Lifting Universal Masking in Schools - Covid-19 Incidence among Students and Staff.

BACKGROUND: In February 2022, Massachusetts rescinded a statewide universal masking policy in public schools, and many Massachusetts school districts lifted masking requirements during the subsequent weeks. In the greater Boston area, only two school districts - the Boston and neighboring Chelsea districts - sustained masking requirements through June 2022. The staggered lifting of masking requirements provided an opportunity to examine the effect of universal masking policies on the incidence of coronavirus disease 2019 (Covid-19) in schools. METHODS: We used a difference-in-differences analysis for staggered policy implementation to compare the incidence of Covid-19 among students and staff in school districts in the greater Boston area that lifted masking requirements with the incidence in districts that sustained masking requirements during the 2021-2022 school year. Characteristics of the school districts were also compared. RESULTS: Before the statewide masking policy was rescinded, trends in the incidence of Covid-19 were similar across school districts. During the 15 weeks after the statewide masking policy was rescinded, the lifting of masking requirements was associated with an additional 44.9 cases per 1000 students and staff (95% confidence interval, 32.6 to 57.1), which corresponded to an estimated 11,901 cases and to 29.4% of the cases in all districts during that time. Districts that chose to sustain masking requirements longer tended to have school buildings that were older and in worse condition and to have more students per classroom than districts that chose to lift masking requirements earlier. In addition, these districts had higher percentages of low-income students, students with disabilities, and students who were English-language learners, as well as higher percentages of Black and Latinx students and staff. Our results support universal masking as an important strategy for reducing Covid-19 incidence in schools and loss of in-person school days. As such, we believe that universal masking may be especially useful for mitigating effects of structural racism in schools, including potential deepening of educational inequities. CONCLUSIONS: Among school districts in the greater Boston area, the lifting of masking requirements was associated with an additional 44.9 Covid-19 cases per 1000 students and staff during the 15 weeks after the statewide masking policy was rescinded.

Adherence to Public Health Measures Mitigates the Risk of COVID-19 Infection in Older Adults: A Community-Based Study.

OBJECTIVE: To assess the prevalence and characteristics of coronavirus disease 2019 (COVID-19) cases during the reopening period in older adults, given that little is known about the prevalence of COVID-19 after the stay-at-home order was lifted in the United States, nor the actual effects of adherence to recommended public health measures (RPHM) on the risk of COVID-19. PATIENTS AND METHODS: This was a cross-sectional study nested in a parent prospective cohort study, which followed a population-based sample of 2325 adults 50 years and older residing in southeast Minnesota to assess the incidence of viral infections. Participants were instructed to self-collect both nasal and oropharyngeal swabs, which were tested by reverse transcription polymerase chain reaction-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay between May 8, 2020, and June, 30, 2020. We assessed the prevalence of COVID-19 cases and characteristics of study subjects. RESULTS: A total of 1505 eligible subjects participated in the study whose mean age was 68 years, with 885 (59%) women, 32 (2%) racial/ethnic minorities, and 906 (60%) with high-risk conditions for influenza. The prevalence of other Coronaviridae (human coronavirus [HCoV]-229E, HCoV-NL63, and HCoV-OC43) during the 2019 to 2020 flu season was 109 (7%), and none tested positive for SARS-CoV-2. Almost all participants reported adhering to the RPHM (1,488 [99%] for social distancing, 1,438 [96%] for wearing mask in a public space, 1,476 [98%] for hand hygiene, and 1,441 (96%) for staying home mostly). Eighty-six percent of participants resided in a single-family home. CONCLUSION: We did not identify SARS-COV-2 infection in our study cohort. The combination of participants' behavior in following the RPHM and their living environment may considerably mitigate the risk of COVID-19.

Barreras y facilitadores del cumplimiento por parte de los trabajadores sanitarios de las directrices de prevención y control de infecciones para las enfermedades infecciosas respiratorias: una síntesis rápida de pruebas cualitativas / Barriers and facilitators to healthcare workers' adherence with infection prevention and control guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis

¿CUÁL ES EL OBJETIVO DE ESTA REVISIÓN?: Esta revisión es una de una serie de revisiones rápidas que los colaboradores de Cochrane han preparado para informar sobre la pandemia de COVID-19 de 2020. El objetivo de esta revisión Cochrane de investigación cualitativa ("síntesis de pruebas cualitativas") es explorar los factores que influyen en el cumplimiento por parte de los trabajadores sanitarios de las directrices de prevención y control de infecciones (PCI) para las enfermedades infecciosas respiratorias. Para responder a esta pregunta, se buscaron y analizaron estudios cualitativos sobre este tema. MENSAJES CLAVE: Los trabajadores de la salud señalan varios factores que influyen en su capacidad y disposición para seguir las directrices de PCI cuando se trata de enfermedades infecciosas respiratorias. Entre ellos figuran factores relacionados con la propia directriz y la forma en que se comunica, el apoyo de los directivos, la cultura del lugar de trabajo, la capacitación, el espacio físico, el acceso a los equipos de protección personal (EPI) y la confianza en ellos, y el deseo de prestar una buena atención al paciente. El examen también destaca la importancia de incluir a todo el personal de las instalaciones, incluido el personal de apoyo, al aplicar las directrices de PCI. ¿QUÉ SE HA ESTUDIADO EN ESTA REVISIÓN?: Cuando las enfermedades infecciosas respiratorias se generalizan, como durante la pandemia COVID-19, el uso de las estrategias de PCI por parte de los trabajadores sanitarios se hace aún más importante. Estas estrategias incluyen el uso de EPI como mascarillas, protectores faciales, guantes y batas; separar a los pacientes con infecciones respiratorias de los demás; y rutinas de limpieza más estrictas. Explorar la forma en que los trabajadores sanitarios ven y experimentan estas estrategias puede ayudar a las autoridades y a los centros sanitarios a aprender más sobre la mejor forma de apoyar a los trabajadores sanitarios para aplicarlas. ¿CUÁLES SON LOS DESCUBRIMIENTOS PRINCIPALES DE ESTA REVISIÓN?: Se encontraron 36 estudios relevantes y se tomaron muestras de 20 de estos para su análisis. Diez estudios eran de Asia, 4 de África, 4 de América del Norte y 2 de Australia. Los estudios exploraron las opiniones y experiencias de enfermeros, médicos y otros trabajadores de la salud al tratar el SARS, el H1N1, el MERS, la tuberculosis o la gripe estacional. La mayoría de estos trabajadores de la salud trabajaban en hospitales; otros trabajaban en entornos de atención primaria y comunitaria. Esta revisión señaló varios factores que influyeron en el cumplimiento de las pautas de PCI por parte de los trabajadores de la salud. Los siguientes factores se basan en los hallazgos evaluados como de confianza moderada a alta.- Los trabajadores sanitarios se sintieron inseguros cuando las guías locales eran largas, poco claras o no coincidían con las guías nacionales o internacionales.- Podían sentirse abrumados porque las directrices locales cambiaban constantemente.- También describieron como las estrategias de PCI conducían a un aumento de la carga de trabajo y de la fatiga, por ejemplo, porque tenían que utilizar los EPI y asumir una limpieza adicional.- Los trabajadores de la salud describieron cómo sus respuestas a las directrices de PCI se veían afectadas por el nivel de apoyo que sentían que recibían de su equipo directivo.- Se consideró vital una comunicación clara sobre las directrices de PCI.- El personal sanitario señaló la falta de formación sobre la infección en sí misma y sobre cómo utilizar los EPI.- También pensaban que era un problema cuando la formación no era obligatoria.- Tener suficiente espacio para aislar a los pacientes se consideró vital.- Demasiadas pocas habitaciones de aislamiento, antecámaras (pequeñas habitaciones que van de un pasillo a una sala de aislamiento) y duchas fueron un problema.- Otras medidas prácticas importantes descritas por los trabajadores sanitarios incluían la reducción al mínimo de las aglomeraciones de personas, la aceleración de los pacientes infectados, la restricción de las visitas y la facilitación del acceso a las instalaciones para lavarse las manos.- La falta de EPI, o que este fuese de mala calidad, era una preocupación grave para los trabajadores y administradores de la atención de la salud.- También destacaron la necesidad de ajustar la cantidad de suministros a medida que continuaban los brotes de infección.- Los trabajadores de la salud creían que seguían más de cerca la orientación de PCI cuando veían su valor.- Otros trabajadores de la salud se sentían motivados a seguir la guía por temor a infectarse a sí mismos y a sus familias, o porque se sentían responsables de sus pacientes.- Algunos trabajadores de la salud encontraron difícil usar máscaras y otros equipos cuando hacía que los pacientes se sintieran aislados, asustados o estigmatizados.- Los trabajadores sanitarios también encontraron incómodo el uso de máscaras y otros equipos.- La cultura del lugar de trabajo también puede influir en que los trabajadores sanitarios sigan o no las directrices de PCI.- En muchos de los hallazgos, los trabajadores sanitarios señalaron la importancia de incluir a todo el personal, incluido el personal de limpieza, los porteros, el personal de cocina y otro personal de apoyo al implementar las directrices de PCI. ¿CÓMO DE ACTUALIZADA ESTÁ ESTA REVISIÓN?: Se buscaron los estudios que se hubiesen publicado hasta marzo de 2020

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Universal Admission Screening for SARS-CoV-2 Infections among Hospitalized Patients, Switzerland, 2020.

Switzerland began a national lockdown on March 16, 2020, in response to the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We assessed the prevalence of SARS-CoV-2 infection among patients admitted to 4 hospitals in the canton of Zurich, Switzerland, in April 2020. These 4 acute care hospitals screened 2,807 patients, including 2,278 (81.2%) who did not have symptoms of coronavirus disease (COVID-19). Overall, 529 (18.8%) persons had >1 symptom of COVID-19, of whom 60 (11.3%) tested positive for SARS-CoV-2. Eight asymptomatic persons (0.4%) also tested positive for SARS-CoV-2. Our findings indicate that screening on the basis of COVID-19 symptoms, regardless of clinical suspicion, can identify most SARS-CoV-2-positive persons in a low-prevalence setting.

Cumprimento às precauções-padrão por profissionais de enfermagem e fatores associados / Observancia de precauciones estándar por parte de profesionales de enfermería y factores asociados / Compliance with standard precautions by nursing professionals and related factors

Resumo Objetivo Verificar o cumprimento às Precauções-Padrão por profissionais de enfermagem e fatores associados. Método Estudo descritivo, transversal, com 522 profissionais de enfermagem, realizado em dois hospitais brasileiros, entre janeiro de 2017 a março de 2018. Os dados foram coletados por meio de um formulário contendo variáveis demográficas e profissionais e a Compliance with Standard Precautions Scale (versão Português-Brasil); posteriormente, analisados por estatísticas descritivas e exploratórias e um modelo de regressão linear múltiplo. Resultados O escore médio global 12,9 (DP=2,5). Técnicos de enfermagem tiveram escores médios estatisticamente significativos maiores (p <0,01) do que enfermeiros. Houve diferença significativa quanto à categoria profissional (p <0,01) e escolaridade (p <0,01), e, marginalmente significativa em relação à idade (p = 0,06). Não houve diferenças quanto à experiência profissional (p = 077), participação em treinamentos (p = 0,79), tipo de hospital (p = 0,13), respectivamente. A escolaridade não contribuiu para um maior cumprimento às medidas (p <0,01), assim como o ensino superior (p ≤ 0,01). Conclusão e Implicações para a prática O aumento na escolaridade e experiência profissional não contribuiu para maior cumprimento às Precações. Por contemplar aspectos da prática de enfermagem, estratégias de prevenção de exposição ocupacional podem ser revistas e aperfeiçoadas.

Resumen Objetivo Verificar la observancia de las Precauciones Estándar por parte de profesionales de enfermería, y sus factores asociados. Método Estudio descriptivo, transversal, con 522 profesionales de enfermería, realizado en dos hospitales brasileños entre enero de 2017 y marzo de 2018. Datos recolectados mediante formulario incluyendo variables sociodemográficas y profesionales, y Compliance with Standard Precautions Scale (versión Portugués-Brasil); analizados por estadística descriptiva y exploratoria y un modelo de regresión lineal múltiple. Resultados Puntaje medio global de 12,9 (DS=2,5). Los auxiliares de enfermería obtuvieron puntajes promedio mayores, estadísticamente significantes (p<0,01) respecto de los enfermeros. Existió diferencia significante respecto de la categoría profesional (p<0,01) y la escolarización (p<0,01); y marginalmente significante en relación a la edad (p=0,06). No hubo diferencias relativas a la experiencia profesional (p=0,77), participación en capacitaciones (p=0,79) y tipos de hospital (p=0,13). La escolarización no contribuyó a una mayor observancia de las medidas (p<0,01), al igual que los estudios superiores (p≤0,01). Conclusión e Implicaciones para la práctica Mayores grados de escolarización y experiencia profesional no contribuyeron a la observancia de las Precauciones. En razón de contemplar aspectos de la práctica de enfermería, las estrategias de prevención y exposición profesional merecen ser revisadas y perfeccionadas.

Abstract Objective To verify compliance with the Standard Precautions by nursing professionals and associated factors. Method A descriptive, cross-sectional study was carried out with 522 nursing professionals, in two Brazilian hospitals, between January 2017 and March 2018. Data were collected using a form containing demographic and professional variables and the Compliance with Standard Precautions Scale (Portuguese-Brazilian version); later, analyzed by descriptive and exploratory statistics and a multiple linear regression model. Results The global mean score was 12.9 (SD = 2.5). Nursing professionals had statistically significant higher scores (p <0.01) than nurses. There was a significant difference in terms of professional category (p < 0.01)) and education (p <0.01), and marginally significant in relation to age (p = 0.06). There were no differences regarding professional experience (p = 077), participation in training (p = 0.79), and type of hospital (p = 0.13), respectively. Education did not contribute to greater compliance with the measures (p <0.01), nor did higher education (p ≤ 0.01). Conclusion and implications for practice Increased education and professional experience did not contribute to greater compliance with the Standards Precautions. By considering aspects of nursing practice, occupational exposure prevention strategies can be reviewed and improved.

Prevalence and predictors of early COVID-19 behavioral intentions in the United States.

Despite early warnings and calls for action, COVID-19 infection rates continue to climb in many areas of the United States. The current study examined participants' reported likelihood of engaging in eight behaviors designated by the Centers for Disease Control and Prevention as critical for the prevention of COVID-19 at the outset of the epidemic. Self-efficacy, perceived threat, and internal and external health locus of control were explored as potential predictors of those behaviors. In addition, demographic and contextual factors, such as age, gender, political identity, and whether or not participants were currently living under a quarantine advisory, were recorded for analysis. Overall, participants reported high engagement with the prevention behaviors. Higher levels of self-efficacy, perceived severity of the illness, and external locus of control in regard to medical professionals were all positively associated with plans to take the recommended precautions. Based on the results, it appears that messaging regarding COVID-19 prevention may be particularly effective when it focuses on the high risk of the illness, the ease with which the prevention behaviors can be taken, and a reassurance that the medical establishment has individuals' best health in mind when it makes its specific recommendations. While numerous countries have succeeded in reducing the spread of COVID-19, the number of new cases in the United States remains high, even relative to other populations also heavily impacted by the disease [1]. Although it would be difficult to pinpoint a single cause or explanation for the epidemic's course in the USA, at the heart of its spread, like the spread of all infectious diseases, is noncompliance with preventative measures. The current research served as a preliminary exploration of the prevalence and predictors of eight COVID-19 prevention behaviors. A brief survey was sent out at the end of March 2020 to 350 U.S. residents in order to assess the likelihood of their engaging in various prevention behaviors recommended at that time and several related psychosocial factors. The psychological factors assessed included health locus of control (HLOC) beliefs, self-efficacy, and perceived threat. In addition, a handful of demographic and contextual factors, such as age, gender, political identity, and whether or not they were working outside the home or were currently living under a quarantine advisory, were recorded for examination.

Prevalence and Predictors of Anxiety and Depression Symptoms during the COVID-19 Pandemic and Compliance with Precautionary Measures: Age and Sex Matter.

Effective management of the global pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (also known as COVID-19), resulted in the implementation of severe restrictions in movement and enforcement of social distancing measures. This study aimed to understand and characterize the psychosocial effects of the COVID-19 pandemic in the general population and to identify risks and protective factors that predict changes in mental health status. In addition, the study investigated compliance with precautionary measures (PM) to halt the spread of the virus. The online anonymous survey collected information on sociodemographic data, compliance with PM, quality of life (QOL), and mental health via the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). A total of 1642 adult participants (71.6% women, 28.4% men) completed the survey in the European island country, Cyprus. A large percentage (48%) reported significant financial concerns and 66.7% significant changes in their QOL. About 41% reported symptoms associated with mild anxiety; 23.1% reported moderate-severe anxiety symptoms. Concerning depression, 48% reported mild and 9.2% moderate-severe depression symptoms. Women, younger age (18-29), student status, unemployment status, prior psychiatric history, and those reporting greater negative impact on their QOL, were at higher risk for increased anxiety and depression symptoms (p < 0.05). The youngest age group and males also reported lower levels of compliance with PM. Higher compliance with PM predicted lower depression scores (p < 0.001) but higher anxiety for measures related to personal hygiene. The results of this study provide important data on the effects of the COVID-19 outbreak on mental health and QOL and identify a variety of personal and social determinants that serve as risks and protective factors. Furthermore, it has implications for policy makers demonstrating the need for effective mental health programs and guidance for the implementation of PM as a public health strategy.

Nursing in the COVID-19 pandemic and beyond: protecting, saving, supporting and honouring nurses.

As the world tackles the largest public health event in more than a century, the COVID-19 pandemic, the true value of nursing is being seen by politicians and the public. But while nurses are being praised for the vital work they do, many are being put into high-risk situations, and some have died, because of a shortage of appropriate, high-quality personal protective equipment. The International Council of Nurses has called for governments to make the provision of such equipment their number one priority to prevent further loss of life among the nurses caring for the world's most vulnerable patients.

Association between individual, work-related and organizational factors and adherence to standard precautions.

OBJECTIVE: To verify the association between individual, work-related and organizational factors with adherence to standard precautions. METHOD: Cross-sectional study, carried out from January to June 2016 with 602 nursing workers from a university hospital. Ten Likert-type psychometric scales were used, with 57 items, organized in three domains: individual, work-related and organizational factors. Data were analyzed with descriptive and inferential statistics. RESULTS: The adherence to the standard precautions obtained a mean intermediate score (4.30 ± 1.03) and a positive correlation with the Risk Personality Scales (r = 0.136, p <0.0001), Prevention Efficacy (r = 0.109 , p <0.0001), Obstacles to follow the precautions (r = 0.394, p <0.0001), PPE availability (r = 0.189 p <0.0001), Safety Climate (r = 0.325, p <0 , 0001) and Training on Prevention of Occupational Exposure (r = + 0.308, p <0.0001). CONCLUSION: Adherence to standard precautions is associated with individual, work-related, and organizational factors.

Factores impactantes en la adhesión y conocimiento del equipo de enfermería a las precauciones-estándar / Fatores impactantes na adesão e conhecimento da equipe de enfermagem às precauções-padrão / Impacting factors on nursing staff adherence and knowledge of standard precautions

Evaluar la adhesión y conocimiento a las Precauciones Estándar (PE) y el impacto de factores individuales, relativos al trabajo y organizacionales en la adhesión del equipo de enfermería a dichas medidas de seguridad. Estudio transversal, correlacional, descriptivo, por medio de los siguientes instrumentos: cuestionario sociodemográfico, cuestionario de Adhesión a las PE (CAPE), Cuestionario de Conocimiento sobre las PE (CCPE) y ocho escalas referentes a un modelo explicativo de adhesión a las PE. La muestra final se compone de 172 profesionales. El CAPE obtuvo un promedio de 71,94 puntos (DP = 6,40) y el CCPE, 15,44 (DP +/- 1,48). Se verificó una correlación significativa (p≤0,001) entre la adhesión y la personalidad de riesgo, percepción de riesgo, percepción de obstáculos para seguir las PE, entrenamiento y disponibilidad de EPI. Se concluye que los factores psicosociales y organizacionales estuvieron correlacionados con la adhesión. No se encontró significancia estadística del impacto del conocimiento en la adhesión a las PE. Sin embargo, se hace necesario la concienciación del carácter multifacético de la adhesión a las referidas de seguridad, que atraviesan factores individuales, pero también organizacionales y que, por lo tanto, necesitan de implicación directa y permanente de la gestión de las instituciones de salud, por medio de educación en la salud y la infraestructura necesaria para comportamientos seguros

Avaliar a adesão e conhecimento às Precauções-padrão (PP) e o impacto de fatores individuais, relativos ao trabalho e organizacionais na adesão da equipe de enfermagem as referidas medidas de segurança. Estudo transversal, correlacional, descritivo, por meio dos seguintes instrumentos: questionário sociodemográfico, Questionário de Adesão às PP (QAPP), Questionário de Conhecimento sobre as PP (QCPP) e oito escalas referentes a um modelo explicativo de adesão às PP. A amostra final constitui-se de 172 profissionais. O QAPP obteve média de 71,94 pontos (DP = 6,40) e o QCPP, 15,44 (DP+/-1,48). Verificado correlação significativa (p≤0,001) entre a adesão e a personalidade de risco, percepção de risco, percepção de obstáculos para seguir as PP, treinamento e disponibilidade de EPI. Conclui-se os fatores psicossociais e organizacionais estiveram correlacionados à adesão. Não foi encontrada significância estatística do impacto do conhecimento na adesão às PP. No entanto, faz-se necessário a conscientização do caráter multifacetado da adesão às referidas de segurança, que perpassam fatores individuais, mas também organizacionais e que, portanto, necessitam de envolvimento direto e permanente da gestão das instituições de saúde, por meio de educação em saúde e infraestrutura necessária para comportamentos seguros

Assess adherence and knowledge to Standard Precautions (SP) and the impact of individual, work-related and organizational factors on the adherence of the nursing team to the aforementioned safety measures. Cross-sectional, correlational, descriptive study using the following instruments: socio-demographic questionnaire, Standard Precautions Adherence Questionnaire (SPAQ), SP Knowledge Questionnaire (SPKQ) and eight scales referring to an explanatory model of SP adherence. The final sample consisted of 172 professionals. The SPAQ obtained a mean of 71.94 points (SD = 6.40) and the SPKC, 15.44 (SD +/- 1.48). Significant correlation (p≤0.001) between adherence and personality of risk, perception of risk, perception of obstacles to follow SP, training and availability of PPE was verified. We conclude that psychosocial and organizational factors were correlated with adherence. No statistical significance was found for the impact of knowledge on adherence to SP. However, it is necessary to raise awareness of the multifaceted nature of adherence to those referred to as security, which pervade individual but also organizational factors and therefore require direct and permanent involvement of management of health institutions, through education in health and infrastructure needed for safe behavior

Relationship among safety culture, nursing care, and Standard Precautions adherence.

Standard Precautions (SP) are an essential, although unmet, component of nursing care. Understanding conditions fostering the integration of SP within nursing workflow is imperative. This research describes the relationships among patient safety culture, adherence to SP, and missed nursing care.

Standard Precautions Among Emergency Medical Services in Urban and Rural Areas.

Backround: Emergency medical services (EMS) workers are at risk of exposure to bloodborne pathogens and frequently exposed to blood and bodily fluids through percutaneous injuries. This study aimed to assess the consistency with which standard precautions (SPs) among rural and urban EMS providers were used. Methods: This study consisted of a cross-sectional survey conducted with a sample of certified EMS providers in West Virginia in which we ascertained details about sociodemographic characteristics, and the frequency of consistent SP. An email invitation was sent to a comprehensive list of agencies obtained from the Office of West Virginia EMS. Findings: A total of 248 out of 522 (47%) EMS providers completed the survey. The majority of the EMS providers (76%) consistently complied with SPs; however, more than one third (38%) of urban EMS providers indicated inconsistent use compared with 19% of rural EMS providers (p = .002). Most EMS providers reported low prevention practices to exposure of blood and body fluids in both areas. Conclusion/Application to Practice: The results emphasize the need to enhanced safe work practices among EMS providers in both rural and urban areas through education and increasing self-awareness. Occupational health professional in municipalities that serve these workers are instrumental in ensuring these workers are trained and evaluated for their compliance with SPs while in the field.

Association between individual, work-related and organizational factors and adherence to standard precautions / Asociación entre factores individuales, laborales y organizacionales con la adherencia a las precauciones estándar / Associação entre fatores individuais, relativos ao trabalho e organizacionais com a adesão às precauções padrão

ABSTRACT Objective: To verify the association between individual, work-related and organizational factors with adherence to standard precautions. Method: Cross-sectional study, carried out from January to June 2016 with 602 nursing workers from a university hospital. Ten Likert-type psychometric scales were used, with 57 items, organized in three domains: individual, work-related and organizational factors. Data were analyzed with descriptive and inferential statistics. Results: The adherence to the standard precautions obtained a mean intermediate score (4.30 ± 1.03) and a positive correlation with the Risk Personality Scales (r = 0.136, p <0.0001), Prevention Efficacy (r = 0.109 , p <0.0001), Obstacles to follow the precautions (r = 0.394, p <0.0001), PPE availability (r = 0.189 p <0.0001), Safety Climate (r = 0.325, p <0 , 0001) and Training on Prevention of Occupational Exposure (r = + 0.308, p <0.0001). Conclusion: Adherence to standard precautions is associated with individual, work-related, and organizational factors.

RESUMEN Objetivo: Verificar la asociación entre los factores individuales, relacionados con el trabajo y organizacionales con el cumplimiento de las precauciones estándar. Método: Estudio transversal, realizado de enero a junio de 2016 con 602 trabajadores de enfermería de un hospital universitario. Se utilizaron diez escalas psicométricas tipo Likert, con 57 ítems, organizados en tres dominios: individual, relacionado con el trabajo y factores organizativos. Los datos fueron analizados con estadística descriptiva e inferencial. Resultados: La adherencia a las precauciones estándar obtuvo una puntuación media intermedia (4.30 ± 1.03) y una correlación positiva con las Escalas de Personalidad de Riesgo (r = 0.136, p <0.0001), Eficacia de la Prevención (r = 0.109) , p <0.0001), Obstáculos para seguir las precauciones (r = 0.394, p <0.0001), Disponibilidad de PPE (r = 0.189 p <0.0001), Clima de seguridad (r = 0.325, p <0 , 0001) y Capacitación en Prevención de la Exposición Ocupacional (r = + 0.308, p <0.0001). Conclusión: La adherencia a las precauciones estándar está asociada con factores individuales, relacionados con el trabajo y organizativos.

RESUMO Objetivo: Verificar a associação entre fatores individuais, relativos ao trabalho e organizacionais com adesão às precauções-padrão. Método: Estudo transversal, realizado de janeiro a junho de 2016 com 602 trabalhadores de enfermagem de um hospital universitário. Foram utilizadas 10 escalas psicométricas do tipo Likert, com 57 itens, organizadas em três domínios: fatores individuais, relativos ao trabalho e organizacionais. Os dados foram analisados com estatística descritiva e inferencial. Resultados: A adesão às precauções-padrão obteve escore médio intermediário (4,30 ±1,03) e apresentou correlação positiva com as escalas de Personalidade de Risco (r=0,136, p < 0,0001), Eficácia da Prevenção (r=0,109, p < 0,0001), Obstáculos para seguir às precauções (r=0,394, p < 0,0001), Disponibilidade de EPI (r=0,189 p < 0,0001), Clima de Segurança (r=0,325, p < 0,0001) e Treinamento em Prevenção da Exposição Ocupacional (r=+0,308, p < 0,0001). Conclusão: A adesão às precauções padrão está associada a fatores individuais, relacionados ao trabalho e organizacionais.

Association between individual, work-related and organizational factors and adherence to standard precautions / Asociación entre factores individuales, laborales y organizacionales con la adherencia a las precauciones estándar / Associação entre fatores individuais, relativos ao trabalho e organizacionais com a adesão às precauções padrão

ABSTRACT Objective: To verify the association between individual, work-related and organizational factors with adherence to standard precautions. Method: Cross-sectional study, carried out from January to June 2016 with 602 nursing workers from a university hospital. Ten Likert-type psychometric scales were used, with 57 items, organized in three domains: individual, work-related and organizational factors. Data were analyzed with descriptive and inferential statistics. Results: The adherence to the standard precautions obtained a mean intermediate score (4.30 ± 1.03) and a positive correlation with the Risk Personality Scales (r = 0.136, p <0.0001), Prevention Efficacy (r = 0.109 , p <0.0001), Obstacles to follow the precautions (r = 0.394, p <0.0001), PPE availability (r = 0.189 p <0.0001), Safety Climate (r = 0.325, p <0 , 0001) and Training on Prevention of Occupational Exposure (r = + 0.308, p <0.0001). Conclusion: Adherence to standard precautions is associated with individual, work-related, and organizational factors.

RESUMEN Objetivo: Verificar la asociación entre los factores individuales, relacionados con el trabajo y organizacionales con el cumplimiento de las precauciones estándar. Método: Estudio transversal, realizado de enero a junio de 2016 con 602 trabajadores de enfermería de un hospital universitario. Se utilizaron diez escalas psicométricas tipo Likert, con 57 ítems, organizados en tres dominios: individual, relacionado con el trabajo y factores organizativos. Los datos fueron analizados con estadística descriptiva e inferencial. Resultados: La adherencia a las precauciones estándar obtuvo una puntuación media intermedia (4.30 ± 1.03) y una correlación positiva con las Escalas de Personalidad de Riesgo (r = 0.136, p <0.0001), Eficacia de la Prevención (r = 0.109) , p <0.0001), Obstáculos para seguir las precauciones (r = 0.394, p <0.0001), Disponibilidad de PPE (r = 0.189 p <0.0001), Clima de seguridad (r = 0.325, p <0 , 0001) y Capacitación en Prevención de la Exposición Ocupacional (r = + 0.308, p <0.0001). Conclusión: La adherencia a las precauciones estándar está asociada con factores individuales, relacionados con el trabajo y organizativos.

RESUMO Objetivo: Verificar a associação entre fatores individuais, relativos ao trabalho e organizacionais com adesão às precauções-padrão. Método: Estudo transversal, realizado de janeiro a junho de 2016 com 602 trabalhadores de enfermagem de um hospital universitário. Foram utilizadas 10 escalas psicométricas do tipo Likert, com 57 itens, organizadas em três domínios: fatores individuais, relativos ao trabalho e organizacionais. Os dados foram analisados com estatística descritiva e inferencial. Resultados: A adesão às precauções-padrão obteve escore médio intermediário (4,30 ±1,03) e apresentou correlação positiva com as escalas de Personalidade de Risco (r=0,136, p < 0,0001), Eficácia da Prevenção (r=0,109, p < 0,0001), Obstáculos para seguir às precauções (r=0,394, p < 0,0001), Disponibilidade de EPI (r=0,189 p < 0,0001), Clima de Segurança (r=0,325, p < 0,0001) e Treinamento em Prevenção da Exposição Ocupacional (r=+0,308, p < 0,0001). Conclusão: A adesão às precauções padrão está associada a fatores individuais, relacionados ao trabalho e organizacionais.

El uso de mascarillas en la práctica de ejercicio físico de alta intensidad durante la pandemia / Mask use during high impact exercise in the pandemic

OBJETIVO: El uso de mascarillas es una de las medidas de protección ante la pandemia de Covid-19. El tipo de mascarilla y cómo usarla durante la realización de ejercicio físico ha generado controversia. Este trabajo tuvo como objetivo analizar el efecto del uso de mascarillas en la práctica de ejercicio físico de alta intensidad. MÉTODOS: Se realizó una revisión exploratoria consultando las bases de datos PubMed, Scopus, Google Scholar y CUIDEN. RESULTADOS: Se describieron la fisiología respiratoria en reposo, al realizar ejercicio físico intenso y cómo afecta el uso de mascarillas durante el ejercicio físico de alta intensidad, en relación con el intercambio gaseoso. CONCLUSIONES: En caso de ejercicio físico intenso no se aconseja el uso de mascarillas por el efecto potenciador de la PCO2, ya que no permitiría la expulsión completa del CO2 expirado y aumentaría su concentración con el incremento fisiológico de la frecuencia respiratoria propia del ejercicio

OBJECTIVE: The use of masks is one of the measures to protect against the Covid-19 pandemic. The type of mask and how to use it during physical exercise has generated controversy. This work aims to analyse the effect of the use of masks in the practice of high intensity physical exercise. METHODS: An exploratory review was conducted by querying the PubMed, Scopus, Google Scholar and CUIDEN databases. RESULTS: Respiratory physiology at rest and performing intense physical exercise was described, explaining how the use of masks during high-intensity physical exercise affects it in relation to gas exchange. CONCLUSIONS: In case of intense physical exercise, the use of masks is not recommended because of the enhancing effect on PCO2. It would not allow the complete expulsion of the expired CO2 and would increase its concentration, along with the typical increase of the breathing rate during the exercise

Assessment of needle stick and sharp injuries among health care workers in central zone of Tigray, northern Ethiopia.

OBJECTIVE: Accidental occupational injuries to health care workers (HCWs) continue to have a significant problem in the healthcare system. Thus, the aim of this study was to assess prevalence of needle sticks and sharp injury and associated factors among health care workers working in Central Zone Tigray northern Ethiopia. RESULT: The prevalence of needle stick and sharp injury in the past 12 months preceding the study and entire job were 25.9% and 38.5% respectively. Nearly one-third (31%) of the injuries occurred in emergency unit and 122 (71.3%) of the materials caused injury were used on patients. Practice of needle recap, ever used cigarette in last 12 months, training, work hours > 40 per week, job dissatisfaction and work experience less than 5 years were found factors significantly associated with needle stick and sharp injury for health care workers. The magnitude of Needle stick and sharp injury is high in the study area. Policy makers should formulate strategies to improve the working condition for healthcare workers and increase their adherence to universal precautions.

Medidas para la adhesión a las recomendaciones de bioseguridad para el equipo de enfermería / Medidas para adesão às recomendações de biossegurança pela equipe de enfermagem / Measures for the adhesion to biosafety recommendations by the nursing team

Objetivo: Evaluar los conocimientos de las recomendaciones de bioseguridad en profesionales de enfermería en unidades de cuidados intensivos. Método: Cuantitativo, descriptivo y transversal. Se utilizó un cuestionario adaptado para evaluar el seguimiento a las normas de bioseguridad. Resultados: De 145 profesionales de enfermería 88,3%(128) mencionaron que recibieron capacitación sobre bioseguridad. Respecto de la higiene de las manos con agua y jabón, 97,9%(142) informó hacerlo antes/después del contacto con el paciente y antes/después de quitarse los guantes estériles y/o de procedimientos. La mayoría afirmó tener conocimiento sobre el uso de PPE. Destácanse fragilidades en cuanto al conocimiento de las propiedades del alcohol y los riesgos laborales. La principal dificultad señalada para utilización de los PPE fue la falta de disponibilidad de estos equipos en las unidades. Conclusión: La mayoría demostró tener conocimiento sobre bioseguridad. Sin embargo este conocimiento no asegura el cumplimiento de las normas por parte de los profesionales (AU)

Objetivo: Avaliar o conhecimento as recomendações de biossegurança junto aos profissionais de enfermagem em Unidades de Terapia Intensiva. Método: Quantitativo, descritivo e de corte transversal. Utilizou-se questionário adaptado para avaliar a adesão às recomendações de biossegurança. Resultados: Dos 145 profissionais da enfermagem entrevistados, 88,3%(128) afirmaram terem recebido capacitação acerca de biossegurança. Quanto a higienização das mãos (HM) com água e sabão, 97,9%(142) mencionaram realizar este procedimento antes/após o contato com o paciente e antes/após remoção das luvas estéreis ou de procedimentos. Por outro lado, a maioria afirmou ter conhecimento quanto ao uso de EPI. Destaca-se fragilidades ainda nos quesitos conhecimento quanto as propriedades do álcool e riscos ocupacionais. A principal dificuldade apontada para o uso desses equipamentos foi a indisponibilidade na unidade. Conclusão: A maioria dos profissionais de enfermagem demonstrou ter conhecimento sobre biossegurança. No entanto este conhecimento não garante o cumprimento das normas pelos profissionais (AU)

Objective: To evaluate the knowledge on biosafety recommendations among nursing professionals working in Intensive Care Units. Method: This was a quantitative, descriptive, and cross-sectional study. An adapted questionnaire was used to evaluate adherence to biosafety recommendations. Results: Out of the 145 nursing professionals interviewed, 88.3% (128) reported having received training on biosafety. Regarding hand hygiene (HH) with soap and water, 97.9% (142) mentioned performing this procedure before and after contact with patients and before and after removing sterile gloves or executing procedures. The majority claimed to be aware of the use of PPE. Emphasis is given to weaknesses in the knowledge about the properties of alcohol and occupational risks. The main difficulty related to the use of PPE was its unavailability in the unit. Conclusion: The majority of nursing professionals demonstrated having knowledge about biosafety. However, this knowledge does not guarantee compliance to guidelines by professionals (AU)

Comparative study of preparation of hazardous drugs with different closed-system drug transfer devices by means of simulation with fluorescein / Estudio comparativo de preparación de fármacos peligrosos con varias modalidades de sistemas cerrados mediante simulación con fluoresceína

Objectives: The level of environmental contamination generated during preparation and administration of hazardous drugs using different valve closed-systems and their combinations was compared. The actual impact on the overall time of preparation of cytostatics and the economic cost of the different modalities were also compared. Methods: Comparative study of the preparation of fluorescein mixtures with different modalities of valve closed-system combinations. Environmental contamination was detected in critical points of connection, and in splashes produced at any other points. The main variable was qualitative detection of contamination by splashes through ultraviolet light when modalities with or without a connector were compared. A final number of 160 mixtures were prepared to detect differences of at least 5%. Results: Splashes were produced in 7 preparations without a connector (p = 0.015). No significant differences (p = 0.445) were detected either in the use of a supporting vial spike vs an anchoring spike, or in the ChemoCLAVE® system vs valve systems with Fleboflex® solutions. Contamination at any critical point was produced in all preparations. The use of a supporting vial spike, syringe connector and bag solution with Luer connection was the most efficient modality. Conclusions: A syringe connector is needed to guarantee a closed system. Anchoring spikes do not show higher advantages as compared with supporting vial spikes. Fleboflex® solutions with Luer bags are more efficient than ChemoCLAVE® and show similar safety. However, connections of these closed systems are not leak-tight, and it is therefore important to continue studies of contamination of the different closed system transfer devices (AU)

Objetivo: Comparar la contaminación generada durante la elaboración y administración de fármacos peligrosos con diferentes componentes de sistemas cerrados y de manera secundaria, seleccionar el sistema más eficiente. Material y métodos: Estudio comparativo de elaboración de mezclas de fluoresceína con diferentes combinaciones de sistemas cerrados de tipo valvular. Se consideró contaminación ambiental la detectada en los puntos críticos de conexión y las salpicaduras generadas en cualquier otro punto distinto. La variable principal fue la detección cualitativa mediante luz ultravioleta de contaminación por salpicaduras al comparar las modalidades con y sin conector. Se calculó un tamaño muestral de 160 preparaciones por modalidad, para detectar diferencias de al menos un 5%. Resultados: Se produjeron salpicaduras en 7 preparaciones, todas sin conector (p = 0,015). No se encontraron diferencias entre utilizar punzón de apoyo o de anclaje (p = 0,445), ni entre el sistema ChemoCLAVE® vs sistema valvular con sueros Fleboflex®. En todas las preparaciones se produjo contaminación en algún punto crítico. La utilización de punzones de apoyo, conectores y sueros luer se ha identificado como la modalidad más eficiente. Conclusiones: Es importante utilizar el conector de jeringa para que el sistema sea completamente cerrado. El uso de punzones de anclaje no parece presentar ventajas frente a los de apoyo y la combinación con los sueros Fleboflex® presenta una seguridad similar al sistema ChemoCLAVE®. Sin embargo, las conexiones de estos sistemas no son secas y, por tanto, es importante continuar con estudios de contaminación que comparen diferentes sistema (AU)