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.

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.

Impact of an educational intervention on standard precautions during the COVID-19 pandemic.

OBJECTIVE: To evaluate the impact of an educational intervention on the knowledge of nursing professionals regarding standard precautions. METHODS: This is an almost experimental study conducted with 100 nursing professionals. Data collection was performed using a sociodemographic characterization instrument and the Standard Precautions Knowledge Questionnaire. The educational intervention was based on five moments, where the approach to questions with less than 70% accuracy was intensified. RESULTS: There was a significant difference between the scores of healthcare professionals before (16.20 ± 1.51) and after (16.90 ± 1.31) the educational intervention (W=3.336; p < 0.05). Regarding knowledge about hand hygiene after glove use, an increase in knowledge from 83% to 93% was obtained. CONCLUSIONS: A positive effect on the professionals' knowledge was recorded, demonstrating advances regarding the strengthening of already acquired knowledge and the understanding of new knowledge.

Proceso de vestirse y desvestirse de los profesionales de enfermería durante la pandemia de covid-19: estudio transversal / Paramentação e desparamentação de profissionais de enfermagem durante a pandemia por covid-19: estudo transversal / Sequence of dressing and undressing by nursing professionals during the covid-19 pandemic: a cross-sectional study

Introducción: Durante la pandemia del covid-19 se implementaron protocolos de seguridad que contribuyeron a la protección de pacientes y profesionales de enfermería. Objetivo: Evaluar el conocimiento sobre el proceso de vestirse y desvertirse de los profesionales de enfermería que actuaron en la asistencia durante la pandemia de covid-19 y verificar la asociación entre ese conocimiento y las características sociodemográficas y de desempeño de los profesionales de enfermería. Método: Estudio transversal, realizado de noviembre de 2020 a diciembre de 2021 con profesionales de enfermería que actúan en el cuidado en las cinco regiones de Brasil. El cuestionario fue desarrollado considerando la Nota Técnica GVIMS/GGTES/ANVISA N° 04/2020. Consta de 10 preguntas, que van de 0 a 10 puntos. Se estableció el punto de corte ≥ 75 puntos y < 74 puntos para indicar conocimiento suficiente y conocimiento insuficiente, respectivamente. La recolección de datos se realizó mediante formularios de Google®, utilizando diferentes redes sociales. Resultados: De los 493 profesionales de enfermería, 157 tenían entre 30 y 39 años, 374 eran del sexo femenino y 358 trabajaban como enfermeros. En cuanto al conocimiento sobre el processo de vestirse y desvestirse, 370 tenían conocimiento suficiente y 123 conocimiento insuficiente. No hubo asociación entre el conocimiento sobre el proceso de vestirse y quitarse con características sociodemográficas y desempeño profesional. Conclusión: Los profesionales de enfermería demostraron conocimientos adecuados sobre el proceso de vestirse y desvestirse y no hubo asociación entre conocimiento y caracterización de los participantes (AU)

Introdução: Durante a pandemia por covid-19 foram implementados de protocolos de segurança que contribuiram para a proteção de pacientes e profissionais de enfermagem. Objetivo: Avaliar o conhecimento sobre a sequência da paramentação e desparamentação por profissionais de enfermagem que atuaram na assistência durante a pandemia por covid-19 e verificar a associação entre esse conhecimento e características sociodemográficas e de atuação dos profissionais de enfermagem. Método: Estudo transversal, realizado de novembro de 2020 a dezembro de 2021 com profissionais de enfermagem atuantes na assistência nas cinco regiões do Brasil. O questionário foi desenvolvido considerando a Nota Técnica GVIMS/GGTES/ANVISA Nº 04/2020. E conta com 10 questões, variando de 0 a 10 pontos. Foi estabelecido o ponto de corte ≥ 75 pontos e < 74 pontos para indicar conhecimento suficiente e conhecimento insuficiente, respectivamente. A coleta de dados foi realizada pelo Google forms®, utilizando diferentes redes sociais. Resultados: Dos 493 profissionais de enfermagem, 157 tinham idade entre 30 a 39 anos, 374 eram do sexo feminino, e 358 atuavam como enfermeiros. Em termos de conhecimento sobre a sequência de paramentação e desparamentação, 370 apresentaram conhecimento suficiente e 123 conhecimento insuficiente. Não teve associação entre o conhecimento sobre paramentação e desparamentação com as características sociodemográficas e de atuação dos profissionais. Conclusão: Os profissionais de enfermagem demonstraram conhecimento adequado sobre a paramentação e desparamentação e não houve associação entre o conhecimento e a caracterização dos participantes. (AU)

Introduction: During the covid-19 pandemic, safety protocols were implemented that contributed to the protection of patients and nursing professionals. Objective: To evaluate the knowledge about the sequence of dressing and undressing by nursing professionals who worked in assistance during the covid-19 pandemic and to verify the association between this knowledge and sociodemographic and performance characteristics of nursing professionals. Method: Cross-sectional study, carried out from November 2020 to December 2021 with nursing professionals working in care in the five regions of Brazil. The questionnaire was developed considering the Technical Note GVIMS/GGTES/ANVISA No. 04/2020. It has 10 questions, ranging from 0 to 10 points. The cutoff point ≥ 75 points and < 74 points was established to indicate sufficient knowledge and insufficient knowledge. Data collection was performed using Google forms®, using different social networks. Results: Of the 493 nursing professionals, 157 were aged between 30 and 39 years, 374 were female, and 358 worked as nurses. In terms of knowledge about the dressing and undressing sequence, 370 had sufficient knowledge and 123 had insufficient knowledge. There was no association between knowledge about dressing and undressing with sociodemographic characteristics and professional performance. Conclusion: Nursing professionals demonstrated adequate knowledge about dressing and undressing and there was no association between knowledge and characterization of the participants. (AU)

Adherence to standard precautions by nursing professionals in a public university hospital: a cross-sectional study.

INTRODUCTION: The aim of this study was to analyze the adherence to standard precautions by nursing professionals in a public university hospital, and to identify associated factors. METHODOLOGY: This was a cross-sectional study with the nursing staff of a public university hospital. The participants provided sociodemographic and immunization data, training data on standard precautions and occupational accident history, and responded to the questionnaire on adherence to standard precautions (QASP). Descriptive data analysis and Pearson's Chi-square test (χ²) were performed, followed by Fisher's exact test to verify the association between the adherence to standard precautions (total score ≥ 76 points) and the sample characterization variables. Additionally, binary logistic regression indicated the odds ratio (OR) of the sample characterization variables for adherence to standard precautions. A p value ≤ 0.05 was considered statistically significant. RESULTS: The average score for adherence to standard precautions, through QASP, by nursing professionals evaluated was 70.5 points. Association between the adherence to standard precautions and the professionals' sample characterization variables was not identified. However, it was observed that experienced professionals (≥15 years of experience in the institution) were more likely to adhere to standard precautions (OR 0.062; IC95% [0.006-0.663]; p = 0.021). CONCLUSIONS: In general, the adherence to standard precautions by nursing professionals working in health service in this study can be considered inadequate, highlighting major weaknesses in hand hygiene practices, use of personal protective equipment (PPE), recapping of used needles, and conduct after suffering occupational accidents. Experienced professionals were more likely to adhere to standard precautions.

Knowledge, Attitude and Practices towards the Prevention of Schistosomiasis Mansoni in an Endemic Area of Alagoas, Northeast Brazil.

We analyzed the knowledge, attitudes and practices (KAP) of schistosomiasis mansoni prevention in an endemic area of Brazil. This cross-sectional study was conducted between March and May 2021, with 412 participants living in the municipality of Feira Grande, Alagoas, Brazil. Data collection occurred through visits to the Health Center Urbano II and Massapê, through an interview with a structured questionnaire to identify the levels of KAP regarding schistosomiasis prevention. Of all respondents, 70.87% lived in rural areas, 22.66% reported a history of past schistosomiasis and 52.71% never participated in schistosomiasis control program actions. Factors associated with better KAP scores were being part of an older age group, not using rainwater and having no history of past schistosomiasis. Specifically, among the domains, attitude was the highest score and knowledge was the lowest. Participation in a health intervention program, knowing someone who had schistosomiasis and having been informed through a public health program seemed to have an important impact on the population's KAP. Our results contributed to broadening perceptions about schistosomiasis prevention, highlighting the positive impacts that health programs and interventions have on disease control.

Instruments to assess adherence to medication in people living with HIV: a scoping review.

OBJECTIVE: To compile the instruments validated in Brazil for assessing adherence of people living with HIV to antiretroviral therapy. METHODS: Scoping review using the Web of Science, Scopus, Medline (via PubMed), Embase, BDENF, CINAHL and Lilacs databases. In addition, the Preprints bioRxiv, Google Scholar and OpenGrey servers were checked. There was no language restriction for the search, and it considered articles published from the year 1996 onwards. RESULTS: Three publications were included in the qualitative synthesis. Following were the instruments identified "Questionário para Avaliação da Adesão ao Tratamento Antirretroviral" (Questionnaire for Assessment of Adherence to Antiretroviral Treatment) developed in Porto Alegre (RS) and published in 2007; the "Escala de autoeficácia para adesão ao tratamento antirretroviral em crianças e adolescentes com HIV/Aids" (Self-efficacy Scale for Adherence to Antiretroviral Treatment in Children and Adolescents with HIV/Aids) developed in São Paulo (SP) and published in 2008; and the "WebAd-Q, um instrumento de autorrelato para monitorar a adesão à terapia antirretroviral em serviços de HIV/Aids no Brasil" (WebAd-Q, a self-report instrument to monitor adherence to antiretroviral therapy in HIV/Aids services in Brazil) developed in São Bernardo do Campo (SP) and published in 2018. The instruments were validated in Brazil, and presented statistically acceptable values for psychometric qualities. CONCLUSION: The instruments to assess adherence of people living with HIV to antiretroviral therapy are validated strategies for the Brazilian context. However, their (re)use in different settings and contexts of the nation should be expanded. The use of these instruments by health professionals can improve the understanding of factors that act negatively and positively on antiretroviral therapy adherence, and the proposition of strategies intended to consolidate good adherence and intervene in the treatment of people with low therapeutic engagement.

Impact of an educational intervention on standard precautions during the COVID-19 pandemic / Impacto de una intervención educativa sobre las precauciones estándar durante la pandemia de COVID-19 / Intervenção educativa para maior conhecimento às precauções padrão na pandemia de COVID-19: estudo quase-experimental

ABSTRACT Objective: To evaluate the impact of an educational intervention on the knowledge of nursing professionals regarding standard precautions. Methods: This is an almost experimental study conducted with 100 nursing professionals. Data collection was performed using a sociodemographic characterization instrument and the Standard Precautions Knowledge Questionnaire. The educational intervention was based on five moments, where the approach to questions with less than 70% accuracy was intensified. Results: There was a significant difference between the scores of healthcare professionals before (16.20 ± 1.51) and after (16.90 ± 1.31) the educational intervention (W=3.336; p < 0.05). Regarding knowledge about hand hygiene after glove use, an increase in knowledge from 83% to 93% was obtained. Conclusions: A positive effect on the professionals' knowledge was recorded, demonstrating advances regarding the strengthening of already acquired knowledge and the understanding of new knowledge.

RESUMEN Objetivo: Evaluar el impacto de una intervención educativa en el conocimiento de los profesionales de enfermería sobre las precauciones estándar. Métodos: Este es un estudio cuasiexperimental realizado con 100 profesionales de enfermería. Para la recopilación de datos, se utilizaron un instrumento de caracterización sociodemográfica y el cuestionario de Conocimiento de las Precauciones Estándar. La intervención educativa se basó en cinco momentos, en los cuales se intensificó el abordaje de cuestiones con menos del 70% de aciertos. Resultados: Hubo una diferencia significativa entre las puntuaciones de los profesionales de salud antes (16,20 ± 1,51) y después (16,90 ± 1,31) de la intervención educativa (W = 3,336; p <0,05). En relación con el conocimiento sobre la higiene de las manos después del uso de guantes, se obtuvo un aumento en el conocimiento del 83% al 93%. Conclusiones: Se registró un efecto positivo en el conocimiento de los profesionales, demostrando avances en cuanto al fortalecimiento de los conocimientos ya adquiridos y la comprensión de nuevos saberes.

RESUMO Objetivo: avaliar o impacto de uma intervenção educativa no conhecimento dos profissionais de enfermagem em relação às precauções padrão. Métodos: trata-se de um estudo quase-experimental, realizada com 100 profissionais de enfermagem. Para a coleta de dados, foram utilizados o instrumento de caracterização sociodemográfica e o questionário de Conhecimento das Precauções-Padrão. A intervenção educativa foi baseada em 05 momentos, onde se intensificou a abordagem em questões com menos de 70% de acerto. Resultados: Houve diferença significativa entre os escores dos profissionais de saúde antes (16,20 ± 1,51) e após (16,90 ± 1,31) a intervenção educativa (W=3,336; p < 0,05). Em relação ao conhecimento sobre a higiene das mãos após uso de luvas, obteve-se um aumento no conhecimento de 83% para 93%. Conclusões: registrou-se efeito positivo no conhecimento dos profissionais, demonstrando avanços no que diz respeito ao fortalecimento dos conhecimentos já adquiridos e à compreensão de novos saberes.

Protocol with non-toxic chemicals to control biofilm in dental unit waterlines: physical, chemical, mechanical and biological perspective.

Biosafety in dentistry aims to combat cross-contamination and biofilm in dental unit waterlines. The aim was to investigate from a physical, chemical, mechanical and biological perspective, a protocol for using chemical products (citric acid, sodium bicarbonate and sodium chloride) to improve and maintain water quality in dental unit waterlines. Change in microhardness and corrosion tendency were observed in stainless steel samples. On the polyurethane surfaces, there were changes in color, microhardness and roughness. Anti-biofilm evaluations revealed a significant reduction in the biofilm biomass, metabolic activity and residual biofilm. These findings suggest that the protocol analyzed in this study showed an innovative potential against biofilm in dental unit waterlines, preserving the physical, chemical and mechanical properties of the materials.

Influence of glucose supplementation on biofilm formation of Candida albicans and Candida glabrata isolated from diabetic and non-diabetic individuals.

OBJECTIVE: This study evaluated the effect of different glucose concentration on biofilm formation of Candida albicans and Candida glabrata strains isolated from diabetic and non-diabetic individuals. METHODS: The study was divided into two stages: (I) selection and identification of 48 C. albicans and C. glabrata strains by polymerase chain reaction followed by restriction fragment length polymorphism analysis (PCR/RFLP); (II) evaluation of biofilm formation by means of viability rates (colony-forming units), biofilm dry matter (mg) and biofilm-covered areas (µm2). Statistical comparisons were performed through nonparametric analysis of longitudinal data in factorial experiments with pairwise comparisons using Friedman Conover's test (α = 0.05). RESULTS: All the Candida spp. had their identifications confirmed by PCR/RFLP. C. albicans biofilm of strains from diabetic individuals cultivated in different glucose concentration showed higher viability rates than strains from non-diabetic individuals. No difference was observed on viability of C. glabrata biofilm. Regarding biofilm dry matter, C. albicans biofilm of strains from diabetic individuals cultivated in different glucose concentration showed lower amount in weight than strains from non-diabetic individuals. In C. glabrata strains, this result was only observed in biofilms cultivated with no glucose supplementation. With regard to biofilm-covered areas, only glucose supplementation and non-diabetic condition showed a positive effect on C. albicans biofilm development, and no condition affected C. glabrata biofilm formation. CONCLUSION: The strain type (C. albicans and C. glabrata) isolated from diabetic and non-diabetic individuals influenced on biofilm formation, but glucose supplementation did not.

Instruments to assess adherence to medication in people living with HIV: a scoping review / Instrumentos para avaliar a adesão medicamentosa em pessoas vivendo com HIV: uma revisão de escopo

ABSTRACT OBJECTIVE To compile the instruments validated in Brazil for assessing adherence of people living with HIV to antiretroviral therapy. METHODS Scoping review using the Web of Science, Scopus, Medline (via PubMed), Embase, BDENF, CINAHL and Lilacs databases. In addition, the Preprints bioRxiv, Google Scholar and OpenGrey servers were checked. There was no language restriction for the search, and it considered articles published from the year 1996 onwards. RESULTS Three publications were included in the qualitative synthesis. Following were the instruments identified "Questionário para Avaliação da Adesão ao Tratamento Antirretroviral" (Questionnaire for Assessment of Adherence to Antiretroviral Treatment) developed in Porto Alegre (RS) and published in 2007; the "Escala de autoeficácia para adesão ao tratamento antirretroviral em crianças e adolescentes com HIV/Aids" (Self-efficacy Scale for Adherence to Antiretroviral Treatment in Children and Adolescents with HIV/Aids) developed in São Paulo (SP) and published in 2008; and the "WebAd-Q, um instrumento de autorrelato para monitorar a adesão à terapia antirretroviral em serviços de HIV/Aids no Brasil" (WebAd-Q, a self-report instrument to monitor adherence to antiretroviral therapy in HIV/Aids services in Brazil) developed in São Bernardo do Campo (SP) and published in 2018. The instruments were validated in Brazil, and presented statistically acceptable values for psychometric qualities. CONCLUSION The instruments to assess adherence of people living with HIV to antiretroviral therapy are validated strategies for the Brazilian context. However, their (re)use in different settings and contexts of the nation should be expanded. The use of these instruments by health professionals can improve the understanding of factors that act negatively and positively on antiretroviral therapy adherence, and the proposition of strategies intended to consolidate good adherence and intervene in the treatment of people with low therapeutic engagement.

RESUMO OBJETIVO Compilar os instrumentos validados no Brasil para avaliação da adesão de pessoas vivendo com HIV à terapia antirretroviral. MÉTODOS Revisão de escopo, utilizando as bases de dados Web of Science, Scopus, Medline (via PubMed), Embase, BDENF, CINAHL e Lilacs. Em complementação, os servidores Preprints bioRxiv, Google Scholar e OpenGrey foram verificados. Para a busca, não houve restrição de idioma e considerou artigos publicados a partir do ano de 1996. RESULTADOS Três publicações foram incluídas na síntese qualitativa. Os instrumentos identificados foram o "Questionário para Avaliação da Adesão ao Tratamento Antirretroviral", desenvolvido em Porto Alegre (RS) e publicado em 2007; a "Escala de autoeficácia para adesão ao tratamento antirretroviral em crianças e adolescentes com HIV/Aids", desenvolvida em São Paulo (SP) e publicada em 2008; e o "WebAd-Q, um instrumento de autorrelato para monitorar a adesão à terapia antirretroviral em serviços de HIV/Aids no Brasil", desenvolvido em São Bernardo do Campo (SP) e publicado em 2018. Os instrumentos foram validados no Brasil e apresentaram valores estatisticamente aceitáveis para as qualidades psicométricas. CONCLUSÃO Os instrumentos para avaliar a adesão de pessoas vivendo com HIV à terapia antirretroviral são estratégias validadas para o contexto do Brasil. Todavia há que se expandir a (re)utilização em diferentes cenários e contextos da nação. A utilização desses instrumentos por profissionais da saúde pode melhorar a compreensão dos fatores que atuam negativa e positivamente na adesão à terapia antirretroviral, e a proposição de estratégias com o objetivo de consolidar a boa adesão e intervir no tratamento das pessoas com baixo engajamento terapêutico.

Reuse of hospital bedpans.

OBJECTIVES: to evaluate the results of two methods of hospital bedpan reprocessing. METHODS: cross-sectional study. Hospital bedpans containing a biological material contamination simulator or organic matter were submitted to manual cleaning followed by disinfection with 70% alcohol solution or thermodisinfection. Permanence of simulated contamination was evaluated by using the fluorescence technique and presence of organic matter was verified by carrying out the protein detection test. RESULTS: the contamination simulator was found in bedpans submitted to both processes. The seat was dirtier after manual cleaning (p=0.044) in comparison with the result obtained with thermodisinfection. Automatized decontamination led to worse results when compared to the manual procedure for the scoop and external bottom (p=0.000). The protein detection test was positive in two items after thermodisinfection. CONCLUSIONS: manual cleaning followed by rubbing with 70% alcohol solution proved more effective than automatized cleaning in the reprocessing of hospital bedpans. There are relevant issues regarding reuse of hospital bedpans.

The use of antimicrobial-impregnated fabrics in health services: an integrative review.

OBJECTIVE: to analyze evidence concerning the feasibility of antimicrobial-impregnated fabrics in preventing and controlling microbial transmission in health services. METHOD: an integrative review using the following databases: MEDLINE (via PubMed), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Latin American and Caribbean Health Sciences Literature (LILACS), regardless of language and date of publication. Seven studies were included in the analysis to verify the types of fabrics and substances used to impregnate the fabrics, applicability in health services, and decrease in microbial load. RESULTS: silver nanoparticles and copper oxide are the main antimicrobial substances used to impregnate the fabrics. The patients' use of these fabrics, such as in bed and bath linens and clothing, was more effective in reducing antimicrobial load than in health workers' uniforms. CONCLUSION: the use of these antimicrobial-impregnated textiles, especially by patients, is a viable alternative to prevent and control microbial transmission in health services. Implementing these fabrics in health workers' uniforms requires further studies, however, to verify its effectiveness in decreasing microbial load in clinical practice.

The use of antimicrobial-impregnated fabrics in health services: an integrative review / Utilización de textiles impregnados con antimicrobianos en los servicios sanitarios: revisión integradora / Utilização de têxteis impregnados com antimicrobianos nos serviços de saúde: revisão integrativa

Objective: to analyze evidence concerning the feasibility of antimicrobial-impregnated fabrics in preventing and controlling microbial transmission in health services. Method: an integrative review using the following databases: MEDLINE (via PubMed), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Latin American and Caribbean Health Sciences Literature (LILACS), regardless of language and date of publication. Seven studies were included in the analysis to verify the types of fabrics and substances used to impregnate the fabrics, applicability in health services, and decrease in microbial load. Results: silver nanoparticles and copper oxide are the main antimicrobial substances used to impregnate the fabrics. The patients' use of these fabrics, such as in bed and bath linens and clothing, was more effective in reducing antimicrobial load than in health workers' uniforms. Conclusion: the use of these antimicrobial-impregnated textiles, especially by patients, is a viable alternative to prevent and control microbial transmission in health services. Implementing these fabrics in health workers' uniforms requires further studies, however, to verify its effectiveness in decreasing microbial load in clinical practice.

Objetivo: analizar las evidencias existentes sobre la viabilidad de utilizar textiles impregnados con sustancias antimicrobianas en la prevención y control de la transmisión microbiana en servicios sanitarios. Método: revisión integradora, utilizando las bases de dados MEDLINE (vía PubMed), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus y Literatura Latino-Americana em Ciências da Saúde (LILACS), sin restricción de idioma y período de publicación. Después de la búsqueda en la literatura científica, fueron seleccionados siete estudios para análisis en cuanto al tipo de textil y sustancia utilizada para impregnación, aplicabilidad en el servicio sanitario y reducción de la carga microbiana. Resultados: nanopartículas de plata y óxido de cobre fueron las principales sustancias antimicrobianas utilizadas para la impregnación de textiles. La utilización de esos textiles por los pacientes, como ropa de hotel y ropa, demostró mayor eficacia en la reducción de la carga microbiana en comparación al uso como uniforme por profesionales sanitarios. Conclusión: la utilización de textiles impregnados con sustancias antimicrobianas, sobre todo por los pacientes, puede ser considerada una alternativa viable en la prevención y control de la transmisión microbiana en los servicios sanitarios. Sin embargo, la implementación de estos textiles como uniforme para profesionales de la salud todavía necesita de mayores investigaciones en cuanto a la reducción de la carga microbiana en la práctica clínica.

Objetivo: analisar as evidências existentes sobre a viabilidade de utilizar têxteis impregnados com substâncias antimicrobianas na prevenção e no controle da transmissão microbiana em serviços de saúde. Método: revisão integrativa, utilizando as bases de dados MEDLINE (via PubMed), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus e Literatura Latino-Americana em Ciências da Saúde (LILACS), sem restrição de idioma e período de publicação. Após a busca na literatura científica, foram selecionados sete estudos para análise quanto ao tipo de têxtil e substância utilizada para a impregnação, a aplicabilidade no serviço de saúde e a redução da carga microbiana. Resultados: nanopartículas de prata e óxido de cobre foram as principais substâncias antimicrobianas utilizadas para a impregnação de têxteis. A utilização desses têxteis pelos pacientes, como roupas de hotelaria e vestuário, demonstrou maior eficácia na redução da carga microbiana em comparação ao uso como uniforme por profissionais de saúde. Conclusão: a utilização de têxteis impregnados com substâncias antimicrobianas, sobretudo pelos pacientes, pode ser considerada uma alternativa viável na prevenção e no controle da transmissão microbiana nos serviços de saúde. Todavia, a implementação destes têxteis, como uniforme para profissionais de saúde, ainda necessita de maiores investigações quanto à redução da carga microbiana na prática clínica.

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.

Reuse of hospital bedpans / Reutilización de chatas higiénicas / Reutilização de comadres hospitalares

ABSTRACT Objectives: to evaluate the results of two methods of hospital bedpan reprocessing. Methods: cross-sectional study. Hospital bedpans containing a biological material contamination simulator or organic matter were submitted to manual cleaning followed by disinfection with 70% alcohol solution or thermodisinfection. Permanence of simulated contamination was evaluated by using the fluorescence technique and presence of organic matter was verified by carrying out the protein detection test. Results: the contamination simulator was found in bedpans submitted to both processes. The seat was dirtier after manual cleaning (p=0.044) in comparison with the result obtained with thermodisinfection. Automatized decontamination led to worse results when compared to the manual procedure for the scoop and external bottom (p=0.000). The protein detection test was positive in two items after thermodisinfection. Conclusions: manual cleaning followed by rubbing with 70% alcohol solution proved more effective than automatized cleaning in the reprocessing of hospital bedpans. There are relevant issues regarding reuse of hospital bedpans.

RESUMEN Objetivos: evaluar los resultados de dos métodos de reprocesamiento de chatas higiénicas. Métodos: estudio transversal. Chatas higiénicas conteniendo simulador de contaminación por material biológico o materia orgánica fueron sometidas a lavado manual/desinfección con alcohol al 70% o termodesinfección. La permanencia de contaminación simulada se evaluó por fluorescencia; la presencia de material orgánico, por prueba de detección de proteínas. Resultados: se constató presencia de simulador de contaminación en chatas sometidas a ambos procesos. El asiento resultó más contaminado luego de la limpieza manual (p=0,044. En la pala y el fondo externo, la descontaminación automatizada tuvo peor resultado comparada con la manual (p=0,000). La prueba de detección de proteínas fue positiva en dos chatas luego de la termodesinfección. Conclusiones: para reprocesar chatas higiénicas, la limpieza manual seguida por fricción con alcohol al 70% resultó más eficaz que la limpieza automatizada. Se plantean interrogantes respecto de reutilizar chatas higiénicas.

RESUMO Objetivos: avaliar os resultados de dois métodos de reprocessamento de comadres hospitalares. Métodos: estudo transversal. Comadres hospitalares contendo simulador de contaminação por material biológico ou matéria orgânica foram submetidas a limpeza manual/desinfecção com álcool a 70% ou termodesinfecção. A permanência de contaminação simulada foi avaliada por fluorescência e a presença de matéria orgânica pelo teste de detecção de proteína. Resultados: constatou-se a presença de simulador de contaminação nas comadres submetidas a ambos os processos. O assento se mostrou mais sujo após a limpeza manual (p=0,044). Nas áreas da pá e fundo externo, a descontaminação automatizada teve pior resultado quando comparada à manual (p=0,000). O teste de detecção de proteínas foi positivo em dois utensílios após a termodesinfecção. Conclusões: no reprocessamento de comadres hospitalares, a limpeza manual seguida de fricção com álcool a 70% mostrou-se mais eficaz que a limpeza automatizada. Há fragilidades relativas à reutilização de comadres hospitalares.

Self-efficacy of health professionals in hand hygiene practice: is it possible to measure?

OBJECTIVE: To identify in the literature the tools used to measure self-efficacy of health professionals in hand hygiene. METHODS: Integrative literature review carried out by consulting the databases PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Europe PubMed Central, and Science Direct using the descriptors Self Efficacy, Hand Hygiene, and Health Personnel. RESULTS: Six articles, all of which with observational design, were selected. It was possible to infer that four studies used validated instruments to measure self-efficacy of health professionals in the conformity with the recommendations for hand hygiene. The other studies used questionnaires that were not validated. FINAL CONSIDERATIONS: Despite the extensive literature on hand hygiene, there is a lack of scientific evidence regarding the use of validated instruments to measure self-efficacy of health professionals in the procedure. The use of properly validated psychometric instruments is useful to guarantee the quality of results in studies.

Analysis of antimicrobial prescriptions in Primary Healthcare. / Análise de prescrições de antimicrobianos na Atenção Primária à Saúde.

OBJECTIVE: To evaluate prescription receipts for antimicrobial prescriptions prescribed in primary healthcare units in a capital city in the Northeast region of Brazil. METHOD: An evaluative, analytical study. Information from the central distribution of essential medicines and the receipts of antimicrobial prescriptions were used. RESULTS: There were 2,232 prescription receipts analyzed, in which metronidazole (250 mg) was prescribed in 28% of the evaluated prescription receipts, the "pill" pharmaceutical form in 30.7%, and the "oral" administration form in 78.2%. In the prescriptions prescribed by nurses, 80.7% were intended for users with sexually transmitted infections. With the exception of the pharmaceutical form, only 34.7% of the prescriptions were in accordance with the Nursing protocol recommendations. There is still no information on the concentration (43.7%), the dosage (39.9%) and the treatment time (36.8%). CONCLUSION: The evaluated receipts of antimicrobial prescriptions do not accurately follow the guidelines of Resolution No. 20/2011, nor of the instituted Nursing protocol.

Prevalence and susceptibility profile of Candida spp. isolated from patients in cancer therapy.

OBJECTIVE: This study determined the prevalence of Candida spp. in the saliva of cancer patients. Furthermore, we assessed the antimicrobial activity of mouthwashes against the isolated strains and its susceptibility to amphotericin B and fluconazole. METHODS: Thirty-four cancer patients undergoing radiotherapy, chemotherapy alone or combined treatment were investigated for oral Candida spp. colonization and compared in regard to mucositis presence. The maximum inhibitory dilution was used to assess the antimicrobial activity of Periogard®, Cepacol® Cool Ice and 0.12 % Chlorhexidine Digluconate mouthwashes against the isolates. In parallel, susceptibility to amphotericin B and fluconazole was determined by agar-based E-test. Data did not adhere to normal distribution as inferred by the Shapiro-Wilk test and statistical analysis was conducted by non-parametric McNemar test (α0.05). RESULTS: Twenty-seven participants (79.4 %) were male, 19 (55.9 %) had mucositis and 9 (26.5 %) were colonized by Candida spp. 12 different strains of Candida spp. were isolated, being Candida albicans the most prevalent strain. Risk of Candida spp. colonization was increased by almost twofold among the participants with mucositis (odds ratio: 1.84; 95 % confidence interval: 0.37-9.07). Mouthwash Cepacol® Cool Ice presented better antimicrobial activity against Candida spp. while 0.12 % Chlorhexidine exhibited the worst activity. All strains were sensitive to amphotericin B, and 2 non-albicans strains were dose-dependent sensitive to fluconazole. CONCLUSION: Considering the increased risk of colonization byCandida spp. in patients with mucositis, and the emergence of antifungal drug resistance, the antiseptics use could benefit the maintenance of cancer patient's oral health.

Patient safety climate from the nursing perspective.

OBJECTIVE: To analyze the patient safety climate in intensive care units from the nursing perspective. METHODS: Cross-sectional study developed with 87 nursing professionals working in three Intensive Care Units of a public hospital for emergency services in Piauí from October to November 2018. The study used a validated Safety Attitudes Questionnaire (SAQ). In the inferential analysis, the Student's t-test, Mann-Whitney, and Kruskal-Wallis were performed. RESULTS: The total SAQ score obtained a mean of 68.57. In analyzing the scores obtained for each domain in the general SAQ, the Job Satisfaction, and Teamwork Climate domains were those that obtained the highest scores, and the lowest score was for the Perception of Hospital Management domain. CONCLUSION: The safety attitudes assessed from the perspective of the nursing team proved to be unfavorable.