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.

Surface cleaning effectiveness in a walk-in emergency care unit: Influence of a multifaceted intervention.

BACKGROUND: Cleaning of surfaces is essential in reducing environmental bioburdens and health care-associated infection in emergency units. However, there are few or no studies investigating cleaning surfaces in these scenarios. Our goal was to determine the influence of a multifaceted intervention on the effectiveness of routine cleaning of surfaces in a walk-in emergency care unit. METHODS: This prospective, before-and-after interventional study was conducted in 4 phases: phase I (situational diagnosis), phase II (implementation of interventions-feedback on results, standardization of cleaning procedures, and training of nursing staff), phase III (determination of the immediate influence of interventions), and phase IV (determination of the late influence of interventions). The surfaces were sampled before and after cleaning by visual inspection, adenosine triphosphate bioluminescence assay, and microbiologic culture. RESULTS: We sampled 240 surfaces from 4 rooms. When evaluated by visual inspection and adenosine triphosphate bioluminescence, there was a progressive reduction of surfaces found to be inadequate in phases I-IV (P < .001), as well as in culture phases I-III. However, phase IV showed higher percentages of failure by culture than phase I (P = .004). CONCLUSIONS: The interventions improved the effectiveness of cleaning. However, this effect was not maintained after 2 months.

Intervenções de enfermagem ao paciente com dor / Nursing interventions to the patient with pain

A dor é uma das principais causas de sofrimento humano, comprometendo a qualidade de vida das pessoas e refletindo no seu estado físico e psicossocial. A dor é, sem dúvida, uma das mais íntimas e exclusivas sensaçõesexperimentadas pelo ser humano, envolve vários componentes sensoriais, afetivos e cognitivos, sociaise comportamentais. Embora uma pessoa consiga sobreviver com dor, ela interfere no seu bem-estar, nas relações sociais e familiares, no desempenho do seu trabalho, influenciando assim a sua qualidade de vida. Portanto, a avaliação da dor se constitui uma premissa na prática do enfermeiro, buscando um cuidado individualizado e dirigindo-se à causa desencadeante da dor a fim de aliviá-la. O objetivo deste artigo de atualização foi descrever a partir da literatura especializada, dados relacionados à avaliação da dor e cuidados de enfermagem ao paciente com dor. Percebe-se, que a dor é um fenômeno subestimado nos pacientes e neste sentido a educação em enfermagem necessita repensar a formação do enfermeiro...