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1.
Br J Nurs ; 29(1): 8, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31917933

RESUMEN

Tracy Doherty, Assistant Director of Infection Prevention & Control, Our Lady of Lourdes Hospital, Drogheda, Co Louth, discusses the maintenance of a clean healthcare environment.


Asunto(s)
Infección Hospitalaria/etiología , Ambiente de Instituciones de Salud , Infección Hospitalaria/prevención & control , Ambiente de Instituciones de Salud/normas , Servicio de Limpieza en Hospital/normas , Humanos , Control de Infecciones
2.
Br J Nurs ; 28(13): 890-891, 2019 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-31303049

RESUMEN

Emeritus Professor Alan Glasper, University of Southampton, discusses strategies used to keep patients in hospital safe from infection.


Asunto(s)
Infección Hospitalaria/prevención & control , Control de Infecciones/métodos , Seguridad del Paciente , Inglaterra , Almacenamiento de Alimentos/normas , Servicio de Limpieza en Hospital/normas , Humanos , Higiene/normas , Medicina Estatal
3.
Glob Health Action ; 12(1): 1480085, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31154993

RESUMEN

Hospital cleaning has been shown to impact on rates of healthcare-associated infections (HCAIs) and good environmental hygiene is critical to quality care, yet those tasked with the role of ensuring a safe and clean environment often go unrecognised as members of the healthcare workforce. Sepsis is a leading cause of maternal and newborn death, a significant proportion of these cases are estimated to be due to HCAIs. Deliveries in health institutions have now reached 75% globally, and in low and middle income countries the corresponding increased pressure on facilities  has impacted both quality of care provided and quality of the birth environment in terms of infection prevention and control (IPC) and HCAIs. The paper discusses the neglected role of health facility cleaners, providing evidence from the literature and from needs assessments conducted by The Soapbox Collaborative and partners in Bangladesh, India, The Gambia and Zanzibar. While not the primary focus of the assessments, common themes emerged consistently pointing to institutional neglect of cleaning and cleaners. The paper argues that low status within facilities, wider societal marginalisation, lack of training, and poor pay and working conditions contribute to the lack of prioritisation placed on health facility environmental hygiene. With increased international attention focused towards health facility water, sanitation and hygiene and a growing focus on IPC, now is the time to address the neglect of this frontline healthcare workforce. We propose that provision of and improved training can enable the recognition of the valuable role cleaning staff play, as well as equipping these staff with the tools required to perform their job to the highest standard. In addition to training, wider systems changes are necessary to establish improvements in environmental hygiene and the role of cleaning staff, including addressing resource availability, supportive supervision, and an increased emphasis on preventative healthcare.


Asunto(s)
Infección Hospitalaria/prevención & control , Maternidades/normas , Servicio de Limpieza en Hospital/normas , Higiene/normas , Control de Infecciones/normas , Seguridad del Paciente/normas , Saneamiento/normas , Adulto , Bangladesh , Femenino , Gambia , Humanos , India , Recién Nacido , Persona de Mediana Edad , Evaluación de Necesidades , Embarazo , Tanzanía
4.
Infect Control Hosp Epidemiol ; 40(1): 100-102, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30419977

RESUMEN

In this systematic evaluation of fluorescent gel markers (FGM) applied to high-touch surfaces with a metered applicator (MA) made for the purpose versus a generic cotton swab (CS), removal rates were 60.5% (476 of 787) for the MA and 64.3% (506 of 787) for the CS. MA-FGM removal interpretation was more consistent, 83% versus 50% not removed, possibly due to less varied application and more adhesive gel.


Asunto(s)
Desinfección/normas , Servicio de Limpieza en Hospital/normas , Control de Infecciones/normas , Habitaciones de Pacientes/normas , Recuento de Colonia Microbiana , Infección Hospitalaria/prevención & control , Desinfección/métodos , Colorantes Fluorescentes , Hospitales , Servicio de Limpieza en Hospital/métodos , Humanos , Control de Infecciones/métodos , Maryland
5.
J Pak Med Assoc ; 68(7): 1084-1089, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30317307

RESUMEN

Patients are the key stakeholders of any hospital and it is important to satisfy them. The objective of this study was to compare the quality of hospitals within Rashidabad; a town in rural Sindh operated by Rashid Memorial Welfare Organization (RMWO), with District Headquarter hospital Tando Allahyar. A cross sectional survey, based on a questionnaire designed in congruence with literature, regarding the hospital quality was conducted on 150 patients in October 2016. The target population was defined as patients getting treatment at hospitals within Rashidabad; whose estimate was reported by RMWO as 2000 per week. Hospital quality index (HQI) was framed in the light of quality of staff, ward, pain management practices and hygiene which includes food. Logistic Regression was applied on HQI that showed dependence of perception about hospital quality on age, hospital location and patient's health. Results were significantly in favour of hospitals within Rashidabad.


Asunto(s)
Hospitales de Distrito/normas , Hospitales Urbanos/normas , Satisfacción del Paciente , Calidad de la Atención de Salud , Adolescente , Adulto , Estudios Transversales , Femenino , Inocuidad de los Alimentos , Encuestas de Atención de la Salud , Servicio de Limpieza en Hospital/normas , Humanos , Masculino , Persona de Mediana Edad , Manejo del Dolor/normas , Pakistán , Habitaciones de Pacientes/normas , Personal de Hospital/normas , Adulto Joven
6.
Infect Control Hosp Epidemiol ; 39(11): 1296-1300, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30221609

RESUMEN

BACKGROUND: Improvement of environmental cleaning in hospitals has been shown to decrease in-hospital cross transmission of pathogens. Several objective methods, including aerobic colony counts (ACCs), the adenosine triphosphate (ATP) bioluminescence assay, and the fluorescent marker method have been developed to assess cleanliness. However, the standard interpretation of cleanliness using the fluorescent marker method remains uncertain. OBJECTIVE: To assess the fluorescent marker method as a tool for determining the effectiveness of hospital cleaning. DESIGN: A prospective survey study. SETTING: An academic medical center. METHODS: The same 10 high-touch surfaces were tested after each terminal cleaning using (1) the fluorescent marker method, (2) the ATP assay, and (3) the ACC method. Using the fluorescent marker method under study, surfaces were classified as totally clean, partially clean, or not clean. The ACC method was used as the standard for comparison. RESULTS: According to the fluorescent marker method, of the 830 high-touch surfaces, 321 surfaces (38.7%) were totally clean (TC group), 84 surfaces (10.1%) were partially clean (PC group), and 425 surfaces (51.2%) were not clean (NC group). The TC group had significantly lower ATP and ACC values (mean ± SD, 428.7 ± 1,180.0 relative light units [RLU] and 15.6 ± 77.3 colony forming units [CFU]/100 cm2) than the PC group (1,386.8 ± 2,434.0 RLU and 34.9 ± 87.2 CFU/100 cm2) and the NC group (1,132.9 ± 2,976.1 RLU and 46.8 ± 119.2 CFU/100 cm2). CONCLUSIONS: The fluorescent marker method provided a simple, reliable, and real-time assessment of environmental cleaning in hospitals. Our results indicate that only a surface determined to be totally clean using the fluorescent marker method could be considered clean.


Asunto(s)
Servicio de Limpieza en Hospital/normas , Control de Infecciones/normas , Saneamiento/normas , Centros Médicos Académicos , Adenosina Trifosfato/análisis , Recuento de Colonia Microbiana , Infección Hospitalaria/prevención & control , Colorantes Fluorescentes , Servicio de Limpieza en Hospital/métodos , Humanos , Control de Infecciones/métodos , Mediciones Luminiscentes , Habitaciones de Pacientes/normas , Estudios Prospectivos , Saneamiento/métodos , Taiwán
7.
Am J Infect Control ; 46(4): 397-401, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29174193

RESUMEN

BACKGROUND: Environmental service workers may be exposed to pathogens during the cleaning of pathogen-containing bodily fluids. METHODS: Participants with experience cleaning hospital environments were asked to clean simulated, fluorescein-containing vomitus using normal practices in a simulated patient room. Fluorescein was visualized in the environment and on participants under black lights. Fluorescein was quantitatively measured on the floor, in the air, and on gloves and shoe covers. RESULTS: In all 21 trials involving 7 participants, fluorescein was found on the floor after cleaning and on participants' gloves. Lower levels of floor contamination were associated with the use of towels to remove bulk fluid (ρ = -0.56, P = .01). Glove contamination was not associated with the number or frequency of contacts with environmental surfaces, suggesting contamination occurs with specific events, such as picking up contaminated towels. Fluorescein contamination on shoe covers was measured in 19 trials. Fluorescein was not observed on participants' facial personal protective equipment, if worn, or faces. Contamination on other body parts, primarily the legs, was observed in 8 trials. Fluorescein was infrequently quantified in the air. CONCLUSIONS: Using towels to remove bulk fluid prior to mopping is part of the recommended cleaning protocol and should be used to minimize residual contamination. Contamination on shoes and the floor may serve as reservoirs for pathogens.


Asunto(s)
Contaminación de Equipos , Pisos y Cubiertas de Piso , Servicio de Limpieza en Hospital/normas , Control de Infecciones , Equipo de Protección Personal , Vómitos , Fluoresceína , Ambiente de Instituciones de Salud , Hospitales , Humanos , Habitaciones de Pacientes
10.
J Prev Med Hyg ; 58(2): E177-E183, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28900359

RESUMEN

INTRODUCTION: Contamination of hospital surfaces plays an important role in the transmission of several healthcare-associated microorganisms, therefore methods for evaluating hospital surfaces' cleaning gain particular importance. Among these, there are visual inspection, quantitative microbiology, fluorescent markers and adenosine triphosphate (ATP) bioluminescence. The latter seems to provide interesting features, detecting the presence of ATP on surface (as Relative Light Units, RLU), a proxy of organic matter and microbial contamination. Several studies have investigated the effectiveness of this technology; with this research, we aim to summarize the most significant results. METHODS: A systematic review was conducted. The keywords (namely, "ATP", "bioluminescence", "hospital" and "surfaces") were searched in PubMed/MEDLINE and Scopus databases, in order to find relevant data, from January 2000 to October 2014. After the selection, we globally considered 27 articles. RESULTS: Most of the studies were conducted in United Kingdom and in USA. Different threshold RLU benchmark values were identified by analyzed studies. Fourteen of these researches compared the ATP bioluminescence with microbiological methods, 11 identified a significant correlation between the two methods, although poor or not complete for 5. DISCUSSION: ATP bioluminescence is not a standardized methodology: each tool has different benchmark values, not always clearly defined. At the moment, we can say that the technique could be used to assess, in real time, hospital surfaces where cleanliness is required, but not sterility.


Asunto(s)
Adenosina Trifosfato/análisis , Microbiología Ambiental , Servicio de Limpieza en Hospital/normas , Control de Infecciones/normas , Mediciones Luminiscentes , Recuento de Colonia Microbiana , Monitoreo del Ambiente , Contaminación de Equipos , Humanos
11.
Am J Infect Control ; 45(12): 1312-1317, 2017 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-28844383

RESUMEN

BACKGROUND: Environmental service workers cleaning bodily fluids may transfer pathogens through the environment and to themselves through contacts. METHODS: Participants with experience in cleaning of hospital environments were asked to clean simulated vomitus using normal practices in a simulated patient room while being videorecorded. Contacts with environmental surfaces and self were later observed. RESULTS: In 21 experimental trials with 7 participants, environmental surfaces were contacted 26.8 times per trial, at a frequency of 266 contacts per hour, on average. Self-contact occurred in 9 of 21 trials, and involved 1-18 contacts, mostly to the upper body. The recommended protocol of cleaning bodily fluids was followed by a minority of participants (2 of 7), and was associated with fewer surface contacts, improved cleaning quality, and different tool use. Participants used different cleaning practices, but each employed similar practices each time they performed an experimental trial. CONCLUSIONS: Training in the use of the recommended protocol may standardize cleaning practices and reduce the number of surface contacts.


Asunto(s)
Servicio de Limpieza en Hospital/normas , Control de Infecciones , Exposición a Riesgos Ambientales , Femenino , Ambiente de Instituciones de Salud , Hospitales , Humanos , Masculino , Habitaciones de Pacientes , Vómitos
12.
Infect Control Hosp Epidemiol ; 38(7): 777-783, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28462761

RESUMEN

OBJECTIVE To determine the impact of an environmental disinfection intervention on the incidence of healthcare-associated Clostridium difficile infection (CDI). DESIGN A multicenter randomized trial. SETTING In total,16 acute-care hospitals in northeastern Ohio participated in the study. INTERVENTION We conducted a 12-month randomized trial to compare standard cleaning to enhanced cleaning that included monitoring of environmental services (EVS) personnel performance with feedback to EVS and infection control staff. We assessed the thoroughness of cleaning based on fluorescent marker removal from high-touch surfaces and the effectiveness of disinfection based on environmental cultures for C. difficile. A linear mixed model was used to compare CDI rates in the intervention and postintervention periods for control and intervention hospitals. The primary outcome was the incidence of healthcare-associated CDI. RESULTS Overall, 7 intervention hospitals and 8 control hospitals completed the study. The intervention resulted in significantly increased fluorescent marker removal in CDI and non-CDI rooms and decreased recovery of C. difficile from high-touch surfaces in CDI rooms. However, no reduction was observed in the incidence of healthcare-associated CDI in the intervention hospitals during the intervention and postintervention periods. Moreover, there was no correlation between the percentage of positive cultures after cleaning of CDI or non-CDI rooms and the incidence of healthcare-associated CDI. CONCLUSIONS An environmental disinfection intervention improved the thoroughness and effectiveness of cleaning but did not reduce the incidence of healthcare-associated CDI. Thus, interventions that focus only on improving cleaning may not be sufficient to control healthcare-associated CDI. Infect Control Hosp Epidemiol 2017;38:777-783.


Asunto(s)
Clostridium difficile , Infección Hospitalaria/epidemiología , Desinfección/métodos , Enterocolitis Seudomembranosa/epidemiología , Control de Infecciones/métodos , Rendimiento Laboral/normas , Carga Bacteriana , Infección Hospitalaria/prevención & control , Enterocolitis Seudomembranosa/prevención & control , Retroalimentación , Fómites/microbiología , Administración Hospitalaria , Hospitales , Servicio de Limpieza en Hospital/normas , Humanos , Incidencia , Control de Infecciones/normas , Ohio/epidemiología , Habitaciones de Pacientes
14.
Health Aff (Millwood) ; 36(2): 355-361, 2017 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-28167726

RESUMEN

Inspections are a key way to monitor and ensure quality of care and maintain high standards in the National Health Service (NHS) in England. Yet there is a perception that inspections can be gamed. This can happen, for example, when staff members know that an inspection will soon take place. Using data for 205 NHS hospitals for the period 2011-14, we tested whether patients' perceptions of cleanliness increased during periods when inspections occurred. Our results show that during the period within two months of an inspection, there was a significant elevation (2.5-11.0 percentage points) in the share of patients who reported "excellent" cleanliness. This association was consistent even after adjustment for secular time trends. The association was concentrated in hospitals that outsourced cleaning services and was not detected in those that used NHS cleaning services.


Asunto(s)
Hospitales/tendencias , Servicio de Limpieza en Hospital/normas , Control de Infecciones/normas , Medicina Estatal , Inglaterra , Hospitales/normas , Servicio de Limpieza en Hospital/métodos , Humanos , Pacientes/psicología , Habitaciones de Pacientes/normas , Encuestas y Cuestionarios
15.
World J Pediatr ; 13(3): 217-221, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28101771

RESUMEN

BACKGROUND: Hospital environment remains a risk for healthcare-associated infections (HAIs). This was a prospective study to evaluate the comprehensive impact of relocating a neonatal intensive care unit (NICU) to a new facility and improved environmental cleaning practice on the presence of methicillin-resistant Staphylococcus aureus (MRSA) on inanimate surfaces and the incident rate of HAIs. METHODS: New environmental cleaning measures were adopted after the NICU was moved to a new and better-designed location. The effect of moving and the new environmental cleaning practice was investigated by comparing the positive number of MRSA on ward surfaces and the incidence density of HAIs between the baseline and intervention periods. RESULTS: Only 2.5% of environmental surfaces were positive for MRSA in the intervention period compared to 44.0% in the baseline period (P<0.001). Likewise, the total incident rate of HAIs declined from 16.8 per 1000 cot-days to 10.0 per 1000 cot-days (P<0.001). CONCLUSION: The comprehensive measures of relocating the NICU to a new facility design with improved environmental cleaning practice are effective and significantly reduce the incidence of HAIs.


Asunto(s)
Infección Hospitalaria/prevención & control , Servicio de Limpieza en Hospital/normas , Control de Infecciones/normas , Unidades de Cuidado Intensivo Neonatal , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/prevención & control , China/epidemiología , Infección Hospitalaria/epidemiología , Humanos , Incidencia , Recién Nacido , Estudios Prospectivos
17.
Curr Opin Infect Dis ; 29(4): 415-23, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27272734

RESUMEN

PURPOSE OF REVIEW: More evidence is emerging on the role of cleaning and decontamination for reducing hospital-acquired infection. Timely and adequate removal of environmental pathogens leads to measurable clinical benefits for patients. This article considers studies published from 2013 examining hospital decontamination technologies and evidence for cost-effectiveness. RECENT FINDINGS: Novel biocides and cleaning products, antimicrobial coatings, monitoring practices and automated equipment are widely accessible. They do not necessarily remove all environmental pathogens, however, and most have yet to be comprehensively assessed against patient outcome. Some studies are confounded by concurrent infection control and/or antimicrobial stewardship initiatives. Few contain data on costs. SUMMARY: As automated dirt removal is assumed to be superior to human effort, there is a danger that traditional cleaning methods are devalued or ignored. Fear of infection encourages use of powerful disinfectants for eliminating real or imagined pathogens in hospitals without appreciating toxicity or cost benefit. Furthermore, efficacy of these agents is compromised without prior removal of organic soil. Microbiocidal activity should be compared and contrasted against physical removal of soil in standardized and controlled studies to understand how best to manage contaminated healthcare environments.


Asunto(s)
Infección Hospitalaria/prevención & control , Descontaminación/métodos , Servicio de Limpieza en Hospital/métodos , Control de Infecciones/métodos , Desinfectantes/toxicidad , Servicio de Limpieza en Hospital/normas , Humanos
18.
Rev. calid. asist ; 31(supl.1): 55-61, jun. 2016. tab, graf, ilus
Artículo en Español | IBECS | ID: ibc-154544

RESUMEN

Con el objetivo de incrementar la cultura de seguridad en relación con la higiene de manos en el Complejo Hospitalario Universitario Insular Materno-Infantil a través de la presencia de recordatorios y mensajes en todo el centro sobre la importancia de la higiene de manos en la prevención de infecciones, hemos desarrollado nuevo material promocional en el mencionado Complejo Hospitalario, formado por el Hospital Universitario Insular y el Hospital Materno-Infantil, ambos centros de tercer nivel con 450 camas cada uno y acreditados para la docencia MIR. Se contrataron los servicios de un caricaturista profesional, que adaptó el lenguaje a los modismos locales, usando los personajes que habitualmente aparecen en las viñetas del periódico y se siguió trabajando con otros profesionales del diseño gráfico. Se midieron los indicadores de adherencia y consumo de productos de base alcohólica, constatándose un incremento de ambos en los meses posteriores a la implantación de la estrategia. Además se hizo una revisión de infraestructuras relacionadas con la higiene de manos, con lo que comprobamos una clara mejoría en la mayoría de las áreas asistenciales. El material fue muy bien acogido por parte de los profesionales. No se realizó ninguna otra intervención distinta de las habituales, por lo que pensamos que esta estrategia está mejorando la cultura de seguridad en relación con la higiene de manos en nuestros centros (AU)


In order to increase safety culture about hand hygiene by means of messages and reminders about its importance in preventing nosocomial infections, we developed a new set of materials in the Complejo Hospitalario Universitario Insular Materno-Infantil of Las Palmas, Gran Canaria, constitued by two centres with 450 beds each and acredited for medical internal residents training. We hired a well-known caricaturist, who adapted the messages to the local way of speaking, by using characters that used to appear in his artwork in the local newspaper. Also, we continued to work with other graphic design professionals. We monitored adherence and consumption of products for hand rubbing. We noted an increase in both indicators in the following months after the implementation of this strategy. Moreover, we revised the infrastructures for hand hygiene, and were able to demonstrate improvements in most of the patient care areas. The material was well accepted by professionals, patients and visitors. No other interventions were made, so we think improvements can be attributable to this strategy in our setting (AU)


Asunto(s)
Humanos , Masculino , Femenino , Higiene de las Manos/métodos , Higiene de las Manos/organización & administración , Higiene de las Manos/normas , Promoción de la Salud/métodos , Promoción de la Salud/normas , Seguridad/normas , Medidas de Seguridad/organización & administración , Medidas de Seguridad/normas , Higiene de las Manos/instrumentación , Higiene de las Manos/legislación & jurisprudencia , Central de Suministros en Hospital/normas , Administración Hospitalaria/normas , Planificación Hospitalaria/normas , Servicio de Limpieza en Hospital/organización & administración , Servicio de Limpieza en Hospital/normas
19.
Implement Sci ; 11: 44, 2016 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-27009342

RESUMEN

BACKGROUND: The Researching Effective Approaches to Cleaning in Hospitals (REACH) study will generate evidence about the effectiveness and cost-effectiveness of a novel cleaning initiative that aims to improve the environmental cleanliness of hospitals. The initiative is an environmental cleaning bundle, with five interdependent, evidence-based components (training, technique, product, audit and communication) implemented with environmental services staff to enhance hospital cleaning practices. METHODS/DESIGN: The REACH study will use a stepped-wedge randomised controlled design to test the study intervention, an environmental cleaning bundle, in 11 Australian hospitals. All trial hospitals will receive the intervention and act as their own control, with analysis undertaken of the change within each hospital based on data collected in the control and intervention periods. Each site will be randomised to one of the 11 intervention timings with staggered commencement dates in 2016 and an intervention period between 20 and 50 weeks. All sites complete the trial at the same time in 2017. The inclusion criteria allow for a purposive sample of both public and private hospitals that have higher-risk patient populations for healthcare-associated infections (HAIs). The primary outcome (objective one) is the monthly number of Staphylococcus aureus bacteraemias (SABs), Clostridium difficile infections (CDIs) and vancomycin resistant enterococci (VRE) infections, per 10,000 bed days. Secondary outcomes for objective one include the thoroughness of hospital cleaning assessed using fluorescent marker technology, the bio-burden of frequent touch surfaces post cleaning and changes in staff knowledge and attitudes about environmental cleaning. A cost-effectiveness analysis will determine the second key outcome (objective two): the incremental cost-effectiveness ratio from implementation of the cleaning bundle. The study uses the integrated Promoting Action on Research Implementation in Health Services (iPARIHS) framework to support the tailored implementation of the environmental cleaning bundle in each hospital. DISCUSSION: Evidence from the REACH trial will contribute to future policy and practice guidelines about hospital environmental cleaning. It will be used by healthcare leaders and clinicians to inform decision-making and implementation of best-practice infection prevention strategies to reduce HAIs in hospitals. TRIAL REGISTRATION: Australia New Zealand Clinical Trial Registry ACTRN12615000325505.


Asunto(s)
Servicio de Limpieza en Hospital/normas , Australia/epidemiología , Análisis Costo-Beneficio , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Práctica Clínica Basada en la Evidencia , Conocimientos, Actitudes y Práctica en Salud , Servicio de Limpieza en Hospital/economía , Humanos , Satisfacción del Paciente , Evaluación de Programas y Proyectos de Salud
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