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.

Monitoring of surface cleaning and disinfection in a Brazilian pediatric unit.

Background: Understanding the correlation between the methods of monitoring surface cleaning and disinfection (SCD) is fundamental for better infection control. Purpose: This study aims to correlate the SCD monitoring methods in a Brazilian pediatric unit. This is an exploratory, longitudinal, and correlational study. Methods: The study was conducted in a pediatric hospitalization unit of a medium-sized hospital from December 2020 to March 2021. Four high-contact surfaces were analyzed before and after the cleaning and disinfection process by means of visual inspection, quantification of adenosine triphosphate (ATP), and colony-forming unit (CFU) count. The study consisted of three stages: stage I involving situational diagnosis of the SCD process; stage II referring to the implementation of the Surface Cleaning and Disinfection Standardization Program (SCDSP); and stage III involving long-term assessment after implementing the program. A total of 192 assessments were performed in each stage, totaling 576 in the three study stages. Conclusions: A significant correlation was found between the ATP quantification methods and microbial count in the bed railing (p = 0.009) and companion's armchair (p = 0.018) surfaces. In both cases, Spearman's correlation coefficients were positive, indicating a positive correlation between ATP and microbial count scores, that is, the higher the ATP values (in RLUs), the greater the microbial counts (in CFUs/cm2). The analysis of the ROC curves suggests that the surfaces presenting ATP below 108 RLUs can be considered approved. The ATP method yielded 78.6% sensitivity; in turn, microbial count presented a sensitivity of 85.7%. It is important to use different methods to monitor the cleaning and disinfection of surfaces, as each one has different sensitivity and specificity.

Space-Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study.

Acute diarrhea is the second leading cause of death among children in developing countries and is strongly related with the socioeconomic conditions of the population. In Brazil, data show a drop in the diarrhea mortality rate. Nevertheless, the northeastern region still has the most deaths. Considering this, we analyze high-risk areas for diarrhea- and gastroenteritis-related deaths, and their association with social determinants of health (SDH) in the state with one of the worst human development indicators in Brazil (Alagoas) between 2000 and 2019. We applied temporal, spatial, and space−time risk modelling. We used a log-linear regression model to assess temporal trends and the local empirical Bayesian estimator, the global and local Moran indices for spatial analysis. Spearman's correlation was used to correlate mortality rates with SDH. A total of 3472 diarrhea-related deaths were reported during this period in Alagoas. We observed a decreasing time trend of deaths in the state (9.41/100,000 in 2000 to 2.21 in 2019; APC = −6.7; p-value < 0.001), especially in children under one year of age. However, there was stability among adults and the elderly. We identified two high-risk spatiotemporal clusters of mortality in inland municipalities. Lastly, mortality rates correlated significantly with 90% of SDH. Taken together, these findings indicate that diarrhea diseases remain a serious public health concern in Alagoas, mainly in the poorest and inland municipalities. Thereby, it is urgently necessary to invest in measures to control and prevent cases, and improve the living conditions of the poorest populations and those with the highest social vulnerability index.

Complicações locais da terapia intravenosa periférica e fatores associados / Complicaciones locales de la terapia intravenosa periférica y factores asociados / Local complications of peripheral intravenous therapy and associated factors

RESUMO Introdução: A Terapia Intravenosa configura-se em importante procedimento terapêutico e diagnóstico, amplamente utilizada pela Enfermagem no cuidado hospitalar. Esse procedimento possui elevado risco em curto prazo, bem como a possibilidade de agravos secundários ligados as complicações derivadas dessa terapia. Objetivo: Identificar a prevalência e os fatores associados às complicações locais da terapia intravenosa periférica em pacientes institucionalizados em um setor de neurologia e clínica médica de um hospital público de ensino. Métodos: Trata-se de um estudo transversal, exploratório e descritivo de abordagem quantitativa, com observação sistemática e busca em dados secundários disponíveis em prontuário de 63 pacientes institucionalizados num hospital público de ensino. Os dados foram coletados de janeiro a março de 2015 e submetidos a tratamento estatístico por meio do programa Statistical Package of Social Sciences, versão 19.0. Resultados: A prevalência de flebite foi de 25,4 porcento, infiltração de 15,9 porcento e 11,1 porcento de hematoma. A maioria dos pacientes do estudo encontrava-se em terapia no intervalo máximo de 48 horas. No momento da observação, os cateteres estavam em sua maioria conectados ao polifix (n=58; 92,1 porcento). Quanto aos sintomas identificou-se edema, dor, desconforto e eritema ao redor da inserção do cateter em 16 (25,4 porcento) dos participantes. Conclusão: A prevalência de complicações da terapia intravenosa foi elevada, com destaque para a flebite, infiltração e hematoma. Houve diferenças entre as taxas de prevalência por clinicas, relacionadas ao intervalo de trocas, e ao tipo de cateter periférico inserido(AU)

RESUMEN Introducción: La terapia intravenosa es un importante procedimiento terapéutico y diagnóstico, ampliamente utilizado por la enfermería en la atención hospitalaria. Este procedimiento tiene un alto riesgo a corto plazo y la posibilidad de complicaciones relacionadas con problemas de salud secundarios derivados de esta terapia. Objetivo: Identificar la prevalencia y los factores asociados con complicaciones locales de la terapia intravenosa periférica en pacientes institucionalizados en un departamento de neurología clínica y clínica médica de un hospital público de enseñanza. Métodos: Estudio transversal, exploratorio y descriptivo, de enfoque cuantitativo, con observación sistemática y búsqueda en los datos secundarios disponibles en las historias clínicas de 63 pacientes institucionalizados en un hospital público de enseñanza. Los datos fueron recogidos de enero a marzo 2015 y sometidos a análisis estadístico utilizando el paquete estadístico para las ciencias sociales, versión 19.0. Resultados: La prevalencia de flebitis fue de 25,4 por ciento, la infiltración del 15,9 por ciento y el hematoma de 11,1 por ciento. La mayoría de los pacientes del estudio se encontraba en terapia en el intervalo máximo de 48 horas. En el momento de la observación, los catéteres fueron en su mayoría conectados con polifix (n = 58; 92,1 por ciento). Se identificó edema, dolor, malestar y eritema alrededor de la inserción del catéter en 16 (25,4 por ciento) de los participantes. Conclusiones: La prevalencia de complicaciones de la terapia intravenosa fue alta, especialmente flebitis, infiltración y hematoma. Hubo diferencias entre las tasas de prevalencia de las clínicas, en relación con el intervalo de cambio y tipo de catéter periférico(AU)

ABSTRACT Introduction: The Intravenous Therapy sets in important therapeutic and diagnosis procedure, widely used by nursing profesionals in a hospital care. This procedure has a high risk in short term and the possibility of secondary complications related to health problems derived from this therapy. Objective: To identify the prevalence and associated factors to local complications of peripheral intravenous therapy in patients institutionalized in a medical clinic and neurological department of a public teaching hospital. Methods: This is a cross-sectional, exploratory and descriptive study, with a quantitative approach with systematic observation and search on secondary data, available in the medical records of 63 patients institutionalized in a public teaching hospital. Data were collected from January to March 2015 and submitted to statistical analysis using the Statistical Package for the Social Sciences, version 19.0. Results: The prevalence of phlebitis was 25.4 percent, of infiltration 15.9 percent and 11.1 percent of hematoma. Most patients in the study were in therapy at the maximum interval of 48 hours. At the time of observation, the catheters were mostly connected to polifix (n = 58; 92.1 percent). Regarding specific symptoms were identified edema, pain, discomfort and erythema around the catheter insertion in 16 (25.4 percent) participants. Conclusion: The prevalence of complications of intravenous therapy was high, especially phlebitis, infiltration and hematoma. There were differences between the prevalence rates for clinics, related to the exchange intervals, and type of peripheral inserted catheter(AU)

Indicadores de calidad en la terapia intravenosa / Analysis of quality indicators in intravenous therapy

RESUMEN Introducción: Los eventos adversos son comunes durante el uso de la terapia intravenosa, pueden causar daño al paciente y contribuir a agravar el estado de salud y la estancia hospitalaria prolongada. Además, al proporcionar acceso directo a la corriente sanguínea, los eventos adversos relacionados con la terapia intravenosa pueden tener repercusiones más graves y perjudiciales. Objetivo: Analizar indicadores de calidad relacionados con la atención de salud en la terapia intravenosa en un hospital público y de enseñanza. Métodos: Estudio descriptivo-exploratorio, transversal realizado en un hospital público, de enseñanza. Para recopilar datos se utilizó una forma adaptada compuesta por 03 indicadores: identificación de acceso venoso periférico, la identificación de goteo intravenoso para botellas de infusión y la identificación de suero y control de la velocidad de infusión de las soluciones. La muestra, intencional, consistió en 94 participantes. Resultados: Se realizaron 1 355 observaciones. De éstas, 439 fueron el acceso venoso periférico, 463 de los catéteres para la infusión intravenosa de 453 botellas de suero y medicamentos. La validez de un acceso venoso periférico, basado solo en accesos identificados correctamente, fue el único cuyo resultado de calidad de la atención (QA) era deseable (100 por ciento) y segura (83,3 por ciento); todos los demás mostraron QA mal (< 70 por ciento). Conclusión: Los resultados encontrados en este estudio están por debajo del deseado para que una asistencia de calidad en terapia intravenosa sea garantizada. La calidad de la atención en la terapia intravenosa es mucho menor que la recomendada(AU)

ABSTRACT Introduction: Adverse events are common during use of intravenous therapy can cause damage to the patient, and contribute to worsening health status and prolonged hospital stay. In addition, by providing direct access to the bloodstream, adverse events related to intravenous therapy may be more serious and harmful repercussions. Objective: To analyze the quality indicators related to health care in intravenous therapy in an extension public research teaching hospital. Methods: Descriptive and exploratory, cross-sectional study in a public hospital, teaching. For data collection, it was used an adapted form composed of 03 following indicators: identification of peripheral venous access, equipment used for intravenous infusion, serum bottles, and speed control of infusion solutions. The intentional sample was consisted of 94 participants. Results: 1355 observations were done.In these observations, 439 were of peripheral venous access, 463 of equipment used for intravenous infusion, 453 of serum bottles and medicine. Based only on properly identified access, the validity of peripheral venous access was the only one whose result of quality of care (QA) was desirable (100 percent) and safe (83,3 percent), all the others showed QA poorly (< 70 percent). Conclusions: The results found in this study are below desired for quality care in intravenous therapy is ensured. The quality of care in intravenous therapy is very lower than recommended(AU)

Effectiveness of Surface Cleaning and Disinfection in a Brazilian Healthcare Facility.

BACKGROUND: Failures in the processes of cleaning and disinfecting health service surfaces may result in the spread and transfer of pathogens that are often associated with healthcare-related infections and outbreaks. AIMS: To assess the effectiveness of environmental surface cleaning and disinfection in a hospital clinic. METHOD: The study was conducted in a nursing ward with 45 beds. A total of 80 samples from five high-touch surfaces were evaluated before and after cleaning and disinfection, using the following methods: visual inspection, adenosine triphosphate bioluminescence assay, aerobic colony count, Staphylococcus aureus colony count, and evaluation of resistance to methicillin. The data analysis used nonparametric comparative and correlative tests to observe any differences in the pre- and post- cleaning and disinfection results for the surfaces assessed. RESULTS: Effective cleaning and disinfection had a significant effect on only two surfaces when measured for the presence of adenosine triphosphate, the inner bathroom door handle (p=0.007) and the toilet bowl (p=0.01). When evaluated for Staphylococcus aureus colony count, the toilet flush handle also demonstrated a significant effect (p=0.04). CONCLUSION: The effectiveness of cleaning and disinfection of the surfaces tested was not satisfactory. An educational intervention is recommended for the cleaning and disinfection staff and the nursing team at the healthcare facility. RELEVANCE TO CLINICAL PRACTICE: The data in the study revealed that daily hospital cleaning and disinfection in the sampled sites are not sufficient in medical and surgical wards. Hospital cleanliness must be reevaluated from the point of view of materials, such as an adequate supply of clean cloths, in addition to establishing more precise cleanliness protocols and accurate monitoring systems.

Risco ocupacional entre profissionais de enfermagem de setores críticos e adesão a precaução padrão / Riesgos laborales entre las enfermeras de sectores críticos y adhesión de las precauciones estándar / Occupational risk between critical sectors nursing professionals and adherence to standard precaution

RESUMO Introdução: os profissionais de Enfermagem estão potencialmente expostos a acidentes ocupacionais, principalmente em setores críticos do ambiente hospitalar, devendo incorporar as precauções padrão, para minimizar este risco. A adesão as precauções padrão é fortemente influenciada por fatores psicossociais, devendo esta relação ser elucidada. Objetivo: apreender as representações sociais de profissionais da enfermagem sobre o risco ocupacional, e analisar sua relação com a adesão as precauções padrão. Métodos: pesquisa exploratória, de abordagem qualitativa, fundamentada na Teoria das Representações Sociais. Os participantes da pesquisa foram 150 trabalhadores de Enfermagem de setores críticos da rede hospitalar de Teresina, Piauí, Brasil. Os dados foram coletados por meio da técnica de associação livre de palavras, e analisados pela análise fatorial de correspondência. Resultados: o núcleo central das representações foi composto pelos vocábulos "cuidado", "habilidade técnica" e "normas". Registrou-se que, para profissionais de enfermagem com nível médio a representação do risco ocupacional esteve fortemente ligado á técnica, enquanto profissionais de nível superior forneceram á representação um enfoque mais biopsicológico. O domínio da técnica em procedimentos parece fornecer uma sensação de segurança que justifica a negligência no uso das medidas de precaução padrão. Conclusões: diferenças na forma de representar o risco ocupacional dentro de uma mesma categoria profissional configura-se em importante empecilho a adesão as medidas de precaução padrão. Essa diferença qualitativa possui potencial para influenciar, não somente nas taxas de adesão mas, na própria epidemiologia desses eventos e demonstra que não há, necessariamente, um senso comum dentro deste grupo profissional no que concerne a saúde ocupacional(AU)

RESUMEN Introducción: los profesionales de enfermería están potencialmente expuestos a accidentes de trabajo, especialmente en sectores críticos del hospital, y deben incorporar las precauciones estándar para minimizar este riesgo. La adhesión a las precauciones estándar está fuertemente influenciada por factores psicosociales, y se debe entender esta relación. Objetivo: identificar las representaciones sociales de los profesionales de enfermería sobre el riesgo ocupacional y evaluar su relación con el cumplimiento de las precauciones estándar. Métodos: investigación exploratoria, enfoque cualitativo, basado en la Teoría de las Representaciones Sociales. Los participantes fueron 150 trabajadores de enfermería en sectores críticos de la red hospitalaria de Teresina, Piauí, Brasil. Los datos fueron recolectados a través de la técnica de la asociación libre de palabras, y se analizaron mediante análisis factorial de correspondencia. Resultados: el núcleo de las representaciones consistió en las palabras "cuidado", "habilidad técnica" y "normas". Se ha observado que para los profesionales de enfermería de nivel medio, la representación de riesgos laborales está fuertemente conectada a la técnica, mientras que los profesionales de nivel superior, a un enfoque más biopsicosocial. El campo de los procedimientos de la técnica parece proporcionar una sensación de seguridad que justifica la negligencia en el uso de las precauciones estándar. Conclusiones: las diferencias en la manera de representar el riesgo laboral dentro de los mismos conjuntos de categorías profesionales se configura en gran obstáculo para la adhesión a las precauciones estándar. Esta diferencia cualitativa tiene el potencial de influir no solo en las cuotas de adhesión, sino en la propia epidemiología de estos eventos, y demuestra que no existe necesariamente un sentido común dentro de este grupo profesional con respecto a la salud ocupacional(AU)

ABSTRACT Introduction: Nursing professionals are potentially exposed to occupational accidents, especially in critical sectors of the hospital environment and must incorporate the standard precautions to minimize this risk. Adherence to standard precautions is strongly influenced by psychosocial factors, should this relationship be understood. Objective: Identify the social representations of nursing professionals about the occupational risk and to assess their relationship with adherence to standard precautions. Methods: Exploratory research, qualitative approach, based on the Theory of Social Representations. The participants were 150 nursing workers in critical sectors of the hospital network of Teresina, Piauí, Brazil. Data were collected through the technique of free association of words, and analyzed by factorial analysis of correspondence. Results: The core of the representations consisted of the words "care", "technical skill" and "standards". It has observed that, for nursing professionals with mid-level representation of occupational risk was strongly connected to the technique, while top-level professionals provided will represent a more biopsychosocial approach. The field of technique procedures seems to provide a sense of security that justify negligence in the use of standard precautions. Conclusions: Differences in the way of representing the occupational hazard within the same professional category sets in major obstacle to adherence to standard precautions. This qualitative difference has the potential to influence not only on membership fees but in itself epidemiology of these events and shows that there is not necessarily a common sense within this professional group with regard to occupational health(AU)