Physical structure and supplies for hand hygiene in the CCU of a public hospital / Estrutura física e insumos destinados à higienização das mãos no CTI de um hospital público / Estructura física e insumos destinados a la higienización de manos en la UCI de un hospital público

Background and Objectives: healthcare-associated infections (HAIs) are a serious public health problem worldwide. They occur mainly in Critical Care Units (CCUs), where physical structure and supplies do not favor hand hygiene (HH) compliance among health professionals. Thus, the present study aimed to describe and assess the physical structure and supplies for HH practice in a CCU of a public cancer hospital in the North region, Pará, Brazil. Methods: this is a descriptive, observational and cross-sectional study with a quantitative approach. Data were collected through a questionnaire based on the Guide to the Implementation of the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. Results: the study identified that there were 17 functioning beds and 6 interdicted, in addition to 11 sinks on site, but only 5 had liquid soap and paper towels, all with water. Ten alcohol dispensers were identified, but only 7 were functioning and replenished. None of the professionals found had a pocket alcoholic bottle. Conclusion: the study concluded that the physical structure and supplies found in the investigated CCU are partially adequate for carrying out hand disinfection. However, improvements in these structures must be implemented as well as periodic audits and permanent health education activities, aiming to remind professionals about HH practice correctly.(AU)

Justificativas e objetivos: as infecções relacionadas à assistência a saúde (IRAS) são um grave problema de saúde pública mundial. Ocorrem principalmente nos Centros de Terapia Intensiva (CTI), onde a estrutura física e insumos não favorecem a adesão da higienização das mãos (HM) entre os profissionais de saúde. Dessa forma, o presente estudo teve como objetivo descrever e avaliar a estrutura física e de insumos destinados à prática de HM em um CTI de um hospital público oncológico da região Norte, Pará, Brasil. Métodos: trata-se de um estudo descritivo, observacional e transversal com abordagem quantitativa. Os dados foram coletados através de um questionário baseado no Guia para a Implementação da Estratégia Multimodal da Organização Mundial da Saúde (OMS) para a Melhoria da Higiene das Mãos. Resultados: o estudo identificou que existiam 17 leitos funcionantes e 6 interditados, além de 11 pias no local, porém apenas 5 possuíam sabão líquido e papel toalha, todas com água. Foram identificados 10 dispensadores de álcool, porém apenas 7 estavam funcionantes e reabastecidos. Nenhum dos profissionais encontrados possuíam frasco alcoólico de bolso. Conclusão: o estudo concluiu que a estrutura física e os insumos encontrados no CTI investigado estão parcialmente adequados para a realização da prática de desinfecção das mãos. Contudo, devem ser implementadas melhorias nessas estruturas, bem como auditorias periódicas e atividades de educação permanente em saúde, visando relembrar os profissionais sobre a prática de HM de forma correta.(AU)

Justificación y objetivos: las infecciones asociadas a la atención de la salud (IAAS) son un grave problema de salud pública a nivel mundial. Ocurren principalmente en Unidades de Cuidados Intensivos (UCI), donde la estructura física y los suministros no favorecen la adherencia a la higiene de manos (HM) entre los profesionales de la salud. Así, el presente estudio tuvo como objetivo describir y evaluar la estructura física y los insumos para la práctica de la HM en una UCI de un hospital oncológico público de la región Norte de Pará, Brasil. Métodos: se trata de un estudio descriptivo, observacional, transversal con enfoque cuantitativo. Los datos fueron recolectados a través de un cuestionario basado en la Guía para la Implementación de la Estrategia Multimodal para la Mejora de la Higiene de Manos de la Organización Mundial de la Salud (OMS). Resultados: el estudio identificó que había 17 camas en funcionamiento y 6 intervenidas, además de 11 lavabos en el lugar, pero solo 5 tenían jabón líquido y toallas de papel, todas con agua. Se identificaron 10 dispensadores de alcohol, pero solo 7 funcionaban y se reponían. Ninguno de los profesionales encontrados tenía una botella de alcohol de bolsillo. Conclusión: el estudio concluyó que la estructura física y los insumos encontrados en la UCI investigada son parcialmente adecuados para la realización de la práctica de desinfección de manos. Sin embargo, se deben implementar mejoras en estas estructuras, así como auditorías periódicas y actividades de educación continua en salud, con el objetivo de recordar a los profesionales sobre la práctica correcta de HM.(AU)

Deficient handwashing amenities in public toilets in the time of the COVID-19 pandemic: a multi-regional survey.

AIMS: To identify the extent of the provision of handwashing amenities in public toilets at the time of the COVID-19 pandemic, and also to make comparisons with a related pre-pandemic survey. METHODS: We collected data from 400 toilet facilities that were open to the public: all those in three contiguous city council territories (228) and a further convenience sample of 172 around other parts of New Zealand. Comparisons were made with the data on the same facilities included in a 2012/2013 survey. RESULTS: Of the toilets in this survey, 2.5% had no water for handwashing and 14.8% had no soap. There was COVID-19-related health messaging signage in 19.5% of toilets, with posters of the COVID-19 QR code used for contact tracing in 12.3%, and generic handwashing signage in 1.8%. The handwashing water had 'no-touch' activation at 28.0% of toilets, and 18.5% of toilets had no-touch bowl flushing. Toilet bowl lids were not present at 32.8%, and 2.3% of toilets had damage that would impair their functionality (eg, broken toilet seats). This new survey found significantly increased provision of soap (risk ratio = 1.47; 95%CI: 1.25 to 1.72), but no increased provision of water, at the 128 sites that had also been examined in the previous survey. CONCLUSIONS: Although handwashing is probably a much less critical COVID-19 control intervention than reducing aerosol transmission, it should still be strongly supported. Yet this survey found multiple deficiencies with handwashing amenities at public toilets and only modest improvements since a previous survey.

Handrub dispensers per acute care hospital bed: a study to develop a new minimum standard.

BACKGROUND: Accessibility to alcohol-based handrub (ABHR) dispenser is crucial to improve compliance to hand hygiene (HH), being offered as wall-mounted dispensers (ABHR-Ds), and/or pocket bottles. Nevertheless, information on the distribution and density of ABHR-Ds and their impact on HH have hardly been studied. Institutions such as the World Health Organisation or the Centers for Disease Control and Prevention do not provide guidance. The Robert-Koch-Institute (RKI) from Germany recommends an overall density of > 0.5 dispensers per patient bed. We aimed to investigate current conditions in hospitals to develop a standard on the minimal number of ABHR-D. METHODS: Between 07 and 09/2019, we applied a questionnaire to 178 hospitals participating in the Swissnoso National Surveillance Network to evaluate number and location of ABHR-Ds per bed in acute care hospitals, and compared the data with consumption and compliance with HH. RESULTS: 110 of the 178 (62%) hospitals provided data representing approximately 20,000 hospital beds. 83% hospitals provided information on both the total number of ABHR-Ds and patient beds, with a mean of 2.4 ABHR-Ds per bed (range, 0.4-22.1). While most hospitals (84%) had dispensers located at the room entrance, 47% reported also locations near or at the bed. Additionally, pocket-sized dispensers (100 mL) are available in 97% of hospitals. CONCLUSIONS: Swiss hospitals provide 2.4 dispensers per bed, much more than governmental recommendation. The first study on the number of ABHR-Ds in hospitals may help to define a minimal standard for national and international recommendations.

Evaluating the Efficacy of the Supertowel™ as a Handwashing Product: A Simulation of Real-World Use Conditions.

The Supertowel is a fabric treated with a permanent antimicrobial bonding and has been designed as a soap alternative in emergency situations. The Supertowel has been shown to be as efficacious as handwashing with soap and water when tested under controlled laboratory conditions. It has also been shown to be a practical, acceptable, and desirable product among crisis-affected populations. The aim of this study was to test whether the Supertowel remains as efficacious when used under conditions which mimic real-world hand cleaning in challenging settings. Two rounds of laboratory tests, with 16 volunteers in each, were conducted to test the efficacy of the Supertowel when used for a shorter duration, when less wet, when used with contaminated water, when visibly dirty, and when dry. Volunteers pre-contaminated their hands with nonpathogenic Escherichia coli. Comparisons were made between hand cleaning with the Supertowel and the reference condition (normally handwashing with soap), using a crossover design. The Supertowel was marginally less efficacious than handwashing with soap when used for 15 seconds (P = 0.04) but as efficacious at 30 and 60 seconds durations. All the other Supertowel conditions were as efficient as their reference comparisons meaning that the Supertowel can effectively remove pathogens from hands when it is wet, damp, or completely dry, when it is used with contaminated water, when visibly dirty with mud and/or oil.

Community engagement in COVID-19 prevention: experiences from Kilimanjaro region, Northern Tanzania.

Prevention of exposure to the COVID-19 virus in the general population is an essential strategy to slow community transmission. This paper shares the experiences and challenges of community engagement in COVID-19 prevention in the Kilimanjaro region, Northern Tanzania implemented by our team from the Institute of Public Health (IPH), Kilimanjaro Christian Medical University College (KCMUCo) in collaboration with the COVID-19 response team in the Moshi Municipality. We conducted an education session with the COVID-19 response team and together brainstormed transmission hotspots and which interventions would be most feasible in their settings. The first hotspot identified was crowded local market spaces. Suggested interventions included targeted and mass public health education through the engagement of market opinion leaders, public announcements, and radio shows. We conducted participatory rural appraisal techniques to enable market vendors and clients to visualize two-meter distances and provided a prototype hand-washing facility that was foot operated. We found mass public health educational campaigns essential to inform and update the public about COVID-19 pandemic and to address rumors and misinformation, which hampers compliance with public health interventions. Coordinated efforts among stakeholders in the country are necessary to develop context-specific prevention and case management strategies following the national and international guidelines. Local ownership of recommended interventions is necessary to ensure compliance.

Lavado correcto de las manos

El correcto lavado reduce la posibilidad de transmisión de enfermedades como la #COVID19.

Influenza A (H1N1) 1: coleta de amostra de secreção respiratória

Influenza A (H1N1) - coleta de amostra de secreção respiratória.

Resistencia a los antimicrobianos: ¡Practique siempre una adecuada higiene de manos! [imagem]

Tarjetas para redes sociales - Resistencia a los antimicrobianos: ¡Practique siempre una adecuada higiene de manos!

Using an ultraviolet cabinet improves compliance with the World Health Organization's hand hygiene recommendations by undergraduate medical students: a randomized controlled trial.

BACKGROUND: Appropriate hand hygiene (HH) is key to reducing healthcare-acquired infections. The World Health Organization (WHO) recommends education and training to improve HH knowledge and compliance. Physicians are ranked among the worst of all healthcare workers for compliant handrubbing with its origin probably being the failure to learn this essential behavior during undergraduate medical studies. This study evaluated if the use of Ultraviolet-cabinets (UVc) for fluorescent-alcohol-based handrubs (AHR) during an undergraduate medical student training improved the compliance rate to the WHO hand hygiene recommendations (completeness of AHR application and HH opportunities). METHODS: This randomized trial compared a HH training with personal feedback (using UVc) to a control group. The first year, the students (2nd degree) were convened by groups (clusters) of 6-9 for a demonstration of the correct execution of WHO procedure. Randomization by cluster was done prior HH training. In the control group, the students hand rubbed under visual supervision of a tutor. In the intervention group after the same visual supervision, completeness of fluorescent-AHR hand application was recorded under UVc and was shown to the student. The intervention group had free access to the UVc until complete application. HH practices were included in simulation sessions for the both groups. One year after (3rd degree), all the students were asked to hand rub with fluorescent-AHR. A tutor (blinded to the study group) assessed the completeness of hand application under UVc and the compliance with the WHO opportunities. Complete application of AHR was defined as fluorescence for all the surfaces of hands and wrists. RESULTS: 242 students participated (140 in the intervention group and 102 in the control group). One year after the initial training, the rate of complete application of AHR was doubled in the intervention group (60.0% vs. 30.4%, p < 0.001). In a multivariate analysis which included gender, additional HH or UVc training, surgical traineeship and regular use of AHR, the hazard ratio for the intervention was 3.84 (95%CI: 2.09-7.06). The compliance with the HH WHO's opportunities was increased in the intervention group (58.1% vs. 42.4%, p < 0.018). CONCLUSION: Using UVc for undergraduate medical students education to hand hygiene improves their technique and compliance with WHO recommendations.

Will you wash your hands with Akili?

WHO has teamed up with Ubongo, Africa-based children's education and entertainment producer, to launch 'Will you wash your hands with Akili?'. The sing-a-long video by Akili and Me shows children how to wash their hands to stay safe during the COVID-19 pandemic.

Preventative measures: we're All In Together let's stop the spread of COVID-19

Preventative measures - We're All In Together let's stop the spread of COVID-19 Trinidad & Tobago. How persons can protect themselves and others from the spread of covid19.

Scaling up Protection, Promotion and Support to Breastfeeding during COVID-19

World Breastfeeding Week is celebrated 1-7 August 2020, the theme this year is “Support breastfeeding for a Healthier Planet”, this webinar explored the benefits of breastfeeding, breastfeeding and COVID-19, breastfeeding and Climate Change as well as country experiences in promoting, protecting and supporting breastfeeding

Limpia tus manos con agua y jabón

Potential methanol toxicity and the importance of using a standardised alcohol-based hand rub formulation in the era of COVID-19.

OBJECTIVES: Hand sanitisers are urgently needed in the time of COVID-19, and as a result of shortages, some people have resorted to making their own formulations, including the repurposing of distilleries. We wish to highlight the importance of those producing hand sanitisers to avoid methylated spirits containing methanol and to follow WHO recommended formulations. METHODS: We explore and discuss reports of methanol toxicity through ingestion and transdermal absorption. We discuss the WHO formulations and explain the rationale behind the chosen ingredients. SHORT CONCLUSION: We advise those producing hand sanitisers to follow WHO recommended formulations, and advise those producing hand sanitisers using methylated spirits, to avoid formulations which contain methanol.

Para quem não pode ficar em casa, que cuidados devem ser tomados? [libras]

"COVID - 19: Perguntas e respostas" é resultado de uma parceria entre o Laboratório Aberto de Interatividade para a Disseminação do Conhecimento Científico e Tecnológico (LAbI), o Laboratório de Tradução Audiovisual da Língua de Sinais (LATRAVILIS) e o projeto InformaSUS, todos vinculados à Universidade Federal de São Carlos (UFSCar).

Quais são os cuidados específicos com grávidas e recém-nascidos? [libras]

"COVID - 19: Perguntas e respostas" é resultado de uma parceria entre o Laboratório Aberto de Interatividade para a Disseminação do Conhecimento Científico e Tecnológico (LAbI), o Laboratório de Tradução Audiovisual da Língua de Sinais (LATRAVILIS) e o projeto InformaSUS, todos vinculados à Universidade Federal de São Carlos (UFSCar).

Que cuidados precisamos tomar ao usar o álcool em gel? [libras]

"COVID - 19: Perguntas e respostas" é resultado de uma parceria entre o Laboratório Aberto de Interatividade para a Disseminação do Conhecimento Científico e Tecnológico (LAbI), o Laboratório de Tradução Audiovisual da Língua de Sinais (LATRAVILIS) e o projeto InformaSUS, todos vinculados à Universidade Federal de São Carlos (UFSCar).

Como é transmitida a COVID-19? [libras]

"COVID - 19: Perguntas e respostas" é resultado de uma parceria entre o Laboratório Aberto de Interatividade para a Disseminação do Conhecimento Científico e Tecnológico (LAbI), o Laboratório de Tradução Audiovisual da Língua de Sinais (LATRAVILIS) e o projeto InformaSUS, todos vinculados à Universidade Federal de São Carlos (UFSCar).

Prevenção ao coronavírus

Vamos falar de prevenção? A Covid-19, doença causada pelo novo coronavírus, tem como sintomas a tosse, febre e dificuldade para respirar, caso a pessoa tenha viajado ou tenha tido acesso aos locais de transmissão, 14 dias antes do início desses sintomas aparecerem. Nesse vídeo, o nosso médico infectologista da Covisa (Vigilância em Saúde) ensina como você deve lavar as mãos corretamente para se prevenir.