Construction and validation of an instrument for event-related sterility of processed healthcare products.

OBJECTIVE: To construct and validate an instrument to assess events related to maintaining the sterility of processed healthcare products. METHODS: This methodological study developed the instrument through analysis by a panel of experts, focusing on the integrity of commonly used packaging: spunbond-meltblown-spunbond and medical-grade paper. The instrument was analyzed using the Content Validity Index and Content Validity Ratio (≥ 0.80) and modified Kappa (≥ 0.74). The instrument underwent pre-testing. RESULTS: Six experienced professionals participated in the expert panel. After two rounds, the final version of the instrument contained five dimensions. In the pre-test, 30 nursing professionals participated, of whom 86.67% considered the instrument good, and 90% found it understandable. CONCLUSION: The construction and validation followed literature recommendations. The instrument is available, aiding in the safe use of processed healthcare products.

Impact of an educational intervention on patient identification adherence by nursing professionals / Impacto de una intervención educativa en la adherencia a la identificación de pacientes por parte de los profesionales de enfermería / Impacto de uma intervenção educacional na adesão à identificação do paciente pelos profissionais de enfermagem

ABSTRACT Objective: to verify the impact of digital educational strategies on nursing professionals' adherence to patient identification as well as the acceptance of these strategies by professionals. Method: this is a pre and post-intervention pilot study developed in a public teaching hospital in a city in the countryside of the state of São Paulo, Brazil, carried out between March and September 2022, in three phases: 1) pre-intervention - audits of identification wristband at the bedside, elaboration and planning of educational strategies; 2) intervention - short-term online training offered to nursing professionals; 3) post-intervention - repeat audits. For comparative analysis between phases, Pearson's chi-square test and Fisher's exact test were used with a significance level of 5%. Results: a total of 166 beds were audited with a high rate of adherence to the use of identification wristbands, in accordance with standards, and the presence of identification plates (> 80%) both in the pre- and post-intervention period, with a significant increase in patients who identified that professionals checked wristband (p=0.0410) during care. Participants positively assessed the strategies used, although low adherence to training was recorded. Conclusion: there was a positive impact on adherence to patient identification, but management and motivational strategies will be necessary to enable future actions to implement online training.

RESUMEN Objetivo: verificar el impacto de las estrategias educativas digitales en la adherencia de los profesionales de enfermería a la identificación de pacientes, así como la aceptación de estas estrategias por parte de los profesionales. Método: estudio piloto pre y posintervención desarrollado en un hospital público docente de una ciudad del interior del estado de São Paulo, Brasil, realizado entre marzo y septiembre de 2022, en tres fases: 1) preintervención - auditorías del brazalete de identificación a pie de cama, elaboración y planificación de estrategias educativas; 2) intervención - formación en línea de corta duración ofrecida a profesionales de enfermería; 3) posintervención - repetición de auditorías. Para el análisis comparativo entre fases, se utilizó la prueba chi-cuadrado de Pearson y la prueba exacta de Fisher con un nivel de significancia del 5%. Resultados: 166 camas fueron auditadas con un alto índice de adherencia al uso de brazaletes de identificación, de acuerdo con las normas, y la presencia de placas de identificación (> 80%) tanto en el período pre como posintervención, con un aumento significativo en pacientes que identificaron que los profesionales revisaban la pulsera (p=0,0410) durante la asistencia. Los participantes evaluaron positivamente las estrategias utilizadas, aunque se registró baja adherencia al entrenamiento. Conclusión: hubo un impacto positivo en la adherencia a la identificación de pacientes, pero serán necesarias estrategias de gestión y motivación que permitan acciones futuras para implementar la capacitación en línea.

RESUMO Objetivo: verificar o impacto de estratégias educacionais digitais na adesão dos profissionais de enfermagem à identificação do paciente, assim como a aceitação destas estratégias por parte dos profissionais. Método: estudo piloto de pré e pós-intervenção desenvolvido em um hospital de ensino público de uma cidade do interior do estado de São Paulo, Brasil, realizado entre março e setembro do ano de 2022, em três fases: 1) pré-intervenção - auditorias da pulseira de identificação à beira-leito, elaboração e planejamento das estratégias educacionais; 2) intervenção - treinamento online de curta duração oferecido aos profissionais de enfermagem; 3) pós-intervenção - repetição de auditorias. Para análise comparativa entre as fases, foi utilizado o teste qui-quadrado de Pearson e o teste exato de Fisher com nível de significância de 5%. Resultados: foram auditados 166 leitos com alta taxa de adesão ao uso de pulseira de identificação, de acordo com as normas, e a presença de placas de identificação (> 80%) tanto no período pré quanto pós-intervenção, com aumento significativo dos pacientes que identificaram que os profissionais conferiam a pulseira (p=0,0410) durante a assistência. Os participantes avaliaram positivamente as estratégias utilizadas, embora tenha sido registrada baixa adesão ao treinamento. Conclusão: houve um impacto positivo na adesão à identificação do paciente, porém estratégias gerenciais e motivacionais serão necessárias para viabilizar ações futuras de implementação do treinamento online.

Comportamento preventivo contra covid-19 e sua relação com as condições sociais e de saúde de pessoas idosas / Preventive behavior against covid-19 and its relationship with the social and health conditions of older adults

Resumo Objetivo Descrever o perfil de comportamento preventivo contra covid-19 adotado pelas pessoas idosas e verificar sua relação com as condições sociais e de saúde. Método Estudo transversal e analítico realizado com 72 indivíduos (≥ 60 anos) cadastrados em uma Universidade Aberta para Pessoas Idosas, no município de Campinas, São Paulo, Brasil. Os participantes foram contatados por meio de ligações telefônicas, no período de novembro de 2020 a junho de 2021. Um total de 11 medidas preventivas foram analisadas para a identificação dos comportamentos adotados pelas pessoas idosas contra covid-19. Para a análise dos dados, utilizaram-se análise de componentes principais, testes qui-quadrado de Pearson e Exato de Fisher, com 95% de confiança. Resultados A adoção de comportamentos preventivos foi avaliada por meio das atividades de: higienização das mãos com água e sabão, uso do álcool em gel, uso de máscara facial e distanciamento social. A maioria dos indivíduos mencionou a adoção de comportamentos preventivos (79,2%), e verificou-se que aqueles com renda inferior a quatro salários-mínimos apresentaram maiores proporções de comportamento (87,5%) quando comparados aos indivíduos de renda superior a 10 salários-mínimos (46,2%) (p=0,038). Conclusão Houve adoção às medidas preventivas para covid-19 pelos idosos, influenciada pela renda. Os achados ressaltam a importância de estratégias educativas para promoção de comportamentos preventivos em saúde, considerando o contexto social.

Abstract Objective To delineate the profile of preventive behavior against covid-19 adopted by older adults and investigate its correlation with social and health conditions. Method A cross-sectional and analytical study conducted with 72 individuals (≥ 60 years) enrolled in an Open University for Older Adults in the municipality of Campinas, São Paulo, Brazil. Participants were contacted via telephone from November 2020 to June 2021. A total of 11 preventive measures were scrutinized to identify the behaviors adopted by older adults against covid-19. Data analysis employed principal component analysis, Pearson's chi-square tests, and Fisher's exact tests, with a confidence level of 95%. Results The adoption of preventive behaviors was assessed through activities such as hand hygiene with soap and water, use of hand sanitizer, wearing facial masks, and practicing social distancing. The majority of individuals reported the adoption of preventive behaviors (79.2%), and it was observed that those with incomes below four minimum wages exhibited higher proportions of compliance (87.5%) compared to individuals with incomes exceeding 10 minimum wages (46.2%) (p=0.038). Conclusion Preventive measures against covid-19 were embraced by the older adults, influenced by income. The findings underscore the significance of educational strategies for fostering health preventive behaviors, taking into account the social context.

Microbial Load of Trocars: Potential Source of Contamination and Surgical Site Infection.

Surgical site infection (SSI) is a common complication that is associated with delayed recovery, prolonged length of hospital stay, exorbitant cost, and mortality. The present prospective longitudinal study aimed to evaluate the relationships between the microbial load of trocars used in laparoscopic gynecological surgery, microbiota in surgical sites, and SSI. The final sample consisted of 24 patients, including 68 swab samples and 48 trocars. Microorganisms were recovered in 100.0% of the swabs collected from the umbilicus and vaginal fornix and in 58.3% (14/24) of the swabs collected from skin at the left McBurney's point. Most of the samples collected from trocars (87.5%) did not exhibit bacterial growth, suggesting proper disinfection. In addition, antisepsis was effective for decolonization of the skin to create an aseptic surgical field.

Laryngoscopes: Evaluation of microbial load of blades.

BACKGROUND: Laryngoscope blades were analyzed, and the presence of blood, bodily fluids, and microorganisms was verified, indicating their potential as a source of cross contamination during clinical usage. The way in which the blades are cleaned and disinfected in daily practice may place the patient and health care team at risk. The aim of this study was to determine the bacterial and fungal load on this equipment. METHODS: Descriptive cross-sectional study. A total of 83 laryngoscope blades, ready for use, were analyzed for their bacterial and fungal load at 2 university hospitals. RESULTS: The microbiologic analysis revealed the presence of microorganisms in 76.2% of cases at institution 1 and 92.7% of cases at institution 2, with microbial loads >10(1) colony forming units in 31.2% and 44.7% of cases, respectively. At both institutions, potentially pathogenic microorganisms were found, including Candida sp, Staphylococcus aureus, Enterococcus faecalis, Streptococcus agalactiae, extended-spectrum ß-lactamase-producing Klebsiella pneumoniae, multiresistant Acinetobacter baumannii, Pantoea sp, Enterobacter gergoviae, Escherichia coli, and Proteus mirabilis. CONCLUSIONS: These results indicate that the use of laryngoscope blades at these 2 institutions present a potential risk. Based on these findings, action needs to be taken so a higher level of safety can be offered to patients and health care professionals who have direct contact with this equipment.

Vigilância pós-alta por telefone: validação e aplicação de instrumento para cirurgias vídeo-assistidas / Vigilancia después del alta por teléfono: validación y aplicación de instrumento para la cirugía asistida por vídeo / Telephone call for post-discharge surveillance: validation and application of tool for video-assisted surgery

RESUMOObjetivo:validar instrumento para vigilância pós-alta por contato telefônico de cirurgias vídeo-assistidas.Método:estudo multi-métodos com elaboração, validação e aplicação de instrumento. A validação foi realizada por peritos considerando pertinência, clareza e abrangência do conteúdo, sob cálculo do índice de validade de conteúdo, sendo válidas as questões com 80% de concordância. Para aplicação do instrumento, a amostra foi composta por 68 mulheres submetidas à cirurgia vídeo-assistidas sendo realizada análise descritiva.Resultados:houve discordância entre peritos na primeira avaliação e o instrumento foi reformulado obtendo-se concordância na segunda avaliação. A taxa de resposta ao contato telefônico foi de 88,2% (60/68). Queixas de dor abdominal, sangramento e edema incisional foram mais frequentes. Nenhuma apresentou infecção.Conclusão:o instrumento foi validado, aplicado e encontra-se disponível para utilização.

RESUMENObjetivo:validar un instrumento para la vigilancia después del alta por teléfono para la cirugía asistida por vídeo.Método:estudio multimétodo de desarrollo, validación y aplicación de la instrumento. La validación fue realizada por expertos que consideran la pertinencia, claridad e integridad de los contenidos, en el cálculo del índice de validez de contenido y preguntas válidas que encontró 80% de concordancia. Para la aplicación del instrumento, la muestra consistió en 68 mujeres sometidas a cirugía asistida-video y llevó a cabo un análisis descriptivo.Resultados:no hubo acuerdo entre los expertos en la primera evaluación y el instrumento fue redisenado obtener un acuerdo en la segunda evaluación. La tasa de respuesta al contacto telefónico fue del 88,2% (60/68). Las quejas de dolor abdominal, hemorragia y edema incisional fueron más frecuentes. Ninguno presentó infección.Conclusión:el cuestionario fue validado, aplica y está disponible para su uso.

ABSTRACTObjective:to validate an instrument for post-discharge surveillance by telephone for video assisted surgeries.Method:a multi-method study with development, validation and application of the instrument. The validation was performed by experts considering the relevance, clarity and completeness of the contents in the calculation of the content validity index and valid questions that demonstrated 80% agreement. For the application of the instrument, the sample consisted of 68 women undergoing video-assisted surgery, and we conducted a descriptive analysis.Results:there was disagreement among experts in the first evaluation, and the instrument was redesigned obtaining agreement in the second evaluation. The response rate to the telephone contact was 88.2% (60/68). Complaints of abdominal pain, bleeding and incisional edema were more frequent. No patients presented with infection.Conclusion:the questionnaire was validated and applied and is available for use.

Carga microbiana de trocartes reprocessáveis após laparoscopias ginecológicas / Microbial load of reprocessable trocars after gynecological videolaparoscopy

OBJETIVO: identificar a carga microbiana presente em trocartes reprocessáveis usados nas laparoscopias ginecológicas. MÉTODOS: estudo exploratório descritivo. Um total de 57 trocartes, sendo 30 com 10 mm de diâmetro e 27 com 5 mm, foram recolhidos na sala de operação, imediatamente após o ato cirúrgico, e colocados em recipiente esterilizado onde foram adicionados 250 mL de água destilada estéril. Foi feita agitação dos trocartes para desprendimento de partículas e obtenção do lavado a ser analisado. Realizou-se filtração por meio de membrana de celulose 0,22 µm, colocadas, com pinça esterilizada, em placas ágar sangue. Após incubação, foi feita a análise microbiológica para contagem de unidades formadoras de colônias e posterior identificação do micro-organismo, usando-se técnicas laboratoriais padronizadas. RESULTADOS: a carga microbiana foi recuperada em 47,4 por cento dos trocartes analisados. Destes, 45,6 por cento apresentou crescimento de 1 a 100 unidades formadoras de colônias. Foram identificados 14 tipos de micro-organismos, dentre os quais, Staphylococcus coagulase negativo (28 por cento) e Bacillus sp (21 por cento) foram isolados com maior frequência. Identificou-se também Aeromonas hydrophila, Alcaligenes sp, Candida parapsilosis e enterobactérias. CONCLUSÕES: o estudo demonstrou que o desafio microbiano enfrentado pelos operadores responsáveis pela limpeza e esterilização dos trocartes é baixo quando comparado com o desafio imposto pelos indicadores biológicos; no entanto, não se pode inferir que os riscos de complicações infecciosas sejam mínimos para pacientes.

PURPOSE: to identify the microbial charge present in reusable trocars used in gynecological laparoscopies. METHODS: a descriptive exploratory study. An amount of 57 trocars, 30 with 10 mm of diameter and 27 with 5 mm, have been collected from the surgical unit, immediately after the surgery and placed in a sterilized recipient, in which 250 mL of sterile distilled water was added. Then, the trocars were agitated for the drainage of particles and to obtain a wash-out fluid to be analyzed. After being filtered through 0.22 µm cellulose membrane, the residue was placed on blood agar plates with a sterilized forceps. Following incubation, microbiological analysis has been done to count the number of colonies and further identify the microorganisms, using standard laboratorial techniques. RESULTS: microbial charge was recovered from 47.4 percent of the trocars analyzed. Among those, 45.6 percent presented 1 to 100 growing colonies. Fourteen types of microorganisms have been identified, among which the more frequently isolated were coagulase-negative Staphylococcus (28 percent) and Bacillus sp (21 percent), Aeromonas hydrophila, Alcaligenes sp, Candida parapsilosis, and enterobacteries were also identified. CONCLUSIONS: the study has demonstrated that the microbial challenge faced by the technician responsible for the cleaning and sterilization of trocars is low, as compared to the challenge imposed by biological markers. Nevertheless, it may be not inferred that the risks for infectious complications for patients are minimal.

[Microbial load of reprocessable trocars after gynecological videolaparoscopy]. / Carga microbiana de trocartes reprocessáveis após laparoscopias ginecológicas.

PURPOSE: to identify the microbial charge present in reusable trocars used in gynecological laparoscopies. METHODS: a descriptive exploratory study. An amount of 57 trocars, 30 with 10 mm of diameter and 27 with 5 mm, have been collected from the surgical unit, immediately after the surgery and placed in a sterilized recipient, in which 250 mL of sterile distilled water was added. Then, the trocars were agitated for the drainage of particles and to obtain a wash-out fluid to be analyzed. After being filtered through 0.22 microm cellulose membrane, the residue was placed on blood agar plates with a sterilized forceps. Following incubation, microbiological analysis has been done to count the number of colonies and further identify the microorganisms, using standard laboratorial techniques. RESULTS: microbial charge was recovered from 47.4% of the trocars analyzed. Among those, 45.6% presented 1 to 100 growing colonies. Fourteen types of microorganisms have been identified, among which the more frequently isolated were coagulase-negative Staphylococcus (28%) and Bacillus sp (21%), Aeromonas hydrophila, Alcaligenes sp, Candida parapsilosis, and enterobacteries were also identified. CONCLUSIONS: the study has demonstrated that the microbial challenge faced by the technician responsible for the cleaning and sterilization of trocars is low, as compared to the challenge imposed by biological markers. Nevertheless, it may be not inferred that the risks for infectious complications for patients are minimal.