk of cross-infection. OBJECTIVE: To evaluate the contamination of the anesthetic medication preparation surface, respiratory circuits, and devices used in general anesthesia with assisted mechanical ventilation. DESIGN AND SETTING: Cross-sectional, quantitative study conducted at the surgical center of a philanthropic hospital, of medium complexity located in the municipality of Três Lagoas, in the eastern region of the State of Mato Grosso do Sul. METHODS: Eighty-two microbiological samples were collected from the breathing circuits. After repeating the samples in different culture media, 328 analyses were performed. RESULTS: A higher occurrence of E. coli, Enterobacter spp., Pseudomonas spp., Staphylococcus aureus, and Streptococcus pneumoniae (P < 0.001) were observed. Variations were observed depending on the culture medium and sample collection site. CONCLUSION: The study findings underscore the inadequate disinfection of the inspiratory and expiratory branches, highlighting the importance of stringent cleaning and disinfection of high-touch surfaces.

Epidemiological characterization of patients with intestinal stomas

Objective: To characterize the sociodemographic and clinical variables of people with intestinal stomas. Materials and Methods: We conducted a cross-sectional study with 47 patients of a Specialized Rehabilitation Center (CER II/APAE) in the municipality of Três Lagoas, state of Mato Grosso do Sul, Midwestern Brazil, from December 2019 to June 2020. Data was analyzed using inferential descriptive statistics (Anderson-Darling, Chi-squared, and Mann-Whitney normality tests). Results: Regarding the patients, 87.23% were from Três Lagoas, 51.06% were female, 40.43% were aged from 60 to 69 years, 59.57% were married, 53.19% were brown, 59.57% were catholic, 36.17% finished elementary school, 46.81% were retired, and 57.45% earned a monthly income below 1 minimum wage. Moreover, 61.70% had undergone terminal colostomy (61.70%), 61.70% had received guidance about its placing, 57.45% had it placed due to situations of urgency, 74.47% had a stoma installed due to a neoplasia, 38.30% were permanent, with 46.81% located in the inferior left quadrant (ILQ), 59.57% presented pasty effluent, 63.83% had a circular diameter, 53.19% had pouches with 2 pieces and 57.45%, with a flexible base, 87.23% had other adjunct equipment, and 95.74% had been trained in self-care. The most common complication was skin/peristomal irritant contact dermatitis (59,57%), and 65,95% of these cases were solved by teaching self-care. The type of stoma was significantly associated with the consistency of the effluent and the size of the protrusion (p> 0.05). Conclusion: The results found can support strategies to implement practices to promote health, develop new public policies, to provide training in self-care, and prevent and treat complications. (AU)

Equipe de limpeza hospitalar no contexto pandêmico: protocolo de scoping review / Hospital housekeeping team in the pandemic context: a scoping review protocol / Equipo de limpieza hospitalaria en el contexto de la pandemia: protocolo de revisión de alcance

OBJETIVO: Mapear a produção científica acerca da atuação dos profissionais de limpeza hospitalar durante a pandemia da COVID-19. MÉTODO: A busca será realizada nas bases de dados eletrônicas: PubMed / MEDLINE, Web of Science, Scopus Preview, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Biblioteca Virtual da Saúde (BVS). Para análise na literatura cinzenta será realizada pesquisa na Biblioteca Digital Brasileira de Teses e Dissertações, Google Scholar e Open Gray, sem aplicação de filtros. Os critérios de elegibilidade serão: estudos disponíveis na íntegra, publicados a partir de dezembro de 2019,e que respondem à questão de pesquisa proposta. Estudos em andamento ou preprint serão excluídos. Será realizada a avaliação do título e do resumo de todos os estudos localizados, com base nos critérios de elegibilidade. Os dados extraídos serão apresentados em diagramas ou no formato tabular, sendo acompanhados por um resumo narrativo.

OBJECTIVE: To map the scientific production about the performance of hospital housekeeping professionals during the COVID-19 pandemic. METHOD: The research will be conducted in the following electronic databases: PubMed/MEDLINE, Web of Science, Scopus Preview, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Biblioteca VirtualdaSaúde (BVS). In the case of the Gray Literature, a search will be performed in the Brazilian Library of Theses and Dissertation, in Google Scholar and in Open Gray, without applying any filters.The eligibility criteria will be the following: studies available in full, published from December 2019 onwards, and that answer the research question proposed. On going or preprint studies will be excluded.The titles and abstracts of all thes tudiesfound will be evaluated based on the eligibility criteria. The data extracted will be presented in diagram sortables, accompanied by a narrative summary.

OBJETIVO: Mapear la producción científica acerca del desempeño de los profesionales de limpieza hospitalaria durante la pandemia de COVID-19. MÉTODO: La búsqueda se realizará en las siguientes bases de datos electrónicas: PubMed/MEDLINE, Web of Science, Scopus Preview, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) y Biblioteca Virtual de la Salud (BVS). En el caso de la investigación en la Literatura Gris, la búsqueda se realizará en la Biblioteca Digital Brasileña de Tesis y Disertaciones, en Google Scholar y en Open Gray, sin aplicar ningún filtro. Los criterios de elegibilidad serán los siguientes: estudios disponibles en su texto completo, publicados a partir de diciembre de 2019, y que respondan la pregunta de investigación propuesta. Se excluirán estudios en curso o en preprint. Se evaluarán los títulos y resúmenes de todos los estudios localizados sobre la base de los criterios de elegibilidad. Los datos extraídos se presentarán en diagramas o tablas, acompañados por un resumen narrativo.

Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods.

OBJECTIVE: to assess the correlation among the ATP-bioluminescence assay, visual inspection and microbiological culture in monitoring the efficiency of cleaning and disinfection (C&D) of high-touch clinical surfaces (HTCS) in a walk-in emergency care unit. METHOD: a prospective and comparative study was carried out from March to June 2015, in which five HTCS were sampled before and after C&D by means of the three methods. The HTCS were considered dirty when dust, waste, humidity and stains were detected in visual inspection; when ≥2.5 colony forming units per cm2 were found in culture; when ≥5 relative light units per cm2 were found at the ATP-bioluminescence assay. RESULTS: 720 analyses were performed, 240 per method. The overall rates of clean surfaces per visual inspection, culture and ATP-bioluminescence assay were 8.3%, 20.8% and 44.2% before C&D, and 92.5%, 50% and 84.2% after C&D, respectively (p<0.001). There were only occasional statistically significant relationships between methods. CONCLUSION: the methods did not present a good correlation, neither quantitative nor qualitatively.

Construcción y validación de una herramienta para evaluación del conocimiento sobre la dermatitis asociada a la incontinencia / Construção e validação de um instrumento para avaliação do conhecimento sobre dermatite associada à incontinência / Construction and validation of a tool for evaluation of knowledge about incontinence-associated dermatitis

Objetivo: Construir y validar una herramienta para evaluar el conocimiento sobre la dermatitis por incontinencia entre profesionales de enfermería. Método: Investigación metodológica para la elaboración y la validación de contenido de una herramienta para evaluación del conocimiento sobre la dermatitis por incontinencia, efectuada en tres etapas, la elaboración de la herramienta se hizo entre junio y octubre de 2020 y la validación de contenido – por siete jueces y seis profesionales – y el pretest, se realizaron entre marzo y mayo de 2021. La construcción de la herramienta se ha fundamentado en documentos de consenso y revisiones sistemáticas del tema. Durante la validación, fue adoptado el Método Delphi. Para el análisis de la concordancia entre examinadores se ha calculado el Índice de Validez de Contenido. Resultados: La concordancia entre los evaluadores fue superior al 83% en los elementos y en el dominio del test. Por medio del análisis de la varianza, se identificó que no hubo diferencia estadística significativa entre las respuestas de los evaluadores. La versión final de la herramienta presenta 57 ítems. Conclusiones: El test elaborado fue considerado adecuado por los evaluadores en cuanto a los criterios de relevancia, claridad y simplicidad, por lo que puede aplicarse en la población objetivo, para orientar acciones de educación permanente en salud. (AU)

Objetivo: Construir e validar um instrumento para avaliar o conhecimento sobre dermatite associada à incontinência entre profissionais de enfermagem. Método: Pesquisa metodológica, para a elaboração e validação de conteúdo de um instrumento para avaliação do conhecimento sobre dermatite associada a incontinência, realizada em três etapas sendo, a elaboração do instrumento entre junho e outubro de 2020, validação de conteúdo por sete juízes e seis profissionais e pré-teste, entre março e maio de 2021. A construção do mesmo, fundamentou-se em documentos de consenso e revisões sistemáticas do tema. Durante a validação adotou-se a Técnica Delphi. Para análise da concordância entre examinadores, calculou-se o Índice de Validade de Conteúdo.Resultados: A concordância entre os avaliadores foi superior a 83%, nos itens e domínios do teste. Através de análise da variância, identificou-se que não houve diferença estatística significativa entre as respostas dos avaliadores. A versão final do instrumento apresenta 57 itens. Conclusões: O teste elaborado foi considerado adequado pelos avaliadores, quanto aos critérios de relevância, clareza e simplicidade, podendo ser aplicado na população fim, para nortear ações de educação permanente em saúde. (AU)

Objective: Building and validating a tool to evaluate knowledge about incontinence-associated dermatitis among nursing professionals. Method: Methodological research, for the elaboration and content validation of a tool to assess knowledge about incontinence-associated dermatitis, carried out in three stages: the elaboration of the instrument between June and October 2020, content validation by seven judges and six professionals, and pre-test, between March and May 2021. Its construction was based on consensus documents and systematic reviews of the topic. During validation, the Delphi method was adopted. Content Validity Index was calculated to analyze the agreement between examiners. Results: The agreement among the evaluators was higher than 83% in the test items and domains. Through analysis of variance, it was identified that there was no statistically significant difference among the evaluators' responses. The final version of the tool has 57 items. Conclusions: The test developed was considered adequate by the evaluators, regarding the criteria of relevance, clarity and simplicity, and can be applied to the target population for guiding permanent health education actions. (AU)

Intervenção Educativa Sobre Dermatite Associada à Incontinência: Estratégia de Ensino no Instagram / Educational Intervention on Incontinence-associated Dermatitis: Teaching Strategy on Instagram / Intervención Educativa en Dermatitis Asociada a Incontinencia: Estrategia Didáctica Sobre Instagram

Objetivos:Descrever e avaliar intervenção educativa realizada por meio de mídia social sobre dermatite associada à incontinência (DAI) com profissionais de enfermagem. Métodos:Estudo de intervenção educativa com abordagem qualitativa pela mídia social Instagram para veiculação dos conteúdos do curso sobre a DAI. A coleta de dados foi realizada com 30 profissionais de enfermagem da clínica médica e unidade de terapia intensiva adulta de hospital de ensino público de Mato Grosso do Sul, de fevereiro a março de 2022. Os dados foram coletados durante o curso e apreciados pela análise de conteúdo de Bardin e à luz do referencial teórico da aprendizagem significativa de Ausubel. Resultados: Da análise dos comentários dos cursistas, emergiram quatro categorias temáticas: ancoragem, que retrata o saber prévio; aprendizagem significativa subordinada, a qual apresenta a construção de conhecimento ancorada no saber prévio; aprendizagem por descoberta, evidenciando a autonomia do participante no aprendizado; e avaliação do processo de ensino-aprendizagem, que revela a avaliação do processo educativo. Conclusão: Os resultados mostraram que a intervenção educativa obteve êxito no que tange ao compartilhamento de evidências sobre DAI aos participantes e que a ferramenta Instagram pode ser adotada para ações educativas mesmo em ambiente hospitalar.

Objectives:To describe and evaluate, in a formative way, an educational intervention carried out through social media on incontinence-associated dermatitis with nursing professionals from a public hospital. Method: Educational intervention study with a qualitative approach conducted in a virtual way through the social media Instagram as a platform for the dissemination of course content on the subject. Data collection was carried out with 30 nursing professionals from the medical clinic and adult intensive care unit of a public teaching hospital in the state of Mato Grosso do Sul, Brazil, between February and March 2022. Data were collected during the course and analysed through content analysis and according to Ausubel's meaningful learning theoretical framework perspective. Results: From the analysis of the participants' comments, four thematic categories emerged: anchoring; subordinated meaningful learning; discovery learning; and evaluation of the teaching-learning process. Conclusion: Through the results found, it was identified that the educational intervention conducted was successful in terms of sharing evidence on the subject to the participants. It was found that the Instagram can be adopted as a tool to carry out educational actions, including in a hospital environment.

Objetivo:Describir y evaluar, de forma formativa, una intervención educativa realizada a través de las redes sociales sobre dermatitis asociada a incontinencia con profesionales de enfermería de un hospital público. Métodos: Estudio de intervención educativa, con enfoque cualitativo, realizado de forma virtual, a través de la red social Instagram® como plataforma de difusión de contenidos de cursos sobre el tema. La recolección de datos se realizó con 30 profesionales de Enfermería de la Clínica Médica y UTI Adultos de un hospital público de enseñanza en el estado de Mato Grosso do Sul, entre febrero y marzo de 2022. Este estudio fue aprobado por el Comité de Ética en Investigación. Los datos fueron recolectados durante el curso y analizados a través del análisis de contenido ya la luz del marco teórico del Aprendizaje Significativo de Ausubel. Resultados: Del análisis de los comentarios de los participantes surgieron cuatro categorías temáticas: anclaje; aprendizaje significativo subordinado; aprendizaje por descubrimiento; y evaluación del proceso de enseñanza-aprendizaje. Conclusión: A través de los resultados encontrados, se identifica que la intervención educativa realizada fue exitosa en cuanto a compartir evidencias sobre el tema a los participantes. Se constató que la herramienta Instagram® puede ser adoptada para realizar acciones educativas, incluso en ambiente hospitalario.

Ação antimicrobiana do gás ozônio em superfícies e na aeromicrobiota / Acción antimicrobiana del gas ozono en superfi cies y en la microbiota del aire / Antimicrobial action of ozone gas on surfaces and in the air

Resumo Objetivo: Avaliar a ação antimicrobiano do gás ozônio (O3) em superfícies e ar ambiente climatizado artificialmente. Métodos: Estudo experimental/laboratorial e transversal realizado em dez salas de um laboratório de pesquisa em microbiologia médica, com risco de segurança biológica classe 2. As superfícies demarcadas do chão, parede e bancada foram avaliadas, quanto à presença ou ausência de micro-organismos, a partir de coletas feitas com swab umedecido em água destilada estéril, antes e após a exposição do gás O3 gerado por dois equipamentos distintos. Após este procedimento, o swab foi inoculado na superfície do meio de cultura Brain Heart Infusion Agar DIFCO® (BHI), seguindo-se a incubação a 35ºC por 24 horas. Para a análise microbiológica do ar, uma placa com BHI foi exposta aberta por uma hora, antes e após o tratamento do gás O3, sendo incubadas segundo os mesmos critérios. Resultados: A atividade antimicrobiana do gás O3 gerado por ambos os equipamentos foi constatada para todas as áreas investigadas, com registros de redução do número de Unidades Formadoras de Colônias. O potencial de inibição antimicrobiana dos aparelhos se manteve próximo para os critérios de análise adotados, com destaque para as áreas de chão e bancada. Considerando-se todas as salas e percentuais de inibição microbiana, frente aos dois equipamentos, os resultados foram: chão (100%), bancada (90%), parede (50%) e ar, 70%. Conclusão: Os equipamentos geradores de gás O3 apresentaram potencial antimicrobiano para medida de controle de microrganismos presentes em superfícies e ar ambiente climatizado artificialmente, sendo um sanitizante factível para utilização.

Resumen Objetivo: Evaluar la acción antimicrobiana del gas ozono (O3) en superficies y en el aire interior climatizado artificialmente. Métodos: Estudio experimental/de laboratorio y transversal realizado en diez salas de un laboratorio de investigación en microbiología médica, con riesgo de seguridad biológica clase 2. Se evaluaron las superficies delimitadas en el piso, pared y mesa en cuanto a la presencia o ausencia de microorganismos, a partir de muestras recolectadas con hisopo humedecido en agua destilada estéril, antes y después de la exposición del gas O3 generado por dos máquinas distintas. Luego de este procedimiento, el hisopo fue inoculado en la superficie del medio de cultivo Brain Heart Infusion Agar DIFCO® (BHI), y después incubado a 35 °C por 24 horas. Para el análisis microbiológico del aire, se expuso una placa con BHI abierta durante una hora, antes y después del tratamiento del gas O3, y luego se incubó con los mismos criterios. Resultados: Se constató la actividad antimicrobiana del gas O3 generado por ambas máquinas en todas las áreas investigadas, y se registró una reducción del número de unidades formadoras de colonias. El potencial de inhibición antimicrobiana de los dispositivos se mantuvo próximo a los criterios de análisis adoptados, con énfasis en el área del piso y mesa. Considerando todas las salas y porcentajes de inhibición microbiana, con las dos máquinas, los resultados fueron: piso (100 %), mesa (90 %), pared (50 %) y aire (70 %). Conclusión: Las máquinas generadoras de gas O3 presentaron potencial antimicrobiano como medida de control de microorganismos presentes en superficies y aire interior climatizado artificialmente, lo que lo convierte en un desinfectante factible para ser usado.

Abstract Objective: Assess the antimicrobial action of ozone gas (O3) on surfaces and artificially cooled ambient air. Methods: Cross-sectional experimental/laboratory study carried out in ten rooms of a medical microbiology research lab, with class 2 biosafety risk. The demarcated surfaces on the floor, wall and counter were assessed in relation to the presence or absence of microorganisms, based on collections done with swabs dampened in sterile distilled water, before and after exposure to ozone gas produced by two different generators. After this procedure, each swab was inoculated on the surface of a Brain Heart Infusion Agar DIFCO® (BHI) culture, followed by incubation at 35ºC for 24 hours. For the microbiological analysis of the air, a petri dish with BHI was openly exposed for one hour, before and after treatment with O3 gas, and were incubated according to the same criteria. Results: The antimicrobial activity of the O3 gas produced by both generators was checked in all the areas investigated, with records indicating a decrease in the number of colony-forming units. The antimicrobial inhibition potential of the generators was close to the analysis criteria adopted, particularly for the floor and counter areas. Based on all the rooms and microbial inhibition percentages, in relation to the two generators, the results were: floor (100%), counter (90%), wall (50%) and air (70%). Conclusion: The O3 generators had antimicrobial potential as a procedure for controlling microorganisms present on surfaces and in artificially cooled ambient air, constituting a feasible sanitizer.