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1.
J Environ Public Health ; 2021: 6614565, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33564314

RESUMO

Background: Mismanagement of healthcare waste (HCW) during the COVID-19 pandemic can facilitate the transmission of coronavirus. Regarding this problem, there is gap of evidence in Ethiopia, and this study aimed to assess the HCW generation rate and management in Tepi General Hospital, southwest Ethiopia. Methods: Institution-based cross-sectional and case studies were conducted. The total amount of waste generated and its type among various case teams were compared using the Kruskal-Wallis test. Spearman's rank correlation coefficient (r) was used to assess the correlation between the total numbers of patients and the total amount of HCW generated. Qualitative data were transcribed verbatim, translated to English, and analyzed with Open Code version 4.02 software, and content analysis was followed. Results: The total mean weight (±SD) of waste generation rate in all service units of the hospital was 492.5 ± 11.5 kg/day. The higher proportion (61.9%) of the total HCW produced was general waste and the remaining (38.1%) was hazardous waste. There was a statistically significant (X 2 = 82.1, p < 0.001) difference in daily HCW generation rate among different case teams. Similarly, the hospital waste generation amount and total patient flow had a strong positive linear relationship (r = 0.7, p=0.032). COVID-19-related medical wastes were not properly handled, segregated, stored, and disposed. There was a scarcity of resources needed to manage HCW, and available resources were utilized poorly. Overall, healthcare wastes were managed as usual (pre-COVID-19). Conclusion: The mean HCW generation rate in Tepi General Hospital was high. Overall, wastes were mismanaged, and COVID-19-related HCWs have been managed as usual. Availing of important resources and training the concerned bodies should be considered during the crisis of COVID-19.


Assuntos
/epidemiologia , Eliminação de Resíduos de Serviços de Saúde/métodos , Resíduos/análise , /prevenção & controle , Estudos Transversais , Etiópia/epidemiologia , Hospitais Gerais , Humanos , Eliminação de Resíduos de Serviços de Saúde/estatística & dados numéricos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Resíduos/estatística & dados numéricos
2.
Rev Bras Enferm ; 73(suppl 2): e20200260, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32965401

RESUMO

OBJECTIVE: to develop a protocol of recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes. METHOD: a study of experts' recommendations using a structured form applied through the Delphi Technique, obtaining 100% agreement among professionals after four rounds of analysis. The population comprised six nurses members of the Scientific Department of Gerontological Nursing of the Brazilian Association of Nursing (Associação Brasileira de Enfermagem). RESULTS: the protocol was structured in a nucleus of nursing interventions to face the spread of COVID-19 in Nursing Homes, consisting of 8 actions. FINAL CONSIDERATIONS: the protocol can help nurse managers to organize assistance to face the pandemic, which can be adaptable to each reality, making training nurses and health teams easier.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Instituição de Longa Permanência para Idosos , Avaliação em Enfermagem/métodos , Casas de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Idoso , Brasil/epidemiologia , Comunicação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Infecções por Coronavirus/transmissão , Técnica Delfos , Desinfecção/métodos , Desinfecção/normas , Família , Feminino , Enfermagem Geriátrica , Educação em Saúde , Humanos , Masculino , Eliminação de Resíduos de Serviços de Saúde/métodos , Pessoa de Meia-Idade , Práticas Mortuárias/métodos , Avaliação em Enfermagem/organização & administração , Avaliação em Enfermagem/normas , Saúde do Trabalhador , Isolamento de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Pneumonia Viral/transmissão
3.
BMJ Open Respir Res ; 7(1)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32913005

RESUMO

Face masks and respirators are the most widely used intervention measures for respiratory protection. In the wake of COVID-19, in response to shortages and lack of availability of surgical masks and respirators, the use of cloth masks has become a research focus. Various fabrics have been promoted with little evidence-based foundation and without guidelines on design principles for optimal performance. In these circumstances, it is essential to understand the properties, key performance factors, filter mechanisms and evidence on cloth masks materials. The general community might also need to decontaminate and reuse disposable, single-use devices as a last resort. We present an overview of the filter materials, filter mechanisms and effectiveness, key performance factors, and hydrophobicity of the common disposable masks, as well as cloth masks. We also reviewed decontamination methods for disposable respiratory devices. As an alternative to surgical masks and respirators, we recommend a cloth mask made of at least three layers (300-350 threads per inch) and adding a nylon stocking layer over the mask for a better fit. Water-resistant fabrics (polyesters/nylon), blends of fabrics and water-absorbing fabrics (cotton) should be in the outside layer, middle layer/layers and inside layer, respectively. The information outlined here will help people to navigate their choices if facing shortages of appropriate respiratory protection during the COVID-19 pandemic.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus , Descontaminação , Máscaras , Pandemias , Pneumonia Viral , Betacoronavirus/isolamento & purificação , Controle de Doenças Transmissíveis/instrumentação , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Descontaminação/métodos , Descontaminação/normas , Desenho de Equipamento , Humanos , Máscaras/normas , Máscaras/provisão & distribução , Eliminação de Resíduos de Serviços de Saúde/métodos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle
4.
Artigo em Inglês | MEDLINE | ID: mdl-32806570

RESUMO

In response to the emergent public health event of COVID-19, the efficiency of transport of medical waste from hospitals to disposal stations is a worthwhile issue to study. In this paper, based on the actual situation of COVID-19 and environmental impact assessment guidelines, an immune algorithm is used to establish a location model of urban medical waste storage sites. In view of the selection of temporary storage stations and realistic transportation demand, an efficiency-of-transport model of medical waste between hospitals and temporary storage stations is established by using an ant colony-tabu hybrid algorithm. In order to specify such status, Wuhan city in Hubei Province, China-considered the first city to suffer from COVID-19-was chosen as an example of verification; the two-level model and the immune algorithm-ant colony optimization-tabu search (IA-ACO-TS) algorithm were used for simulation and testing, which achieved good verification. To a certain extent, the model and the algorithm are proposed to solve the problem of medical waste disposal, based on transit temporary storage stations, which we are convinced will have far-reaching significance for China and other countries to dispatch medical waste in response to such public health emergencies.


Assuntos
Algoritmos , Infecções por Coronavirus/epidemiologia , Eliminação de Resíduos de Serviços de Saúde/métodos , Pneumonia Viral/epidemiologia , Transportes/métodos , População Urbana , Betacoronavirus , China/epidemiologia , Cidades , Humanos , Pandemias , Saúde Pública , Transportes/normas
6.
Ann Ig ; 32(5): 472-520, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32744582

RESUMO

INTRODUCTION: The health emergency caused by the spread of SARS-COV-2 virus has required the adoption of passive measures against contagion, such as social distancing. The use of filtering masks, of the different types available on the market, such as surgical and facial filtering masks (FFP1, FFP2 and FFP3), is also recommended. OBJECTIVES: The aim of this paper, within the Italian and European regulatory reference framework, is to suggest a rational application of existing methodologies that enable to know and assess the features and/or make a face mask intended to be used by the community. In addition to this, the study aims to provide a correct regulatory framework and useful information for a correct use and disposal of face masks. Another purpose is the assessment of the hygienic, sanitary and regulatory aspects related to the use and disposal of face masks. METHODS: The analysis of filtering masks is based on the review of scientific literature, the state of art of technology and the filtering means/materials available. Reference is made to filtering mechanisms and devices, the testing methods, the technical, manufacturing and performance features, and to the Italian and European regulatory reference framework. Reference is also made to the hygienic, sanitary and regulatory aspects related to the use and disposal of face masks. RESULTS: Surgical masks or, alternatively, filtering masks with a filtration efficiency between 90% and 95% for 3-µm particles, are the most practicable choice with minor contraindications. The reusable type of mask is conceptually superior compared to single-use masks, but cleaning procedures to be followed are quite complex and not always described in a clear way. CONCLUSIONS: The definition of rigorous and repeatable tests on mask filtration capacity, breathability, wearability, duration of use, regeneration, as well as safe disposal methods, are the main way to provide users with correct selection and use criteria. The results must be disclosed and disseminated quickly.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/prevenção & controle , Filtração/instrumentação , Higiene/normas , Máscaras/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Têxteis/normas , Desenho de Equipamento , Europa (Continente) , França , Humanos , Higiene/legislação & jurisprudência , Itália , Máscaras/classificação , Eliminação de Resíduos de Serviços de Saúde/legislação & jurisprudência , Eliminação de Resíduos de Serviços de Saúde/métodos , Eliminação de Resíduos de Serviços de Saúde/normas
7.
PLoS One ; 15(7): e0235982, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32658935

RESUMO

BACKGROUND: Healthcare waste management is the subject of a neglected issue in many developing countries. Health care facilities are facing a major challenge in handling healthcare wastes and reducing their potential risks to human health and the environment. Insufficient understanding of the risk associated with healthcare waste by health workforce can contribute to poor waste management practices. The main aim of this study is to assess risk perception towards healthcare waste among hospital attendants and to identify associated factors. METHODOLOGY: We carried out a cross-sectional hospital-based study among 120 attendants of a private and public hospital in Kathmandu, Nepal. We used two-stage random sampling for the selection of hospital and participants. We conducted a face-to-face interview with the participants using semi-structured questionnaires. Based on the mean score, we classified risk perception as good and poor. Bivariate and multivariate analysis was carried out to determine associates of risk perception towards healthcare waste. RESULTS: Approximately 51.0% of hospital attendants had poor risk perception of healthcare waste. Nearly half of the participants (49.2%) had inadequate knowledge and 43.0% had a negative attitude. Factors such as healthcare waste management training (p = 0.028), housekeeping department (p = 0.036) and attitude (p = 0.001) were associated with risk perception of healthcare waste. CONCLUSION: Hospital attendants had a poor understanding of risk perception of healthcare waste. Periodic training on healthcare waste management and edification on the risk associated with healthcare waste is essential to boost awareness among all healthcare workers. Communication on behavioral improvements for appropriate waste management must be prioritized to change the perception of health workers.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Hospitais/normas , Eliminação de Resíduos de Serviços de Saúde/métodos , Doenças Profissionais/epidemiologia , Medição de Risco/métodos , Gerenciamento de Resíduos/normas , Adulto , Estudos Transversais , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Eliminação de Resíduos de Serviços de Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Nepal/epidemiologia , Inquéritos e Questionários , Adulto Jovem
8.
BMC Public Health ; 20(1): 884, 2020 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-32513139

RESUMO

BACKGROUND: Recent analysis of drinking water in South Africa found the presence of ARVs, other pharmaceutical and personal care products. The environmental and human health risk that this presents is daunting. The increased use of ARVs with poor disposal practices could be the reason for these substances being present in drinking water. Therefore, this study aimed to determine the knowledge and practices of HIV infected patients, regarding medicine disposal. METHOD: A descriptive, cross sectional, quantitative study that utilised a structured, self-administered, questionnaire was undertaken at 3 different public ARV clinics in the eThekwini Metro of KwaZulu Natal, SA. The variables included questions on demographics, knowledge and practices of medicine disposal of ARV and other medications. Data was captured using excel spreadsheets and analysed using SPSS version 25. Chi square tests were used to compare factors between correct and incorrect knowledge and practice groups. RESULTS: Four hundred and eighty four participants agreed to participate in this study, of which the majority (71.1%) were females. Over 87% of the participants knew that improper disposal of medicines were harmful to the environment with only 28.3% knowing that there were laws governing the way medicines should be disposed. Majority of participants that had unused and expired ARVs at home disposed of these medicines. The most common route of medicine disposal for ARVs was by throwing these medicines into the bin (56.4%). Only 24.2% of participants were informed by healthcare professionals about the proper method of medicine disposal. Participants who had secondary and tertiary level of education (p = 0.043) and the ability to speak English (p = 0.001) had appropriate knowledge on medicine disposal. CONCLUSION: This study identified that poor medicine disposal practices and lack of adequate information about the proper methods of medicine disposal were evident among the participant population. There is a need for patient education and healthcare professional intervention to ensure patients are aware of standard proper medicine disposal practices.


Assuntos
Terapia Antirretroviral de Alta Atividade , Conscientização , Conhecimentos, Atitudes e Prática em Saúde , Eliminação de Resíduos de Serviços de Saúde/métodos , Adulto , Estudos Transversais , Armazenamento de Medicamentos/métodos , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Opinião Pública , África do Sul/epidemiologia , Inquéritos e Questionários
9.
Gastroenterol Hepatol ; 43(7): 389-407, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32561216

RESUMO

INTRODUCTION: The COVID-19 pandemic has led to the suspension of programmed activity in most of the Endoscopy Units in our environment. The aim of this document is to facilitate the resumption of elective endoscopic activity in an efficient and safe manner. MATERIAL AND METHODS: A series of questions considered to be of clinical and logistical relevance were formulated. In order to elaborate the answers, a structured bibliographic search was carried out in the main databases and the recommendations of the main Public Health and Digestive Endoscopy institutions were reviewed. The final recommendations were agreed upon through telematic means. RESULTS: A total of 33 recommendations were made. The main aspects discussed are: 1) Reassessment and prioritization of the indication, 2) Restructuring of spaces, schedules and health personnel, 3) Screening for infection, 4) Hygiene measures and personal protective equipment. CONCLUSION: The AEG and SEED recommend restarting endoscopic activity in a phased, safe manner, adapted to local resources and the epidemiological situation of SARS-CoV-2 infection.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Endoscopia Gastrointestinal , Controle de Infecções/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Assistência ao Convalescente , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Desinfecção , Endoscopia Gastrointestinal/efeitos adversos , Endoscopia Gastrointestinal/instrumentação , Contaminação de Equipamentos , Humanos , Higiene , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Eliminação de Resíduos de Serviços de Saúde/métodos , Eliminação de Resíduos de Serviços de Saúde/normas , Oxigenoterapia/instrumentação , Isolamento de Pacientes , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Risco , Fatores de Tempo
10.
Acad Radiol ; 27(8): 1119-1125, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32499157

RESUMO

RATIONALE AND OBJECTIVES: The use of chest computed tomography (CT) in the era of the COVID-19 pandemic raises concern regarding the transmission risks to patients and staff caused by CT room contamination. Meanwhile the Center for Disease Control guidance for air exchange in between patients may heavily impact workflows. To design a portable custom isolation device to reduce imaging equipment contamination during a pandemic. MATERIALS AND METHODS: Center for Disease Control air exchange guidelines and requirements were reviewed. Device functional requirements were outlined and designed. Engineering requirements were reviewed. Methods of practice and risk mitigation plans were outlined including donning and doffing procedures and failure modes. Cost impact was assessed in terms of CT patient throughput. RESULTS: CT air exchange solutions and alternatives were reviewed. Multiple isolation bag device designs were considered. Several designs were custom fabricated, prototyped and reduced to practice. A final design was tested on volunteers for comfort, test-fit, air seal, and breathability. Less than 14 times enhanced patient throughput was estimated, in an ideal setting, which could more than counterbalance the cost of the device itself. CONCLUSION: A novel isolation bag device is feasible for use in CT and might facilitate containment and reduce contamination in radiology departments during the COVID Pandemic.


Assuntos
Infecções por Coronavirus , Equipamentos Descartáveis/normas , Contaminação de Equipamentos/prevenção & controle , Controle de Infecções/métodos , Pandemias , Isolamento de Pacientes , Pneumonia Viral , Tomografia Computadorizada por Raios X/instrumentação , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos de Viabilidade , Pessoal de Saúde , Humanos , Eliminação de Resíduos de Serviços de Saúde/métodos , Pandemias/prevenção & controle , Isolamento de Pacientes/instrumentação , Isolamento de Pacientes/métodos , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Radiografia Torácica/métodos , Tomografia Computadorizada por Raios X/efeitos adversos
11.
Environ Pollut ; 262: 114665, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32443202

RESUMO

Hospitals are important sources of pollutants resulted from diagnostic, laboratory and research activities as well as medicine excretion by patients, which include active component of drugs and metabolite, chemicals, residues of pharmaceuticals, radioactive markers, iodinated contrast media, etc. The discharge of hospital wastes and wastewater, especially those without appropriate treatment would expose the public in danger of infection. In particular, under the Coronavirus Disease 2019 (COVID-19) pandemic context in China, it is of great significance to reduce the health risks to the public and environment. In this study, technologies of different types of hospital wastes and wastewater disinfection have been summarized. Liquid chlorine, sodium hypochlorite, chlorine dioxide, ozone, and ultraviolet irradiation disinfection are commonly used for hospital wastewater disinfection. While incineration, chemical disinfection, and physical disinfection are commonly used for hospital wastes disinfection. In addition, considering the characteristics of various hospital wastes, the classification and selection of corresponding disinfection technologies are discussed. On this basis, this study provides scientific suggestions for management, technology selection, and operation of hospital wastes and wastewater disinfection in China, which is of great significance for development of national disinfection strategy for hospital wastes and wastewater during COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Desinfecção/métodos , Eliminação de Resíduos de Serviços de Saúde/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Águas Residuárias/virologia , Betacoronavirus , China , Humanos
12.
Blood Purif ; 49(6): 761-764, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32340018

RESUMO

There has been a global outbreak of the coronavirus disease 2019 (COVID-19) since December 2019. Here, we describe the case of a 49-year-old male undergoing maintenance hemodialysis (HD) who got infected with COVID-19 and our experience in performing HD for him. The patient's symptoms and lung imaging changes were atypical. However, his lymphocyte range decreased upon admission and the polymerase chain reaction of the pharyngeal swab for the -COVID-19 nucleic acid was positive. The patient developed respiratory failure and required mechanical ventilation 8 days after admission. In the end, he died from multiple organ dysfunction syndrome. The difficulties in diagnosis, infection control, and treatment of COVID-19 in maintenance HD patients are discussed in this report.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Diálise Renal , Antivirais/uso terapêutico , Técnicas de Laboratório Clínico , Terapia Combinada , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Infecção Hospitalar/prevenção & controle , Nefropatias Diabéticas/terapia , Progressão da Doença , Evolução Fatal , Humanos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Falência Renal Crônica/terapia , Pulmão/diagnóstico por imagem , Masculino , Eliminação de Resíduos de Serviços de Saúde/métodos , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/etiologia , Pandemias/prevenção & controle , Isolamento de Pacientes , Faringe/virologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Diálise Renal/métodos , Respiração Artificial , Avaliação de Sintomas , Tomografia Computadorizada por Raios X
13.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(4): 353-356, 2020 Apr 06.
Artigo em Chinês | MEDLINE | ID: mdl-32268640

RESUMO

This technical guideline is applicable to disinfection of wastewater and wastes of medical organizations during COVID-19 outbreak. The purpose of the guideline is to eliminate various pathogenic bacteria, fungi, and viruses, effectively block the virus transmission pathways, and guide medical organizations to carry out the prevention and control of COVID-19.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Desinfecção/métodos , Eliminação de Resíduos de Serviços de Saúde/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/métodos , Águas Residuárias , Betacoronavirus , China , Infecções por Coronavirus/transmissão , Surtos de Doenças , Docentes de Medicina/organização & administração , Humanos , Pneumonia Viral/transmissão
14.
Artigo em Inglês | MEDLINE | ID: mdl-32238096

RESUMO

This work presents the health-care waste (HCW) management and an approach to assess and identify polymers in a General Surgery Unit - Internment Service (GSU) of a Brazilian university hospital, to estimate the main polymers presenting in medical devices that are consumed during a year, discarded either as infecting (Group A) or as scarifying residue (Group E). Among the waste produced from the medical devices, 3.14 ton (98.79%) were composed of polymers (63.06% of plastics and 35.73% elastomers) while around 0.03 ton (1.21%) by metals. The proposed approach is composed of 4 steps: (1) Collecting data about consumed medical devices to be categorized into the residues Groups (A and E); (2) Identifying the polymeric composition with information provided by suppliers; (3) Characterizing the polymer functional groups by Fourier-Transform Infrared Spectroscopy (FTIR) and (4) Determining the polymer melting point by Differential Scanning Calorimetry (DSC). According to the results, the analyzed HCW was composed mainly of polypropylene (80.88%), high-density polyethylene (5.28%), polystyrene (4.51%), and cellulose (3.58%), from a total of 11 different polymers.


Assuntos
Eliminação de Resíduos de Serviços de Saúde/métodos , Polímeros/análise , Gerenciamento de Resíduos/métodos , Brasil , Celulose/análise , Hospitais de Ensino , Polietileno/análise , Poliestirenos/análise , Espectroscopia de Infravermelho com Transformada de Fourier
15.
J Environ Public Health ; 2020: 2934296, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32190061

RESUMO

Hospital waste management in Ghana faces the risk of cross-contamination from the lack of thorough sorting of the waste at the points of generation, codisposal of hazardous and nonhazardous waste types, and use of open-fire pits and substandard incinerators for burning infectious waste. This has increased the potential for the spread of infections and chemical pollutants. A cross-sectional study was conducted in five hospitals in Ghana to assess behavioral patterns on waste sorting and the effectiveness of hospital waste management in Ghana. A total of 250 questionnaires were distributed purposively to some staff of the five hospitals to assess workers' perceptions on medical waste sorting and handling. Additionally, focused group discussions and transect walks were adopted to examine the current collection, storage, treatment, and disposal methods used in the health facilities. Chi-square analyses showed significant differences in waste-sorting behavior based only on occupation (p < 0.0001, n=180) and not on gender, education, or experience in the health sector. Even though contaminated sharps were separated into brown safety boxes, color coding for other infectious waste containers was inconsistent across the health facilities. The study revealed that incineration is still the modal method of treatment in Ghanaian hospitals and therefore new approaches such as an engineering approach were required to minimize its environmental effects. It is recommended that periodic in-service training workshops be held for healthcare staff on the right source-segregation of medical waste, in order to facilitate the effective and safe handling, transport, treatment, and disposal of waste from health facilities.


Assuntos
Instalações de Saúde/estatística & dados numéricos , Eliminação de Resíduos de Serviços de Saúde/métodos , Estudos Transversais , Gana , Pesquisas sobre Serviços de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Pessoal de Saúde/estatística & dados numéricos , Humanos , Incineração/métodos , Incineração/normas , Serviço Hospitalar de Engenharia e Manutenção/métodos , Serviço Hospitalar de Engenharia e Manutenção/normas , Eliminação de Resíduos de Serviços de Saúde/normas
16.
Einstein (Sao Paulo) ; 18: eAO5066, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32074222

RESUMO

OBJECTIVE: To characterize storage and disposal practices associated with expired medicines in home pharmacies of Primary Care users. METHODS: Cross-sectional study based on data collected from 423 users of 15 Primary Care units located in a Brazilian city, between August 2014 and July 2016. Data were collected via face-to-face interviews. Categorical (demographic and socioeconomic characteristics) and continuous variables were expressed as proportions and means and standard deviations, respectively . Storage behaviors and disposal practices associated with unused and expired medicines were described as frequencies. RESULTS: Most (83%) interviewees were female and approximately 70% had completed high school. The kitchen was the most common medicine storage place (58.6%). Approximately 75% of participants reported inappropriate medicine disposal practices. CONCLUSION: This study revealed high rates of inappropriate medicine disposal practices with direct impacts on pharmacological treatment and the environment. Continuing education of healthcare professionals and the general public is required to raise awareness about proper medicine use and disposal.


Assuntos
Armazenamento de Medicamentos/estatística & dados numéricos , Família/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Eliminação de Resíduos de Serviços de Saúde/estatística & dados numéricos , Brasil , Estudos Transversais , Escolaridade , Meio Ambiente , Feminino , Humanos , Masculino , Eliminação de Resíduos de Serviços de Saúde/métodos , Farmácias/estatística & dados numéricos , Inquéritos e Questionários
17.
Hosp Top ; 98(1): 7-15, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32075544

RESUMO

The study was conducted with the objective of leading a situational assessment of Pune city with regard to Bio medical waste management, exploring knowledge, attitude & practices (KAP) of healthcare workers, and identifying challenges of stakeholders. Results revealed 69.2% of the hospitals had a biomedical waste management facility. Facilities like incineration, shredder, sharp pit, encapsulation, deep burial, and chemical disinfection were non- existing in 60% to 90% of hospitals. Bivariate analysis on questions with the type of employees and (KAP) was calculated. The utilization of the existing services and noncompliance are the major findings from the study.


Assuntos
Conscientização , Eliminação de Resíduos de Serviços de Saúde/métodos , Adulto , Feminino , Pessoal de Saúde/tendências , Humanos , Índia , Masculino , Eliminação de Resíduos de Serviços de Saúde/instrumentação , Eliminação de Resíduos de Serviços de Saúde/normas , Pessoa de Meia-Idade
18.
Sci Rep ; 10(1): 2968, 2020 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-32076072

RESUMO

Lack of a safe and convenient disposal method for expired and unused medications may lead to many problems such as accidental exposure, intentional misuse, and food and water contamination. Activated carbon can offer safe disposal of medications due to its highly porous structure, which exerts strong physical adsorption forces with chemicals. This study aimed to evaluate the efficiency of an activated carbon-based drug disposal system for deactivating three model sedative prescription medications. Deactivation was performed by mixing the medication, activated carbon, and tap water. Desorption was evaluated by exposing the deactivation system to wash-out solutions. Rapid, precise, accurate, and sensitive HPLC-UV method for each drug was successfully developed, validated and employed. Results of the 28-day deactivation study showed that on average, more than 94.00% of drugs were rapidly deactivated within 8 hours. All drugs reached more than 99.00% deactivation by the end of 28-day period. Desorption study demonstrated that all medications were retained by the system, with insignificant amount of drug (0.25%) leached into the washout solutions within 24 hours. In conclusion, activated carbon rapidly and successfully deactivated the medications tested, suggesting activated carbon-based drug disposal system provides a convenient, secure, and effective method for unused medication.


Assuntos
Carvão Vegetal/química , Hipnóticos e Sedativos/isolamento & purificação , Eliminação de Resíduos de Serviços de Saúde/métodos , Uso Indevido de Medicamentos sob Prescrição/prevenção & controle , Medicamentos sob Prescrição/isolamento & purificação , Adsorção , Alprazolam/química , Alprazolam/isolamento & purificação , Humanos , Hipnóticos e Sedativos/química , Medicamentos sob Prescrição/química , Temazepam/química , Temazepam/isolamento & purificação , Zolpidem/química , Zolpidem/isolamento & purificação
19.
Chemosphere ; 239: 124839, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31726519

RESUMO

The inhalational anaesthetic agent - sevoflurane is widely employed for the induction and maintenance of surgical anaesthesia. Sevoflurane possesses a high global warming potential that imposes negative impact to the environment. The only way to resolve the issue is to remove sevoflurane from the medical waste gas before it reaches the atmosphere. A continuous adsorption study with a fixed-bed column was conducted using two commercial granular activated carbons (E-GAC and H-GAC), to selectively remove sevoflurane. The effect of bed depth (Z, 5-15 cm), gas flow rate (Q, 0.5-6.0 L/min) and inlet sevoflurane concentration (C0, ∼55-700 mg/L) was investigated. E-GAC demonstrated ∼60% higher adsorption capacity than H-GAC under the same operating conditions. Varying the levels of Z, Q and C0 showed significant differences in the adsorption capacities of E-GAC, whereas only changing the C0 level had significant differences for H-GAC. Three breakthrough models (Adams-Bohart, Thomas, and Yoon-Nelson) and Bed-depth/service time (BDST) analysis were applied to predict the breakthrough characteristics of the adsorption tests and determine the characteristic parameters of the column. The Yoon-Nelson and Thomas model-predicted breakthrough curves were in good agreement with the experimental values. In the case of the Adams-Bohart model, a low correlation was observed. The predicted breakthrough time (tb) based on kinetic constant (kBDST) in BDST analysis showed satisfactory agreement with the measured values. The results suggest the possibility of designing, scaling up and optimising an adsorption system for removing sevoflurane with the aid of the models and BDST analysis.


Assuntos
Poluentes Atmosféricos/análise , Anestésicos Inalatórios/análise , Carvão Vegetal/química , Eliminação de Resíduos de Serviços de Saúde/métodos , Resíduos de Serviços de Saúde/análise , Sevoflurano/análise , Adsorção
20.
Rev. bras. enferm ; 73(supl.2): e20200260, 2020. tab
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1125938

RESUMO

ABSTRACT Objective: to develop a protocol of recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes. Method: a study of experts' recommendations using a structured form applied through the Delphi Technique, obtaining 100% agreement among professionals after four rounds of analysis. The population comprised six nurses members of the Scientific Department of Gerontological Nursing of the Brazilian Association of Nursing (Associação Brasileira de Enfermagem) Results: the protocol was structured in a nucleus of nursing interventions to face the spread of COVID-19 in Nursing Homes, consisting of 8 actions. Final considerations: the protocol can help nurse managers to organize assistance to face the pandemic, which can be adaptable to each reality, making training nurses and health teams easier.


RESUMEN Objetivo: desarrollar un protocolo de recomendaciones para abordar la propagación de COVID-19 en hogares para ancianos. Método: estudio de recomendaciones de expertos utilizando una forma estructurada aplicada utilizando la técnica Delphi, obteniendo un 100% de acuerdo entre profesionales después de cuatro rondas de análisis. La población estaba compuesta por seis enfermeras que son miembros del departamento científico de enfermería gerontológica de la Asociación Brasileña de Enfermería (Associação Brasileira de Enfermagem). Resultados: el protocolo se estructuró en un núcleo de intervenciones de enfermería para enfrentar la difusión de COVID-19 en Hogares para Ancianos y consta de 8 acciones. Consideraciones finales: el protocolo puede ayudar a los gerentes de enfermería a organizar la asistencia para enfrentar la pandemia, que puede adaptarse a cada realidad, facilitando la capacitación de los equipos de enfermería y salud.


RESUMO Objetivo: elaborar um protocolo de recomendações para o enfrentamento da disseminação da COVID-19 em Instituições de Longa Permanência para Idosos. Método: estudo de recomendações de especialistas utilizando-se um formulário estruturado aplicado por meio da Técnica Delphi, obtendo-se 100% de concordância entre os profissionais após quatro rodadas de análise. A população foi constituída por seis enfermeiros membros do Departamento Científico de Enfermagem Gerontológica da Associação Brasileira de Enfermagem. Resultados: o protocolo foi estruturado em um núcleo de intervenções de enfermagem para o enfrentamento da disseminação da COVID-19 em Instituições de Longa Permanência para Idosos, consistindo em 8 ações. Considerações finais: o protocolo poderá auxiliar os enfermeiros gestores a organizar a assistência para enfrentar a pandemia, que pode ser adaptável a cada realidade, facilitando o treinamento das equipes de enfermagem e saúde.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Betacoronavirus , Instituição de Longa Permanência para Idosos , Avaliação em Enfermagem/métodos , Casas de Saúde , Isolamento de Pacientes , Pneumonia Viral/enfermagem , Pneumonia Viral/transmissão , Pneumonia Viral/epidemiologia , Brasil/epidemiologia , Família , Desinfecção/métodos , Desinfecção/normas , Educação em Saúde , Saúde do Trabalhador , Técnica Delfos , Eliminação de Resíduos de Serviços de Saúde/métodos , Infecções por Coronavirus/enfermagem , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/epidemiologia , Comunicação , Enfermagem Geriátrica , Pessoa de Meia-Idade , Práticas Mortuárias/métodos , Avaliação em Enfermagem/normas , Avaliação em Enfermagem/organização & administração
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