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.

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.

Epidemiological characterization of patients with intestinal stomas

Objective: To characterize the sociodemographic and clinical variables of people with intestinal stomas. Materials and Methods: We conducted a cross-sectional study with 47 patients of a Specialized Rehabilitation Center (CER II/APAE) in the municipality of Três Lagoas, state of Mato Grosso do Sul, Midwestern Brazil, from December 2019 to June 2020. Data was analyzed using inferential descriptive statistics (Anderson-Darling, Chi-squared, and Mann-Whitney normality tests). Results: Regarding the patients, 87.23% were from Três Lagoas, 51.06% were female, 40.43% were aged from 60 to 69 years, 59.57% were married, 53.19% were brown, 59.57% were catholic, 36.17% finished elementary school, 46.81% were retired, and 57.45% earned a monthly income below 1 minimum wage. Moreover, 61.70% had undergone terminal colostomy (61.70%), 61.70% had received guidance about its placing, 57.45% had it placed due to situations of urgency, 74.47% had a stoma installed due to a neoplasia, 38.30% were permanent, with 46.81% located in the inferior left quadrant (ILQ), 59.57% presented pasty effluent, 63.83% had a circular diameter, 53.19% had pouches with 2 pieces and 57.45%, with a flexible base, 87.23% had other adjunct equipment, and 95.74% had been trained in self-care. The most common complication was skin/peristomal irritant contact dermatitis (59,57%), and 65,95% of these cases were solved by teaching self-care. The type of stoma was significantly associated with the consistency of the effluent and the size of the protrusion (p> 0.05). Conclusion: The results found can support strategies to implement practices to promote health, develop new public policies, to provide training in self-care, and prevent and treat complications. (AU)

Equipe de limpeza hospitalar no contexto pandêmico: protocolo de scoping review / Hospital housekeeping team in the pandemic context: a scoping review protocol / Equipo de limpieza hospitalaria en el contexto de la pandemia: protocolo de revisión de alcance

OBJETIVO: Mapear a produção científica acerca da atuação dos profissionais de limpeza hospitalar durante a pandemia da COVID-19. MÉTODO: A busca será realizada nas bases de dados eletrônicas: PubMed / MEDLINE, Web of Science, Scopus Preview, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Biblioteca Virtual da Saúde (BVS). Para análise na literatura cinzenta será realizada pesquisa na Biblioteca Digital Brasileira de Teses e Dissertações, Google Scholar e Open Gray, sem aplicação de filtros. Os critérios de elegibilidade serão: estudos disponíveis na íntegra, publicados a partir de dezembro de 2019,e que respondem à questão de pesquisa proposta. Estudos em andamento ou preprint serão excluídos. Será realizada a avaliação do título e do resumo de todos os estudos localizados, com base nos critérios de elegibilidade. Os dados extraídos serão apresentados em diagramas ou no formato tabular, sendo acompanhados por um resumo narrativo.

OBJECTIVE: To map the scientific production about the performance of hospital housekeeping professionals during the COVID-19 pandemic. METHOD: The research will be conducted in the following electronic databases: PubMed/MEDLINE, Web of Science, Scopus Preview, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Biblioteca VirtualdaSaúde (BVS). In the case of the Gray Literature, a search will be performed in the Brazilian Library of Theses and Dissertation, in Google Scholar and in Open Gray, without applying any filters.The eligibility criteria will be the following: studies available in full, published from December 2019 onwards, and that answer the research question proposed. On going or preprint studies will be excluded.The titles and abstracts of all thes tudiesfound will be evaluated based on the eligibility criteria. The data extracted will be presented in diagram sortables, accompanied by a narrative summary.

OBJETIVO: Mapear la producción científica acerca del desempeño de los profesionales de limpieza hospitalaria durante la pandemia de COVID-19. MÉTODO: La búsqueda se realizará en las siguientes bases de datos electrónicas: PubMed/MEDLINE, Web of Science, Scopus Preview, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) y Biblioteca Virtual de la Salud (BVS). En el caso de la investigación en la Literatura Gris, la búsqueda se realizará en la Biblioteca Digital Brasileña de Tesis y Disertaciones, en Google Scholar y en Open Gray, sin aplicar ningún filtro. Los criterios de elegibilidad serán los siguientes: estudios disponibles en su texto completo, publicados a partir de diciembre de 2019, y que respondan la pregunta de investigación propuesta. Se excluirán estudios en curso o en preprint. Se evaluarán los títulos y resúmenes de todos los estudios localizados sobre la base de los criterios de elegibilidad. Los datos extraídos se presentarán en diagramas o tablas, acompañados por un resumen narrativo.

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.

Construcción y validación de una herramienta para evaluación del conocimiento sobre la dermatitis asociada a la incontinencia / Construção e validação de um instrumento para avaliação do conhecimento sobre dermatite associada à incontinência / Construction and validation of a tool for evaluation of knowledge about incontinence-associated dermatitis

Objetivo: Construir y validar una herramienta para evaluar el conocimiento sobre la dermatitis por incontinencia entre profesionales de enfermería. Método: Investigación metodológica para la elaboración y la validación de contenido de una herramienta para evaluación del conocimiento sobre la dermatitis por incontinencia, efectuada en tres etapas, la elaboración de la herramienta se hizo entre junio y octubre de 2020 y la validación de contenido – por siete jueces y seis profesionales – y el pretest, se realizaron entre marzo y mayo de 2021. La construcción de la herramienta se ha fundamentado en documentos de consenso y revisiones sistemáticas del tema. Durante la validación, fue adoptado el Método Delphi. Para el análisis de la concordancia entre examinadores se ha calculado el Índice de Validez de Contenido. Resultados: La concordancia entre los evaluadores fue superior al 83% en los elementos y en el dominio del test. Por medio del análisis de la varianza, se identificó que no hubo diferencia estadística significativa entre las respuestas de los evaluadores. La versión final de la herramienta presenta 57 ítems. Conclusiones: El test elaborado fue considerado adecuado por los evaluadores en cuanto a los criterios de relevancia, claridad y simplicidad, por lo que puede aplicarse en la población objetivo, para orientar acciones de educación permanente en salud. (AU)

Objetivo: Construir e validar um instrumento para avaliar o conhecimento sobre dermatite associada à incontinência entre profissionais de enfermagem. Método: Pesquisa metodológica, para a elaboração e validação de conteúdo de um instrumento para avaliação do conhecimento sobre dermatite associada a incontinência, realizada em três etapas sendo, a elaboração do instrumento entre junho e outubro de 2020, validação de conteúdo por sete juízes e seis profissionais e pré-teste, entre março e maio de 2021. A construção do mesmo, fundamentou-se em documentos de consenso e revisões sistemáticas do tema. Durante a validação adotou-se a Técnica Delphi. Para análise da concordância entre examinadores, calculou-se o Índice de Validade de Conteúdo.Resultados: A concordância entre os avaliadores foi superior a 83%, nos itens e domínios do teste. Através de análise da variância, identificou-se que não houve diferença estatística significativa entre as respostas dos avaliadores. A versão final do instrumento apresenta 57 itens. Conclusões: O teste elaborado foi considerado adequado pelos avaliadores, quanto aos critérios de relevância, clareza e simplicidade, podendo ser aplicado na população fim, para nortear ações de educação permanente em saúde. (AU)

Objective: Building and validating a tool to evaluate knowledge about incontinence-associated dermatitis among nursing professionals. Method: Methodological research, for the elaboration and content validation of a tool to assess knowledge about incontinence-associated dermatitis, carried out in three stages: the elaboration of the instrument between June and October 2020, content validation by seven judges and six professionals, and pre-test, between March and May 2021. Its construction was based on consensus documents and systematic reviews of the topic. During validation, the Delphi method was adopted. Content Validity Index was calculated to analyze the agreement between examiners. Results: The agreement among the evaluators was higher than 83% in the test items and domains. Through analysis of variance, it was identified that there was no statistically significant difference among the evaluators' responses. The final version of the tool has 57 items. Conclusions: The test developed was considered adequate by the evaluators, regarding the criteria of relevance, clarity and simplicity, and can be applied to the target population for guiding permanent health education actions. (AU)

Intervenção Educativa Sobre Dermatite Associada à Incontinência: Estratégia de Ensino no Instagram / Educational Intervention on Incontinence-associated Dermatitis: Teaching Strategy on Instagram / Intervención Educativa en Dermatitis Asociada a Incontinencia: Estrategia Didáctica Sobre Instagram

Objetivos:Descrever e avaliar intervenção educativa realizada por meio de mídia social sobre dermatite associada à incontinência (DAI) com profissionais de enfermagem. Métodos:Estudo de intervenção educativa com abordagem qualitativa pela mídia social Instagram para veiculação dos conteúdos do curso sobre a DAI. A coleta de dados foi realizada com 30 profissionais de enfermagem da clínica médica e unidade de terapia intensiva adulta de hospital de ensino público de Mato Grosso do Sul, de fevereiro a março de 2022. Os dados foram coletados durante o curso e apreciados pela análise de conteúdo de Bardin e à luz do referencial teórico da aprendizagem significativa de Ausubel. Resultados: Da análise dos comentários dos cursistas, emergiram quatro categorias temáticas: ancoragem, que retrata o saber prévio; aprendizagem significativa subordinada, a qual apresenta a construção de conhecimento ancorada no saber prévio; aprendizagem por descoberta, evidenciando a autonomia do participante no aprendizado; e avaliação do processo de ensino-aprendizagem, que revela a avaliação do processo educativo. Conclusão: Os resultados mostraram que a intervenção educativa obteve êxito no que tange ao compartilhamento de evidências sobre DAI aos participantes e que a ferramenta Instagram pode ser adotada para ações educativas mesmo em ambiente hospitalar.

Objectives:To describe and evaluate, in a formative way, an educational intervention carried out through social media on incontinence-associated dermatitis with nursing professionals from a public hospital. Method: Educational intervention study with a qualitative approach conducted in a virtual way through the social media Instagram as a platform for the dissemination of course content on the subject. Data collection was carried out with 30 nursing professionals from the medical clinic and adult intensive care unit of a public teaching hospital in the state of Mato Grosso do Sul, Brazil, between February and March 2022. Data were collected during the course and analysed through content analysis and according to Ausubel's meaningful learning theoretical framework perspective. Results: From the analysis of the participants' comments, four thematic categories emerged: anchoring; subordinated meaningful learning; discovery learning; and evaluation of the teaching-learning process. Conclusion: Through the results found, it was identified that the educational intervention conducted was successful in terms of sharing evidence on the subject to the participants. It was found that the Instagram can be adopted as a tool to carry out educational actions, including in a hospital environment.

Objetivo:Describir y evaluar, de forma formativa, una intervención educativa realizada a través de las redes sociales sobre dermatitis asociada a incontinencia con profesionales de enfermería de un hospital público. Métodos: Estudio de intervención educativa, con enfoque cualitativo, realizado de forma virtual, a través de la red social Instagram® como plataforma de difusión de contenidos de cursos sobre el tema. La recolección de datos se realizó con 30 profesionales de Enfermería de la Clínica Médica y UTI Adultos de un hospital público de enseñanza en el estado de Mato Grosso do Sul, entre febrero y marzo de 2022. Este estudio fue aprobado por el Comité de Ética en Investigación. Los datos fueron recolectados durante el curso y analizados a través del análisis de contenido ya la luz del marco teórico del Aprendizaje Significativo de Ausubel. Resultados: Del análisis de los comentarios de los participantes surgieron cuatro categorías temáticas: anclaje; aprendizaje significativo subordinado; aprendizaje por descubrimiento; y evaluación del proceso de enseñanza-aprendizaje. Conclusión: A través de los resultados encontrados, se identifica que la intervención educativa realizada fue exitosa en cuanto a compartir evidencias sobre el tema a los participantes. Se constató que la herramienta Instagram® puede ser adoptada para realizar acciones educativas, incluso en ambiente hospitalario.

Conhecimento da equipe de enfermagem sobre lesão por pressão / Nursing team knowledge about pressure injuries / Conocimientos del equipo de enfermería sobre la lesión por presión

Objetivo:avaliar o nível de conhecimentos da equipe de enfermagem da clínica médica de um hospital universitário sobre lesão por pressão. Método: estudo descritivo-exploratório, aprovado por Comitê de Ética em Pesquisa. Os dados foram coletados através de questionário validado. Participaram 50 indivíduos, sendo 35 técnicos de enfermagem e 15 enfermeiros. Resultados: os técnicos em enfermagem obtiveram média de 83,5% e os enfermeiros obtiveram média de 89,9%. Realizou-se um modelo de regressão para verificar variáveis que influenciam no nível de conhecimento, sendo identificado que possuir mais de 5 anos na profissão aumenta 1,61 vezes a chance de o profissional apresentar um conhecimento adequado. Conclusão: foi identificada uma fragilidade no conhecimento sobre lesão por pressão. Tendo em vista os custos envolvidos no tratamento e as complicações advindas dessas lesões, as instituições de saúde devem implementar ações educativas sobre esse agravo.

Objective:to assess the level of knowledge of the nursing staff of the medical clinic of a university hospital about pressure injuries. Method: descriptive-exploratory study, approved by the Research Ethics Committee. Data were collected through a validated questionnaire. Fifty individuals participated, 35 nursing technicians and 15 nurses. Results: nursing technicians had an average of 83.5% and nurses had an average of 89.9%. A regression model was carried out to verify variables that influence the level of knowledge, and it was identified that having more than 5 years in the profession increases 1.61 times the chance that the professional has adequate knowledge. Conclusion: a weakness in knowledge about pressure injuries was identified. In view of the costs involved in the treatment and complications arising from these injuries, health institutions must implement educational actions about this condition.

Objetivo:evaluar el nivel de conocimientos del equipo de enfermería de clínica médica de un hospital universitario sobre lesión por presión. Método: estudio descriptivo/exploratorio, aprobado por Comité de Ética en Investigación. Los datos fueron recolectados por medio de un cuestionario validado. Participaron 50 individuos, siendo 35 técnicos de enfermería y 15 enfermeros. Resultados: los técnicos en enfermería obtuvieron un promedio del 83,5 % y los enfermeros un promedio del 89,9 %. Se realizó un modelo de regresión para verificar variables que influyen en el nivel de conocimiento, identificándose que el contar con más de 5 años en la profesión aumenta 1,61 veces la probabilidad que el profesional presente un conocimiento adecuado. Conclusión: fue identificada una fragilidad en el conocimiento sobre lesión por presión. Teniendo en cuenta los costos involucrados en el tratamiento y las complicaciones derivadas de esas lesiones, las instituciones de salud deben implementar acciones educativas sobre esa afección

Colonization of methicillin-resistant Staphylococcus aureus among healthcare students: an integrative review

ABSTRACT BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a worldwide concern given its presence even in non-hospitalized healthy individuals, such as university students. OBJECTIVE: To identify in the literature the prevalence of colonization by MRSA among healthcare students. DESIGN AND SETTING: Integrative review of the literature conducted in Universidade Federal do Piauí. METHOD: A search for primary studies was performed in the following databases: Medical Literature Analysis and Retrieval System on-line; Cumulative Index to Nursing and Allied Health Literature; Web of Science; Scopus; and LILACS. RESULTS: This review included 27 studies that demonstrated MRSA infection prevalence ranging from 0.0 to 15.3% among students. CONCLUSION: The prevalence of colonization of MRSA among healthcare students is high, and the nasal cavity was cited as an important reservoir location for these microorganisms.

Colonization of methicillin-resistant Staphylococcus aureus among healthcare students: an integrative review.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a worldwide concern given its presence even in non-hospitalized healthy individuals, such as university students. OBJECTIVE: To identify in the literature the prevalence of colonization by MRSA among healthcare students. DESIGN AND SETTING: Integrative review of the literature conducted in Universidade Federal do Piauí. METHOD: A search for primary studies was performed in the following databases: Medical Literature Analysis and Retrieval System on-line; Cumulative Index to Nursing and Allied Health Literature; Web of Science; Scopus; and LILACS. RESULTS: This review included 27 studies that demonstrated MRSA infection prevalence ranging from 0.0 to 15.3% among students. CONCLUSION: The prevalence of colonization of MRSA among healthcare students is high, and the nasal cavity was cited as an important reservoir location for these microorganisms.

Influencing factors of hand hygiene in critical sections of a brazilian hospital.

INTRODUCTION: The aim of this study was to monitor adherence to hand hygiene by health professionals working in critical sections and to assess the factors that influenced adherence, such as physical structure of the units, use of procedure gloves, employment bond of the worker, and perception of patient safety climate. METHODOLOGY: Observational and correlational study carried out in critical areas of a university hospital in the Midwest region of Brazil. RESULTS: The overall hand hygiene adherence rate was 46.2% (n = 3,025). Adherence was higher among nurses 59.8% (n = 607) than among nursing technicians (p < 0.001), and the section with the greatest adherence was the neonatal Intensive Care Unit 62.9% (n = 947) (p < 0.001). Unlike the neonatal unit, in the adult unit the dispensers of alcohol-based handrubs were poorly located, without arms reach, and the taps were manual. In this section, a greater frequency of procedure glove use was also observed, 90.6% (n = 536), as compared to the other sections (p < 0.001). Regarding safety climate perception, temporary employees had higher means as compared to regular employees (p = 0.0375). CONCLUSIONS: Hand hygiene adherence was affected and/or influenced by the physical structure, use of procedure gloves, work regime, and patient safety climate.

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.

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.

Broad Diversity of Fungi in Hospital Water.

INTRODUCTION: Some studies have reported the occurrence of microorganisms isolated from water. Considering these microorganisms, fungi are known to occur ubiquitously in the environment, including water, and some are pathogenic and may cause health problems, especially in immunocompromised individuals. The aim of this study was to identify fungi in hospital water samples and to correlate their presence with the concentration of free residual chlorine. METHODS: Water samples (100 mL) were collected from taps (n = 74) and water purifiers (n = 14) in different locations in a university hospital. Samples were filtered through a nitrocellulose membrane and placed on Sabouraud dextrose agar and incubated for 24 hours at 30°C. Fungi were identified according to established methods based on macroscopic and microscopic characteristics (filamentous) and physiological tests (yeasts). Free chlorine residual content was measured at the time of sample collection. RESULTS: Seventy species of fungi were identified in the water samples and about 56% of the water samples contained culturable fungi. Cladosporium oxysporum, Penicillium spinulosum, and Aspergillus fumigatus were the most common filamentous fungi. Aureobasidium pullulans and Candida parapsilosis were the most common yeasts. Chemical analyses revealed that free residual chlorine was present in 81.8% of the samples within recommended concentrations. Among samples from water purifiers, 92.9% showed low levels of free residual chlorine (<0.2 mg/L). There was no significant association between chlorine concentrations (either within or outside the recommended range) and the presence of filamentous fungi and yeasts. CONCLUSIONS: This study showed that hospital water can be a reservoir for fungi, some of which are potentially harmful to immunocompromised patients. Free residual chlorine was ineffective in some samples.

Impact of Educational Intervention on Cleaning and Disinfection of an Emergency Unit.

We aimed to evaluate the impact of an educational intervention on the surface cleaning and disinfection of an emergency room. This is an interventional, prospective, longitudinal, analytical and comparative study. Data collection consisted of three stages (Stage 1-baseline, Stage 2-intervention and immediate assessment, Stage 3-long term assessment). For the statistical analysis, we used a significance level of α = 0.05. The Wilcoxon and the Mann-Whitney test tests were applied. We performed 192 assessments in each stage totaling 576 evaluations. Considering the ATP method, the percentage of approval increased after the educational intervention, as the approval rate for ATP was 25% (Stage 1), immediately after the intervention it went to 100% of the approval (Stage 2), and in the long run, 75% of the areas have been fully approved. Stage 1 showed the existence of significant differences between the relative light units (RLU) scores on only two surfaces assessed: dressing cart (p = 0.021) and women's toilet flush handle (p = 0.014); Stage 2 presented three results with significant differences for ATP: dressing cart (p = 0.014), women's restroom door handle (p = 0.014) and women's toilet flush handle (p = 0.014); in step III, there was no significant difference for the ATP method. Therefore, conclusively, the educational intervention had a positive result in the short term for ATP; however, the same rates are not observed with the colony-forming units (CFU), due to their high sensitivity and the visual inspection method since four surfaces had defects in their structure.

Effectiveness of clinical surface cleaning and disinfection: evaluation methods.

OBJECTIVE: To discuss the methods employed to evaluate the effectiveness of clinical surface cleaning and disinfection (C&D). METHOD: This is a theoretical reflection based on scientific studies and the experience of the authors. Knowledge and current gaps, the need for further studies, and practical application of the methods were approached. RESULTS: There are four main methods used to evaluate the effectiveness of clinical surface C&D: visual inspection, fluorescent markers, microbiological cultures, and adenosine triphosphate (ATP) bioluminescence. The first two are used to evaluate the process and to predict adherence to protocols by the staff, and the last two are employed to evaluate the results, therefore being the most relevant to assess the risk of infection. FINAL CONSIDERATIONS: The ideal method was not found, because all of them showed limitations. There is a need for strategies to optimize the precision of these methods.

Effectiveness of clinical surface cleaning and disinfection: evaluation methods / Eficiencia de la limpieza y desinfección de superficies clínicas: métodos de evaluación / Eficiência da limpeza e desinfecção de superfícies clínicas: métodos de avaliação

ABSTRACT Objective: To discuss the methods employed to evaluate the effectiveness of clinical surface cleaning and disinfection (C&D). Method: This is a theoretical reflection based on scientific studies and the experience of the authors. Knowledge and current gaps, the need for further studies, and practical application of the methods were approached. Results: There are four main methods used to evaluate the effectiveness of clinical surface C&D: visual inspection, fluorescent markers, microbiological cultures, and adenosine triphosphate (ATP) bioluminescence. The first two are used to evaluate the process and to predict adherence to protocols by the staff, and the last two are employed to evaluate the results, therefore being the most relevant to assess the risk of infection. Final considerations: The ideal method was not found, because all of them showed limitations. There is a need for strategies to optimize the precision of these methods.

RESUMEN Objetivo: Discutir los métodos utilizados para evaluar la eficiencia de la limpieza y desinfección (L&D) de superficies clínicas. Método: Reflexión teórica fundamentada en estudios científicos y en la experiencia de los autores. Fueron abordados el conocimiento y las carencias presentes, la necesidad de investigaciones futuras y la práctica en la aplicación de los métodos. Resultados: Los métodos más habitualmente aplicados para evaluar la eficiencia de la L&D de superficies clínicas son cuatro: inspección visual, marcadores fluorescentes, cultivos microbiológicos y test de adenosina trifosfato por bioluminiscencia. Los dos primeros son utilizados para evaluar el proceso. Prevén la adhesión a los protocolos por parte del equipo. Los dos últimos son aplicados para evaluar los resultados, por lo cual son más relevantes para descubrir riesgos de infección. Consideraciones finales: No se encontró el método ideal, dado que todos presentan limitaciones. Se necesitan estrategias que optimicen la precisión de estos métodos.

RESUMO Objetivo: Discutir os métodos empregados para avaliar a eficiência da limpeza e desinfecção (L&D) de superfícies clínicas. Método: Trata-se de uma reflexão teórica fundamentada em estudos científicos e experiência dos autores. Foram abordados o conhecimento e as lacunas atuais, a necessidade de futuras investigações e a prática na utilização dos métodos. Resultados: São quatro os principais métodos utilizados para avaliar a eficiência da L&D de superfícies clínicas: inspeção visual, marcadores fluorescentes, culturas microbiológicas e teste de adenosina trifosfato por bioluminescência. Os dois primeiros são utilizados para avaliar o processo e preveem a adesão aos protocolos pela equipe, enquanto os dois últimos são empregados para avaliar os resultados, portanto, mais relevantes na avaliação do risco de infecção. Considerações finais: Não foi encontrado um método ideal, pois todos apresentaram limitações. São necessárias estratégias que potencializem a precisão desses métodos.

Patient safety climate from the nursing perspective / Clima de seguridad del paciente en la perspectiva de la enfermaría / Clima de segurança do paciente na perspectiva da enfermagem

ABSTRACT 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.

RESUMEN Objetivo: Analizar el clima de seguridad del paciente en unidades de terapia intensiva en la perspectiva de la enfermaría. Métodos: Estudio transversal desarrollado con 87 profesionales de enfermaría que actúan en tres Unidades de Terapia Intensiva de un hospital público de urgencia de Piauí en el período de octubre y noviembre de 2018. Ha sido utilizado un cuestionario validado de Actitudes de Seguridad - Safety Attitudes Questionnaire (SAQ). En el análisis inferencial, han sido realizados el Teste t de Student, Mann-Whitney e Kruskal-Wallis. Resultados: La calificación del SAQ total obtuvo media de 68,57. En análisis de las calificaciones obtenidas para cada dominio en el SAQ general, los dominios Satisfacción en el Trabajo y Clima de Trabajo en Equipo han sido los que obtuvieron las calificaciones más altas y la calificación más baja ha sido para el dominio Percepción de la Gerencia del Hospital. Conclusión: Las actitudes de seguridad evaluadas bajo la perspectiva del equipo de enfermaría se ha mostrado desfavorables.

RESUMO Objetivo: Analisar o clima de segurança do paciente em unidades de terapia intensiva na perspectiva da enfermagem. Métodos: Estudo transversal desenvolvido com 87 profissionais de enfermagem que atuam em três Unidades de Terapia Intensiva de um hospital público de urgência do Piauí no período de outubro a novembro de 2018. Utilizou-se um questionário validado de Atitudes de Segurança - Safety Attitudes Questionnaire (SAQ). Na análise inferencial, foram realizados o Teste t de Student, Mann-Whitney e Kruskal-Wallis. Resultados: O escore do SAQ total obteve média de 68,57. Em análise dos escores obtidos para cada domínio no SAQ geral, os domínios Satisfação no Trabalho e Clima de Trabalho em Equipe foram os que obtiveram os escores mais altos e o escore mais baixo foi para o domínio Percepção da Gerência do Hospital. Conclusão: As atitudes de segurança avaliadas sob a perspectiva da equipe de enfermagem mostraram-se desfavoráveis.

Avaliação de um processo educativo sobre prevenção de lesão por pressão / Evaluation of an educational process about prevention of pressure injury

Objetivo: descreve rum processo de ensino sobre prevenção de lesão por pressão, bem como avaliar de modo formativo esse processo com base nos referenciais teóricos de Paulo Freire e da Metodologia da Problematização por meio do Arco de Maguerez. Método: estudo de intervenção educativa, com abordagem qualitativa, realizado em um hospital público de ensino do município de Dourados, Mato Grosso do Sul, Brasil, em março e abril de 2018, e aprovado por Comitê de Ética em Pesquisa com Seres Humanos. Os dados foram coletados durante os encontros educativos, que foram gravados em sua totalidade em áudio. Posteriormente, foram transcritos e analisados por meio da técnica de análise de conteúdo, abstraindo, assim, as categorias temáticas, que tiveram correlação com os referenciais teóricos do autor Paulo Freire. Resultados:a partir da análise das falas, escritos avaliativos e anotações de diário de campo, identificaram-se as seguintes categorias: diálogo; problematização; pesquisa/investigação; e avaliação dos encontros educativos. Considerações finais: as estratégias educativas adotadas foram exitosas,pois receberam boas avaliações por parte dos participantes e promoveram um espaço de discussão em grupo, mobilização para a melhoria das práticas assistenciais, troca de experiências e reflexão sobre o tema.

Objective: to describe an educational process on prevention of pressure injury, as well as to Assess in a formative manner this process based on the theoretical framework of Paulo Freire and the Methodology of Problematization through the Arch of Maguerez. Method: a study of educational intervention, with qualitative approach, carried out in a PIblic university hospital in the city of Dourados, Mato Grosso do Sul, Brazil, during March and April, 2018, and approved by Ethics Committee on Research with Human Beings. The data were collected during the educational meetings, which were recorded, in its entirety, in audio. Subsequently, they were transcribed and analyzed by the content analysis technique, comprehending, thus, the thematic categories,which correlated with the theoretical references of the author Paulo Freire. Results: parting from the analysis of the speeches, evaluative writings and field journal notes, the following categories were identified: dialogue; problematization; research/investigation; and evaluation of educational meetings. Final considerations: the adopted educational strategies were successful, it received good evaluations from participants and promoted an environment for discussion in groups, mobilization for the improvement of assistance practices, exchange of experiences and reflection on the subject.