The effectiveness of simulation-based training on KAU hospital housekeeping staff performance.

BACKGROUND: Hospital Housekeeping staff play a key role in maintaining safe and clean environments to prevent infection and its spread in hospital. Innovative training approaches are necessary for this category; especially since their educational level is below average. Simulation based training can be a valuable tool for them in health care sector. However, no studies have explored the impact of simulation-based training on housekeeping staff performance, which is the focus of this study. OBJECTIVE: This research focuses on exploring the effectiveness of simulation-based training for Hospital Housekeeping Staff. METHODS: The study used pre-post training data from 124 housekeeping staff in different work areas at KAUH to measure the effectiveness of the program on their performance. The training includes five segments: General Knowledge training, Personal Protective Equipment, Hand Hygiene, Cleaning Biological Materials, and Terminal Cleaning. The study incorporated a two-sample paired T-test, One-Way ANOVA to detect differences in mean performance pre-and post-training and between groups in terms of gender and work area. RESULTS: Study results show a significant improvement in housekeeping staff performance after the training, where the performance measure of GK was improved by 33%, PPE 42%, HH 53%, Biological Spill Kit is 64%, and terminal cleaning 11% However, there is no significant difference in performance improvements in all stations in regards of gender and work area except for the Biological Spill Kit in terms of the work area. CONCLUSION: Results show the effectiveness of training as there are statistically significant differences in housekeeping staff mean performance pre-and post-training. The simulation-based training changed the behavior of the cleaners, as they became more confident and understanding in performing their work. Expanding the use of simulation as a basis for training this important group and further study is recommended.

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.

Portación nasal de Staphylococcus aureus en el personal de salud de áreas críticas de un Hospital Pediátrico durante julio-setiembre 2018 / Nasal carriage of Staphylococcus aureus in health personnel in critical areas of a Pediatric Hospital during July-September 2018 / Transporte nasal de Staphylococcus aureus em profissionais de saúde em áreas críticas de um Hospital Pediátrico durante julho-setembro de 2018

Las infecciones intrahospitalarias (IIH) son causa de elevada morbimortalidad y representan un problema sanitario importante. El personal de salud es reservorio y potencial transmisor de los agentes etiológicos de las mismas. S. aureus es uno de los microorganismos implicados, por lo tanto es importante conocer la frecuencia de portación en el personal de salud y establecer el perfil de susceptibilidad antimicrobiana para contribuir con la elaboración de medidas de prevención incluyendo actividades educativas. Objetivo: Conocer la frecuencia de portación de S. aureus, distribución y antibiotipos de las cepas presentes en el personal sanitario del Hospital Pediátrico de Referencia (HPR). Materiales y métodos: Se realizó un estudio descriptivo durante el periodo julio-setiembre del año 2018. Se incluyeron muestras de hisopados nasales de trabajadores de la salud de distintas áreas de internación que consintieron participar en el estudio. Se excluyeron aquellos que recibieron antibióticos dentro de los 3 meses previos al estudio. Las muestras fueron sembradas en agar sangre ovina al 5% (ASO) y se incubaron a 35-37ºC en aerobiosis por 24-48 horas. La identificación de las colonias sospechosas de Staphylococcus aureus por métodos convencionales y MALDI-TOF. El patrón de resistencia antimicrobiana de S. aureus se detectó por disco-difusión. En los cultivos resistentes a meticilina (SAMR) se determinó la presencia del gen mecA y se realizó la tipificación del SCCmec por pruebas de reacción en cadena de polimerasa. Resultados: Se obtuvieron 225 hisopados a partir de 225 trabajadores, presentaron desarrollo 212. En 49 se recuperaron cultivos de S. aureus. Correspondieron a SAMR 11 de las 49 cepas, todas portaban el gen mecA. Hubo predominio en el personal de enfermería (7/11), en los servicios de hemato-oncología (3/11) y cuidados intensivos neonatales (4/11). Asociaron resistencia a macrólidos y clindamicina 8 de 11 aislamientos SAMR, a gentamicina 2 y a mupirocina uno. El SCCmec más frecuentemente identificado fue el tipo IV (7/11). Conclusiones: Los resultados muestran la presencia de cepas SAMR entre el personal de salud del CHPR y aportan información complementaria para efectuar prevención y control de las IIH, actuando sobre todo en el personal de salud encargado de la atención de pacientes susceptibles.

Hospital-acquired infections (IIH) are a cause of high morbidity and mortality and represent a major health problem. Health personnel are reservoirs and potential transmitters of their etiological agents. S. aureus is one of the microorganisms involved, therefore it is important to know the frequency of carriage in health personnel and establish the antimicrobial susceptibility profile to contribute to the development of prevention measures, including educational activities. Objective: To know the frequency of carriage of S. aureus, distribution and antibiotypes of the strains present in the health personnel of the Reference Pediatric Hospital (HPR). Materials and methods: A descriptive study was carried out during the period July-September 2018. Nasal swab samples from health workers from different hospitalization areas who agreed to participate in the study were included. Those who received antibiotics within 3 months prior to the study were excluded. The samples were seeded in 5% sheep blood agar (ASO) and incubated at 35-37ºC in aerobiosis for 24-48 hours. Identification of suspicious Staphylococcus aureus colonies by conventional methods and MALDI-TOF. The antimicrobial resistance pattern of S. aureus was detected by disc diffusion. In methicillin-resistant cultures (MRSA), the presence of the mecA gene was determined and SCCmec was typified by polymerase chain reaction tests. Results: 225 swabs were obtained from 225 workers, 212 showed development. S. aureus cultures were recovered from 49. 11 of the 49 strains corresponded to MRSA, all of them carried the mecA gene. There was a predominance in the nursing staff (7/11), in the hematology-oncology services (3/11) and neonatal intensive care (4/11). They associated resistance to macrolides and clindamycin in 8 of 11 MRSA isolates, 2 to gentamicin, and 1 to mupirocin. The most frequently identified SCCmec was type IV (7/11). Conclusions: The results show the presence of MRSA strains among the health personnel of the CHPR and provide complementary information to carry out prevention and control of IIH, acting especially on the health personnel in charge of the care of susceptible patients.

As infecções hospitalares (HII) são causa de alta morbidade e mortalidade e representam um importante problema de saúde. Os profissionais de saúde são reservatórios e potenciais transmissores de seus agentes etiológicos. O S. aureus é um dos micro-organismos envolvidos, por isso é importante conhecer a frequência de portadores em profissionais de saúde e estabelecer o perfil de suscetibilidade antimicrobiana para contribuir no desenvolvimento de medidas de prevenção incluindo atividades educativas. Objetivo: Conhecer a frequência de portadores de S. aureus, distribuição e antibiótipos das cepas presentes no pessoal de saúde do Hospital Pediátrico de Referência (HPR). Materiais e métodos: Foi realizado um estudo descritivo durante o período de julho a setembro de 2018. Foram incluídas amostras de swab nasal de profissionais de saúde de diferentes áreas de internação que concordaram em participar do estudo. Aqueles que receberam antibióticos nos 3 meses anteriores ao estudo foram excluídos. As amostras foram semeadas em 5% de ágar sangue de carneiro (ASO) e incubadas a 35-37ºC em aerobiose por 24-48 horas. Identificação de colônias suspeitas de Staphylococcus aureus por métodos convencionais e MALDI-TOF. O padrão de resistência antimicrobiana de S. aureus foi detectado por difusão em disco. Em culturas resistentes à meticilina (MRSA), a presença do gene mecA foi determinada e SCCmec foi tipificado por testes de reação em cadeia da polimerase. Resultados: 225 swabs foram obtidos de 225 trabalhadores, 212 apresentaram desenvolvimento. Culturas de S. aureus foram recuperadas de 49. 11 das 49 cepas correspondiam a MRSA, todas carregavam o gene mecA. Houve predominância na equipe de enfermagem (7/11), nos serviços de hematologia-oncologia (3/11) e de terapia intensiva neonatal (4/11). Eles associaram resistência a macrolídeos e clindamicina em 8 de 11 isolados de MRSA, 2 à gentamicina e 1 à mupirocina. O SCCmec mais frequentemente identificado foi o tipo IV (7/11). Conclusões: Os resultados mostram a presença de cepas de MRSA entre os profissionais de saúde do CHPR e fornecem informações complementares para realizar a prevenção e controle da HII, atuando principalmente sobre os profissionais de saúde responsáveis ​​pelo atendimento de pacientes suscetíveis.

The efficiency of cleaning in intensive care units: A systematic review / Eficacia de la limpieza en las unidades de cuidados intensivos: revisión sistemática

Objectives: This review aims to analyze the studies on cleaning practices and the efficiency of the cleaning carried out in environments that have a great risk of resistant microorganism infection, such as intensive care units.Methods: In this study, a retrospective literature review was undertaken of the relevant publications between the years 2005 and 2020, using the keywords “Cross Infection, Infection Control, Multidrug-Resistant Bacteria, Intensive Care, Room Cleaning, Environmental Cleaning, Hospital-Associated Infection”; using the international databases Pubmed, CINAHL and EBSCO and domestic database ULAKBIM on search engines. Titles and abstracts of all relevant articles found on electronic searches were reviewed by the researchers independently. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline and Patient, Intervention, Comparison, Outcomes, Study design model were used in analysing the studies.Results: The selected studies were reviewed in four main categories: Materials used in cleaning, the period between taking environmental samples, cleaning methods, and the efficiency of cleaning. Among the studies included herein, eight were randomized controlled trials, three were retrospective intervention studies, two were case-control studies and one was a retrospective cohort study.Conclusions: Today, the assessment of cleaning in environments can be evaluated by different methods, but there are advantages and disadvantages of these methods. Therefore, in the relevant literature, it is suggested that cleaning must be evaluated by several methods, not only one. Also, training the staff that carries out the cleaning and rewarding correct behavior by giving feedback are important approaches to increase the efficiency of cleaning. It is suggested that cleaning must be carried out every day, regularly with effective methods and equipment; frequency of cleaning during epidemics must be increased, institutions

Objetivos: El objetivo de esta revisión es analizar los estudios sobre la práctica y la eficacia de la limpieza realizada en entornos con alto riesgo de infección por microorganismos resistentes, tales como las unidades de cuidados intensivos.Métodos: En este estudio se realizó una revisión retrospectiva de la literatura dentro de las publicaciones relacionadas entre los años 2005 y 2020, utilizando palabras clave tales como cross infection, infection control, multidrug-resistant bacteria, intensive care, room cleaning, environmental cleaning, hospital-associated infection (infección cruzada, control de infecciones, bacterias multirresistenes a los fármacos, cuidados intensivos, limpieza de habitaciones, limpieza ambiental, infección adquirida en los hospitales), utilizando bases de datos internacionales tales como Pubmed, CINAHL y EBSCO, y la base de datos nacional ULAKBIM en los motores de búsqueda. Los títulos y resúmenes de todos los artículos relacionados seleccionados en las búsquedas electrónicas fueron revisados por investigadores de manera independiente. Se utilizaron las directrices de The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols y el modelo del diseño Patient, Intervention, Comparison, Outcomes, Study para analizar los estudios.Resultados: Se revisaron los estudios seleccionados en 4 categorías principales: materiales utilizados en la limpieza, periodo transcurrido entre las tomas de muestras ambientales, métodos de limpieza y eficacia de la limpieza. Entre los estudios incluidos en la revisión 8 eran ensayos controlados aleatorizados, 3 eran estudios retrospectivos de intervención, 2 eran estudios de control de casos y uno era un estudio retrospectivo de cohorte.

Autoestima de trabalhadores terceirizados do setor de conservação de higiene e limpeza de hospitais privados / Self-esteem of outsourced workers in the hygiene conservation and cleaning sector of private hospitals

No Brasil, o setor hospitalar vem utilizando de forma progressiva a terceirização dos seus serviços, ou seja, a contratação de agentes terceiros para suprir a sua força de trabalho, visando redução de custos e melhora da competitividade no mercado. Este estudo tem por objetivo analisar a autoestima de trabalhadores terceirizados de serviços de higiene e limpeza em instituições hospitalares privadas. Trata-se de pesquisa do tipo exploratória, descritiva, de abordagem qualitativa dos dados, tendo como cenário duas instituições hospitalares privadas que possuem serviços de conservação de limpeza e higiene de uma cidade no interior de Minas Gerais, classificadas como pertencentes ao grupo III segundo a Portaria nº. 82/2014 do Ministério da Saúde. Os participantes foram trabalhadores terceirizados dos serviços de higiene e limpeza que atuam nas instituições hospitalares selecionadas. Para a coleta de dados foram utilizados dois roteiros: questionário de identificação de dados sociodemográficos elaborado pela pesquisadora, apresentando tempo de preenchimento de no máximo cinco minutos; entrevista semiestruturada individual com questões sobre a sua autoestima, com duração aproximada de 20 a 30 minutos. As entrevistas ocorreram em local arejado, limpo e seco; foram gravadas, posteriormente transcritas e feita análise temática indutiva dos dados. Em virtude da Pandemia COVID19, a pesquisadora realizou a coleta de dados individualmente, seguindo protocolo das instituições. A amostra do estudo constitui-se de 15 trabalhadores. Observou-se a prevalência do sexo feminino e a idade média foi de 41 anos, variando entre 24 e 60 anos de idade. Quanto à escolaridade, duas pessoas (13,3%) dos trabalhadores afirmaram ter ensino fundamental completo, sete pessoas (46,7%) têm ensino fundamental incompleto. Quanto ao tempo de serviço, foi constatado que seis trabalhadores (40%) atuam há mais de cinco anos na função, o que evidencia uma população experiente. No que se refere ao tempo de atuação no local de trabalho, três (20%) trabalhadores tem menos de um ano e nove (60%), está entre um a cinco anos no trabalho, demonstrando elevado índice de rotatividade no serviço. A análise dos dados permitiu identificar aspectos positivos do trabalho relacionados a autoestima como satisfação pessoal e profissional, horários flexíveis, benefícios, ambiente de trabalho e relacionamento com colegas e chefia. Os dados também revelaram aspectos limitantes podendo afetar de forma negativa a autoestima do trabalhador e levando a insatisfação, tais como o acúmulo de funções assistenciais pelo número reduzido de trabalhadores. A pesquisa auxilia para o avanço da ciência e conhecimento, uma vez que agrega aspectos relacionados a autoestima de trabalhadores terceirizados de serviços de higiene e limpeza em instituições hospitalares privadas. O estudo contribui para provocar a reflexão de gestores do serviço de limpeza de hospitais quanto à importância de garantir condições que favoreçam a diminuição da exposição dos trabalhadores às cargas de trabalho referentes a mudanças que aconteçam, internas e externas, bem como promover ações educativas e coletivas relacionadas à adequação do ambiente laboral e das práticas de trabalho realizadas neste contexto

In Brazil, the hospital sector has been progressively using the outsourcing of its services, i.e., hiring third-party agents to supply its workforce, aiming to reduce costs and improve market competitiveness. This study aims to analyze the self-esteem of outsourced workers of hygiene and cleaning services in private hospital institutions. This is descriptive exploratory research with a qualitative approach to data, having as scenario two private hospital institutions that have cleaning and hygiene conservation services of a city in the interior of Minas Gerais, classified as belonging to group III according to Ordinance No. 82/2014 of the Ministry of Health. Participants were outsourced workers of hygiene and cleaning services who work in the selected hospital institutions. For data collection, two scripts were used: a questionnaire to identify social demographic data prepared by the researcher, with a maximum of five minutes to be filled out; and an individual semi-structured interview with questions about self-esteem, lasting approximately 20 to 30 minutes. The interviews took place in a ventilated, clean, and dry place; they were recorded, later transcribed, and an inductive thematic analysis was made of the data. Because of the COVID19 pandemic, the researcher collected the data individually, following the protocol of the institutions. The study sample consisted of fifteen workers from the hygiene and cleaning service of the selected hospital institutions. It was observed the prevalence of the female gender and the average age was 41, ranging from 24 to 60 years old. As for education, 02 people (13.3%) of workers said they had completed elementary school and 07 people (46.7%) had incomplete elementary school. As for the length of service, it was found that six workers (40%) have been working for more than five years, which shows an experienced population. With regard to working time in the workplace, three (20%) workers have less than one year and nine (60%) have been working for one to five years, demonstrating a high rate of turnover in the service. Data analysis allowed us to identify positive aspects of work related to self-esteem such as personal and professional satisfaction, flexible hours, benefits, work environment and relationship with colleagues and management.The data also revealed limiting aspects that can negatively affect the worker's self-esteem and lead to dissatisfaction, such as the accumulation of care functions by the reduced number of workers.The research helps to advance science and knowledge, as it adds aspects related to the self-esteem of outsourced workers in hygiene and cleaning services in private hospitals. The study contributes to provoking the reflection of hospital cleaning service managers regarding the importance of ensuring conditions that favor the reduction of workers' exposure to workloads related to changes that happen, internal and external, as well as promoting educational and collective actions. related to the adequacy of the work environment and work practices carried out in this context

Avaliação dos processos de higienização hospitalar através do lean healthcare: estratégias para segurança e qualidade do cuidado em saúde / Evaluation of Hospital hygiene processes through Lean Healthcare: strategies for safety and quality of health care

Este estudo teve o objetivo de indicar estratégias de melhoria contínua dos processos de higienização de superfícies hospitalares de uma unidade de terapia intensiva através de abordagem Lean Healthcare. É um estudo de caráter exploratório, descritivo, observacional, em que a coleta de dados ocorreu no período de julho de 2021 a janeiro de 2022 por observações in loco e entrevistas com cinco profissionais do serviço de higienização. Utilizaram-se as ferramentas: Gemba, mapeamento de fluxo de valor e diagrama do espaguete adaptado, árvore da realidade atual (ARA), Matriz GUT, Matriz de esforço impacto e 5W2H, para levantar, analisar problemas e propor intervenções para futuras melhorias. Como indicador de qualidade do processo optou-se pelo uso de marcadores fluorescentes com análise de 10 higienizações terminais. Para tratamento dos dados utilizou-se o software Miro®, o Excel® e uma planta física projetada da área. Atendeu parcialmente às diretrizes SQUIRE 2.0 através do uso de ferramentas Lean com foco na melhoria da qualidade, segurança e cuidados em saúde. Identificou-se o uso inadequado de desinfetante e de equipamento de proteção individual, manejo incorreto de perfurocortante, além da ordem, técnica e movimentos incorretos. O percentual do indicador completo/correto do processo de higienização terminal foi de 70%. Além disso, o teste do marcador fluorescente demonstrou apenas 33% de conformidade da limpeza, concluindo que não houve padrão em nenhuma higienização terminal observada. Além disso, identificou-se inadequações que comprometeram a qualidade do processo de limpeza e desinfecção de leitos, o que é uma premissa básica para otimização do trabalho e sustentabilidade institucional. Nesse contexto, os resultados sumarizados neste estudo demonstraram que a utilização das ferramentas Lean contribuiu para a proposição de intervenções objetivas baseadas nos reais problemas identificados e analisados.

This study aimed to adjust strategies for continuous improvement of hospital equipment management processes in an intensive care unit through Lean Healthcare approch. It is exploratory, descriptive, observational in which data collection took place from July 2021 to January 2022 through on-site observations and interviews with five professionals from the hygiene service. Use as tools: Gemba, value mapping and adapted flow flow, current reality tree (ARA), GUT Matrix, Impact Effort Matrix and 5W2H, to raise, analyze problems and propose interventions for future improvements. As an indicator of process quality, we chose to use fluorescent indicators with analysis of 10 cleaning terminals. To use Miro® software, Excel® and an area data treatment plant. Attended health services. Inadequate use of disinfectant and personal protective equipment, inadequate sharps, in addition to incorrect order, techniques and movements were identified. The percentage of the indicator/correct in the evaluation process of the complete terminal was 70%. In addition, the fluorescent marker test is only 33% cleaning compliance, concluding that there was no pattern in any terminal cleaning observed. In addition, the necessary adaptations to guarantee the sustainability and quality of the bed cleaning process, which is basic for the optimization of work and institutional infection. In these summaries, in this study, the results are calculated and the use of Lean tools designed to propose objective interventions in real problems and estimates.

Accidentes laborales del personal de limpieza en el servicio de Urgencias, Hospital Clínico Viedma, tercer trimestre 2021 / Occupational accidents of cleaning staff in the Emergency Department, Viedma Clinical Hospital, third quarter 2021

El accidente de trabajo es un hecho repentino relacionado con las actividades laborales, provocando al trabajador daño, enfermedad o muerte. Cuando no ocasiona lesión se habla de un incidente, ya que casi siempre el hecho de ocurrir la lesión es algo fortuito. El sector salud, no está exento de la posibilidad de sufrir una enfermedad por accidente por diversas causas ya sea mediante el contagio de un agente patógeno o un daño accidental. Los objetos punzocortantes constituyen probablemente el mayor riesgo ocupacional en los manipuladores de desechos, por el daño que pueden causar y la transmisión de enfermedades.La presente investigación se realizó para describir las acciones que realiza el personal de limpieza ante un accidente laboral. El trabajo tuvo un abordaje cuantitativo de tipo descriptivo, transversal, prospectivo y retrospectivo, tomando como muestra 12 personas que trabajan en el servicio de emergencias del Hospital Clínico Viedma, gestión 2021.Los resultados más significativos muestran el 67 % del personal de limpieza sufrió accidentes como golpes, seguido de un 58 % con exposición a fluidos corporales da a conocer que es un riesgo elevado que va relacionado con la mala manipulación de residuos infecciosos por parte del personal de salud, por tanto, podrían desarrollar enfermedades como VIH. (AU)

Higiene e conduta: ambiente / Hygiene and conduct: environment

Esta Norma Técnica tem por objetivo estabelecer as condições de higiene e conduta dos ambientes de Bancos de Leite Humano e de Postos de Coleta de Leite Humano, visando a garantia da qualidade nestes serviços e sua certificação.

Ambiência: limpeza e desinfecção de ambientes / Environment: cleaning and ambience disinfection

Esta Norma Técnica tem por objetivo estabelecer as condições para limpeza e desinfecção de ambientes em Bancos de Leite Humano e Postos de Coleta de Leite Humano, visando a garantia da qualidade nestes serviços e sua certificação

Evaluation of the environmental contamination and exposure risk in medical/non-medical staff after oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy.

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a technique to directly deliver chemotherapeutic drugs in the abdomen for the treatment of peritoneal metastases. Pressurization improves the treatment efficacy but increases the risk of exposure for the medical/non-medical staff who can be exposed by dermal or ocular contact, or inhalation of aerosols containing the cytotoxic drugs. The aim of this study was to evaluate the risk of exposure for the medical/non-medical staff (nurses, surgeons, anaesthesiologists and cleaning personnel; n = 13) during PIPAC with oxaliplatin performed according to the protocol recommended in France. Blood samples were collected 1 h before and immediately after PIPAC, and urine samples 1 h before, and then 3 h and the morning after PIPAC. In the control, non-exposed group (n = 7), only one urine and blood sample were collected. Surface contamination in the operating room was assessed in water- and Surfanios-impregnated wipe samples. The total elemental platinum in each sample was quantified by inductively coupled plasma mass spectrometry, using a method adapted to quantify trace amounts (ng.L-1) in very low volumes (100 µl). No surface contamination was detected. Although 25% of urine samples in the exposed group contained platinum, no statistical difference was observed in urine and plasma samples collected before and after PIPAC and with the control group samples. These findings suggest that the French PIPAC protocol does not increase the risk of exposure to platinum in all staff categories involved. This protocol could be considered in future occupational policies and consensus statements. Trial registration: NCT04014426.

Comparing visual inspection and performance observation for evaluation of hospital cleanliness.

BACKGROUND: Environmental cleaning is an effective measure to prevent infections. However, performance observation has been rarely delineated. This study aimed to compare correlations among visual inspection, performance observation, and effectiveness by using adenosine triphosphate bioluminescence (ATP bioluminescence) as a comparator to find out which method is better to assess hospital cleanliness. METHODS: This prospective study was conducted at a medical center from April 2019 to October 2020. Seven high-touch surfaces were evaluated during and after terminal cleaning by performance observation, visual inspection, and ATP bioluminescence. RESULTS: The scores by performance observation, visual inspection, and ATP were 55.4%, 87.5%, and 26.6% after cleaning. The correlations between performance observation and visual inspection and between performance observation and ATP interpretation were weak positive (φ = 0.300, 0.324, P < .001). No correlation was between the visual inspection and ATP interpretation (φ=0.137). The median of ATP readings was lower in "compliant" group by performance observation and "clean" group by visual inspection than "not compliant" group and "not clean" group (P < .001). CONCLUSIONS: Performance observation combined with ATP would be preferred to include to audit cleanliness on high-risk surfaces. Visual inspection would be a rapid and time-saving assessment tool on low-risk surfaces.

Hepatitis B virus infection and its associated factors among medical waste collectors at public health facilities in eastern Ethiopia: a facility-based cross-sectional study.

BACKGROUND: The risk of hepatitis B virus infection among medical waste handlers who undergo collection, transportation, and disposal of medical wastes in the health institutions is higher due to frequent exposure to contaminated blood and other body fluids. There is limited evidence on the seroprevalence of hepatitis B among medical waste handlers in eastern Ethiopia. The study was aimed at studying the seroprevalence of Hepatitis B Virus and associated risk factors among medical waste collectors at health facilities of eastern Ethiopia. METHODS: A facility-based cross-sectional study was conducted among randomly selected medical waste collectors from public health facilities in eastern Ethiopia from March to June 2018. A pre-tested and well-structured questionnaire was used to collect data on socio-demographic characteristics and hepatitis B infection risk factors. A2.5ml venous blood was also collected, centrifuged and the serum was analyzed for hepatitis B surface antigen using the instant hepatitis B surface antigen kit. Descriptive summary measures were done. Chi-square and Fisher exact tests were used to assess the risk of association. Multivariate logistic regression was conducted with 95% CI and all value at P-value < 0.05 was declared statistically significant. RESULTS: From a total of 260 (97.38%) medical waste collectors participated, HBV was detected in 53 (20.4%) of the participants [95%CI; 15.8, 25.6]. No significant differences were observed in the detection rates of HBV with respect to socio-demographic characteristics. In both bivariate and multivariable logistic regression analysis, being unvaccinated (AOR = 6.35; 95%CI = [2.53-15.96], P = 0.001), history of blood transfusion (receiving) (AOR; 3.54; 95%CI; [1.02-12.24], P = 0.046), history of tattooing (AOR = 2.86; 95%CI = [1.12-7.27], p = 0.03), and history of multiple sexual partner (AOR = 10.28; 95%CI = [4.16-25.38], P = 0.001) remained statistically significantly associated with HBsAg positivity. CONCLUSION: This cross-sectional study identified that HBV infection is high among medical waste collectors in eastern Ethiopia. Immunization and on job health promotion and disease prevention measures should be considered in order to control the risk of HBV infection among medical waste collectors in eastern Ethiopia.

Evidence-based review of safe theatre practice during the COVID-19 pandemic beyond personal protective equipment.

INTRODUCTION: COVID-19 remains a threat for a fear of a second pandemic. Emergency orthopaedic operations are still among the most commonly performed procedures with increased risk of transmission of SARS CoV-2 to the patients and the healthcare workers. The aim of this study was to present the evidence available into best practices limiting the spread of COVID-19 in healthcare setting during current and future pandemics. METHODS: A review of the literature was performed in multiple databases (PubMed, the Cochrane Library, Google Scholar, World Health Organization and Centers for Disease Control), using 'COVID-19' with other relevant keywords in different combinations. Owing to the limited and heterogenous evidence available, data were presented in a narrative manner. FINDINGS: From the evidence gathered it was noted that a multimodal approach to minimising pathogen transmission is required. This primarily comprises the wider engineering and administrative controls to reduce the concentration of the pathogen and to separate staff and patients from it. Theatre isolation and traffic control bundling, theatre flow and logistics, ventilation and waste management form a pivotal role in the environmental/engineering controls. Administrative measures include policies for both patients and staff. For patients, isolation and preoperative screening are of utmost value. For staff, testing for COVID-19, risk assessment, redeployment and provision of persona; protective equipment, together with the necessary training are important administrative controls. CONCLUSION: We believe these measures are likely to improve the sustainability of resources and can be carried to elective settings in order to return to some form of normality and help to mitigate the effects of future pandemics.