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1.
Rev Bras Enferm ; 73 Suppl 2: e20200467, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32667573

RESUMO

OBJECTIVE: to identify with the literature the measures to prevent and control neonatal infection by COVID-19. METHODS: a scope review carried out by searching for studies in databases and institutional health websites. The final sample was 25 articles. RESULTS: among the main measures are the use of masks by suspected or infected people in contact with healthy newborns, hand hygiene before and after each care and feeding as well as the tools used for milking. It is indispensable to use personal protective equipment by health professionals in neonatology services to maintain a private room for infected newborns or to use physical barriers. Early diagnosis and timely case management is essential to reduce virus transmissibility. CONCLUSIONS: the research contributed to elucidate health and nursing actions in preventing and controlling neonatal infection by COVID-19.


Assuntos
Infecções por Coronavirus/prevenção & controle , Higiene das Mãos/normas , Pessoal de Saúde/estatística & dados numéricos , Controle de Infecções/normas , Enfermagem Neonatal/normas , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Adulto , Betacoronavirus , Feminino , Higiene das Mãos/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Controle de Infecções/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Equipamento de Proteção Individual/estatística & dados numéricos
2.
J Cosmet Dermatol ; 19(8): 1822-1825, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32460391

RESUMO

BACKGROUND: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2; COVID-19), which causes coronavirus disease 2019, is highly contagious and a particularly popular problem in all around the world and also in all departments of every hospital. AIMS: Protecting the well-being of the aesthetic dermatologists while providing a sufficient workforce is vital for pandemic planning. RESULTS AND CONCLUSIONS: In this article, we will discuss this problem from an aesthetic dermatology aspect and we will review whether these procedures are safe or not.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Técnicas Cosméticas , Dermatologia/organização & administração , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Anti-Infecciosos Locais/administração & dosagem , Anti-Infecciosos Locais/normas , Congressos como Assunto/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Dermatologistas/organização & administração , Dermatologistas/normas , Dermatologia/educação , Dermatologia/normas , Educação Médica/organização & administração , Educação Médica/normas , Estética , Higiene das Mãos/normas , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Telemedicina/organização & administração , Telemedicina/normas
3.
Artigo em Inglês | MEDLINE | ID: mdl-32410913

RESUMO

In January 2020, China reported a cluster of cases of pneumonia associated with a novel pathogenic coronavirus provisionally named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). Since then, Coronavirus Disease 2019 (COVID-19) has been reported in more than 180 countries with approximately 6.5 million known infections and more than 380,000 deaths attributed to this disease as of June 3rd , 2020 (Johns Hopkins University COVID map; https://coronavirus.jhu.edu/map.html) The majority of confirmed COVID-19 cases have been reported in adults, especially older individuals with co-morbidities. Children have had a relatively lower rate and a less serious course of infection as reported in the literature to date. One of the most vulnerable pediatric patient populations is cared for in the neonatal intensive care unit. There is limited data on the effect of COVID-19 in fetal life, and among neonates after birth. Therefore there is an urgent need for proactive preparation, and planning to combat COVID-19, as well as to safeguard patients, their families, and healthcare personnel. This review article is based on the Centers for Disease Control and Prevention's (CDC) current recommendations for COVID-19 and its adaptation to our local resources. The aim of this article is to provide basic consolidated guidance and checklists to clinicians in the neonatal intensive care units in key aspects of preparation needed to counter exposure or infection with COVID-19. We anticipate that CDC will continue to update their guidelines regarding COVID-19 as the situation evolves, and we recommend monitoring CDC's updates for the most current information.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Fidelidade a Diretrizes , Controle de Infecções/organização & administração , Unidades de Terapia Intensiva Neonatal/organização & administração , Serviços de Saúde Materno-Infantil , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Complicações Infecciosas na Gravidez/virologia , Adulto , Aleitamento Materno , Extração de Leite , Defesa Civil , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Salas de Parto , Feminino , Higiene das Mãos/normas , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Urbanos , Humanos , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Comunicação Interdisciplinar , Serviços de Saúde Materno-Infantil/organização & administração , Cidade de Nova Iorque/epidemiologia , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/terapia , Visitas a Pacientes
7.
PLoS One ; 15(3): e0229911, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155208

RESUMO

BACKGROUND: The unique characteristics of long-term care facilities (LTCFs) including host factors and living conditions contribute to the spread of contagious pathogens. Control measures are essential to interrupt the transmission and to manage outbreaks effectively. AIM: The aim of this systematic review was to verify the causes and problems contributing to transmission and to identify control measures during outbreaks in LTCFs. METHODS: Four electronic databases were searched for articles published from 2007 to 2018. Articles written in English reporting outbreaks in LTCFs were included. The quality of the studies was assessed using the risk-of-bias assessment tool for nonrandomized studies. FINDINGS: A total of 37 studies were included in the qualitative synthesis. The most commonly reported single pathogen was influenza virus, followed by group A streptococcus (GAS). Of the studies that identified the cause, about half of them noted outbreaks transmitted via person-to-person. Suboptimal infection control practice including inadequate decontamination and poor hand hygiene was the most frequently raised issue propagating transmission. Especially, lapses in specific care procedures were linked with outbreaks of GAS and hepatitis B and C viruses. About 60% of the included studies reported affected cases among staff, but only a few studies implemented work restriction during outbreaks. CONCLUSIONS: This review indicates that the violation of basic infection control practice could be a major role in introducing and facilitating the spread of contagious diseases in LTCFs. It shows the need to promote compliance with basic practices of infection control to prevent outbreaks in LTCFs.


Assuntos
Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Controle de Infecções/organização & administração , Instituições Residenciais/organização & administração , Infecção Hospitalar/epidemiologia , Higiene das Mãos/organização & administração , Higiene das Mãos/normas , Higiene das Mãos/estatística & dados numéricos , Hepacivirus/isolamento & purificação , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Hepatite B/transmissão , Hepatite B/virologia , Vírus da Hepatite B/isolamento & purificação , Hepatite C/epidemiologia , Hepatite C/prevenção & controle , Hepatite C/transmissão , Hepatite C/virologia , Humanos , Higiene/normas , Controle de Infecções/normas , Controle de Infecções/estatística & dados numéricos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Influenza Humana/transmissão , Influenza Humana/virologia , Assistência de Longa Duração/organização & administração , Assistência de Longa Duração/normas , Assistência de Longa Duração/estatística & dados numéricos , Orthomyxoviridae/isolamento & purificação , Orthomyxoviridae/patogenicidade , Instituições Residenciais/normas , Instituições Residenciais/estatística & dados numéricos , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/prevenção & controle , Infecções Estreptocócicas/transmissão , Streptococcus pyogenes/isolamento & purificação
9.
Br J Nurs ; 29(1): 10, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31917942

RESUMO

Neesha Ridley, Senior Lecturer, University of Central Lancashire, discusses the importance of hand hygiene in preventing healthcare-associated infections.


Assuntos
Infecção Hospitalar/prevenção & controle , Higiene das Mãos/normas , Gestão de Riscos/métodos , Humanos
10.
Optom Vis Sci ; 97(1): 24-27, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31895274

RESUMO

SIGNIFICANCE: The Los Angeles County Department of Public Health investigated an outbreak of epidemic keratoconjunctivitis secondary to adenovirus linked to a single optometry clinic between June and July 2017. Suboptimal infection prevention practices were identified in the implicated clinic. PURPOSE: The purpose of this study was to determine infection prevention practices in optometry clinics within Los Angeles County. METHODS: A 17-question survey on infection prevention practices among a sample of optometry providers in the county was conducted by the Los Angeles County Department of Public Health. The survey was administered via e-mails sent to a local optometric society's Listserv and in person at a local continuing education event for optometrists. The results were analyzed and are represented as percentages. RESULTS: There were 42 responses, 20 via the online survey (response rate, 15%) and 22 via the in-person survey (response rate, 22%). More than half had no written hand-hygiene policy (58.5%, n = 24/41), 46.2% (n = 18/39) did not wear gloves while examining patients with eye drainage, and about half (48.6%, n = 18/37) did not use droplet precautions for patients with respiratory symptoms. The vast majority used multidose eye-drop vials (92.5%, n = 37/40), but 41.6% (n = 15/36) did not discard the vial if the tip came into contact with conjunctiva/skin/environmental surface. To ensure a clean tonometer for each patient, the majority (68.4%, n = 26/38) used 70% isopropyl alcohol, 47.4% (n = 18/38) used noncontact tonometers, and 23.6% (n = 9/38) used disposable tips (answers not mutually exclusive); none used bleach. CONCLUSIONS: Our data highlight several areas of concern in the practice of standard or transmission-based precautions in the sampled population. First, hand-hygiene policies are not well enforced. Second, personal protective equipment is not appropriately used while examining potentially infectious patients. Third, eye-drop vials are not consistently discarded if contaminated with eye secretions. Lastly, a large proportion of surveyed practices use inadequate disinfection techniques of tonometers.


Assuntos
Instituições de Assistência Ambulatorial/normas , Controle de Infecções/métodos , Optometria/normas , Adulto , Atitude do Pessoal de Saúde , Infecção Hospitalar/prevenção & controle , Desinfecção/métodos , Feminino , Higiene das Mãos/normas , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Máscaras , Inquéritos e Questionários
11.
Int J Infect Dis ; 90: 197-200, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31605810

RESUMO

BACKGROUND: Hand hygiene (HH) is crucial to prevent healthcare-associated infections and the spread of multidrug-resistant organisms. The monitoring of HH compliance may be affected by observer expertise. A sufficient duration of HH is necessary to remove microorganisms. The aim of this study was to measure compliance with both the World Health Organization (WHO) checklist and optimal HH as reported by unit-based observers and infection control nurses (ICN). METHODS: Optimal HH was defined as adhering to the exact duration and following a six-step procedure. The disparity in compliance with the WHO checklist and optimal HH was analyzed among each profession, unit, and indication, covering a period of 3 years. RESULTS: There was a statistically significant difference in WHO checklist compliance (94.4% vs. 87.0%, p<0.01) and optimal HH rate (86.3% vs. 42.4%, p<0.01) between unit-based observers and ICN. The optimal HH rate was especially lower for doctors (30.1%), in the intensive care units (39.4%), and before clean and aseptic procedures (37.0%) as observed by ICN. CONCLUSIONS: Although the overall WHO checklist HH rate was reported to be higher than 90%, optimal HH was only half this rate. More education and awareness of the significance of HH, as well as adherence to the optimal HH procedures, are needed to prevent hospital-acquired infections.


Assuntos
Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes , Higiene das Mãos/normas , Lista de Checagem , Higiene das Mãos/métodos , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Unidades de Terapia Intensiva , Médicos/estatística & dados numéricos , Organização Mundial da Saúde
13.
Artigo em Inglês | MEDLINE | ID: mdl-31835651

RESUMO

BACKGROUND: Most research on hand hygiene compliance in community settings indicates that compliance is poor. It is not conclusive as to whether poster interventions are effective at improving compliance. METHODS: An independent, self-designed poster intervention was installed in one set of male and female public restrooms in a university campus in the UK. The hand hygiene practice and compliance of the university population was measured via indirect observation over a 60 day period. RESULTS: During the pre-intervention observation period, 51.09% of the university population practiced basic hand hygiene compliance (washed hands with water, soap and dried afterwards), and 7.88% practiced adequate hand hygiene compliance (washed hands with water and soap for 20 s or more and dried afterwards for 20 s or more). During the post-intervention observation period, 55.39% of the university population were observed practicing basic hand hygiene compliance, and 7.97% practicing adequate hand hygiene compliance. Gender differences revealed that more females practiced basic hand hygiene in the post-intervention observation period (62.81%) than during the pre-intervention period (49.23%) and this was statistically significant (χ2 = 13.49, p = < 0.01). DISCUSSION: The poster intervention had a limited effect on improving the basic and adequate hand hygiene compliance of the general population when using public restrooms. The use of independent, self-designed posters to improve hand hygiene practice and compliance is largely ineffective in the short term and should be used with caution in future intervention strategies.


Assuntos
Fidelidade a Diretrizes/estatística & dados numéricos , Higiene das Mãos , Promoção da Saúde/métodos , Pôsteres como Assunto , Toaletes , Adulto , Feminino , Higiene das Mãos/métodos , Higiene das Mãos/normas , Higiene das Mãos/estatística & dados numéricos , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Reino Unido , Universidades
14.
PLoS One ; 14(12): e0226548, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31841540

RESUMO

BACKGROUND: Poor water sanitation and hygiene (WASH) in health care facilities increases hospital-associated infections, and the resulting greater use of second-line antibiotics drives antimicrobial resistance. Recognising the existing gaps, the World Health Organisations' Water and Sanitation for Health Facility Improvement Tool (WASH-FIT) was designed for self-assessment. The tool was designed for small primary care facilities mainly providing outpatient and limited inpatient care and was not designed to compare hospital performance. Together with technical experts, we worked to adapt the tool for use in larger facilities with multiple inpatient units (wards), allowing for comparison between facilities and prompt action at different levels of the health system. METHODS: We adapted the existing facility improvement tool (WASH-FIT) to create a simple numeric scoring approach. This is to illustrate the variation across hospitals and to facilitate monitoring of progress over time and to group indicators that can be used to identify this variation. Working with stakeholders, we identified those responsible for action to improve WASH at different levels of the health system and used piloting, analysis of interview data to establish the feasibility and potential value of the WASH Facility Survey Tool (WASH-FAST) to demonstrate such variability. RESULTS: We present an aggregate percentage score based on 65 indicators at the facility level to summarise hospitals' overall WASH status and how this varies. Thirty-four of the 65 indicators spanning four WASH domains can be assessed at ward level enabling within hospital variations to be highlighted. Three levels of responsibility for WASH service monitoring and improvement were identified with stakeholders: the county/regional level, senior hospital management and hospital infection prevention and control committees. CONCLUSION: We propose WASH-FAST can be used as a survey tool to assess, measure and monitor the progress of WASH in hospitals in resource-limited settings, providing useful data for decision making and tracking improvements over time.


Assuntos
Desinfecção das Mãos/métodos , Desinfecção das Mãos/normas , Higiene das Mãos/normas , Saneamento/normas , Inquéritos e Questionários/normas , Purificação da Água/normas , Organização Mundial da Saúde , Infecção Hospitalar/prevenção & controle , Estudos de Viabilidade , Saúde Global , Implementação de Plano de Saúde/normas , Hospitais , Humanos , Guias de Prática Clínica como Assunto/normas , Melhoria de Qualidade , Saneamento/métodos , Fatores de Tempo , Purificação da Água/métodos , Abastecimento de Água/normas
15.
Rev Bras Enferm ; 72(6): 1653-1662, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644757

RESUMO

OBJECTIVE: to identify the knowledge and ability of caregivers on hand hygiene in hematopoietic stem cell transplantation. METHOD: a prospective cross-sectional study. A questionnaire was used to identify the knowledge and it was observed the hygiene technique performance. Data were collected in two units (autologous and allogeneic transplant). RESULTS: the 37 participants recognized the importance of hand hygiene and 95.5% related to removal of dirt or infection prevention. 91.9% stated that it was important to clean their hands with soap and water when entering and leaving the room, and 64.9% understood that it was necessary to apply alcoholic solution after washing. On average, the caregivers scored 6.16 steps, when demonstrating the washing technique and 3.91 steps in the friction with alcoholic solution. CONCLUSION: although they recognize the importance of the procedure, there are deficits related to the moment and the correct way of doing it, evidencing the need for strategies aimed at improving this process.


Assuntos
Cuidadores/normas , Competência Clínica/normas , Higiene das Mãos/normas , Transplante de Células-Tronco Hematopoéticas/enfermagem , Adulto , Idoso , Brasil , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Competência Clínica/estatística & dados numéricos , Estudos Transversais , Feminino , Higiene das Mãos/métodos , Higiene das Mãos/estatística & dados numéricos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários
16.
Artigo em Inglês | MEDLINE | ID: mdl-31614408

RESUMO

PURPOSE: To determine if an objective structured clinical examination (OSCE) could be used to evaluate and monitor hand hygiene and personal protective equipment (PPE) proficiency for medical interns in the United States. METHODS: Interns in July 2015 (N=123, Cohort 1) without OSCE-based contact precaution evaluation and teaching were evaluated early 2016 by OSCE for hand hygiene and PPE proficiency. They performed poorly. Therefore, the new interns entering July 2016 (N=151, Cohort 2) were immediately tested in the same OSCE station as Cohort 1 and provided feedback and teaching. Cohort 2 was then retested in the OSCE station early 2017. The Mann Whitney U test was used to compare Cohort 1 vs. Cohort 2 performances on checklist items. Cohort 2 performance differences at the beginning and end of the intern year were compared using McNemar's X2 test for paired nominal data. RESULTS: Checklist items were scored, summed and reported as percent correct. In Cohort 2, the mean percent correct was higher in posttest than pretest, 92% vs. 77% )(P <0 .0001). The passing rate (100% correct) was significantly higher, 55% vs. 16%. Comparing Cohort 1 and Cohort 2 at the end of intern year, the mean percent correct was higher for Cohort 2 compared to Cohort 1, 95% vs 90% (P < 0.0001). 55% of the Cohort 2 passed (a perfect score) compared to 24% in Cohort 1 (P < 0.0001). CONCLUSION: An OSCE can be utilized to evaluate and monitor hand hygiene and PPE proficiency for interns in the United States.


Assuntos
Higiene das Mãos/métodos , Equipamento de Proteção Individual/ética , Exame Físico/normas , Lista de Checagem , Estudos de Coortes , Higiene das Mãos/normas , Humanos , Internato e Residência/ética , Atenção Plena , Equipamento de Proteção Individual/normas , Exame Físico/estatística & dados numéricos , Análise e Desempenho de Tarefas , Estados Unidos/epidemiologia , Precauções Universais/métodos
17.
GMS J Med Educ ; 36(4): Doc39, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31544139

RESUMO

Adhering to hygiene standards in daily clinical work is an important characteristic of qualitatively high-value medical care. In this regards, hand hygiene is often focused on in the literature. From the viewpoint of medical education research, we argue that this focus is too narrow to explain how staff who are working clinically with patients implement and adhere to standards of hygiene across a wide variety of tasks of their daily clinical routine. We present basic features of a differentiated concept of hygiene competence, which includes specialized knowledge, corresponding inner attitudes, and action routines that are customized to the needs of specific situations. Building on that, we present a current simulation-based course concept aimed at developing hygiene competence in medical education. Furthermore, we describe a test instrument that is designed according to the principle of a situational judgment test and that appears promising for the assessment of hygiene competence. The course and the measurement instrument are discussed in regards to their fit to the competence model and the related perspectives for research and teaching.


Assuntos
Higiene das Mãos/normas , Conhecimentos, Atitudes e Prática em Saúde , Controle de Infecções , Treinamento por Simulação , Competência Clínica/normas , Educação Médica , Humanos , Equipe de Assistência ao Paciente
18.
BMC Res Notes ; 12(1): 516, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31420003

RESUMO

OBJECTIVE: Antimicrobial resistance among the bacteria present in ready-to-eat foods like vegetable salads is an emerging concern today. The current study was undertaken to investigate the presence of multi-drug resistant extended-spectrum ß-lactamase (ESBL) producing E. coli and Salmonella spp. in raw vegetable salads served at hotels and restaurants in Bharatpur. A total of 216 salad samples were collected from three different grades of hotels and restaurants and examined for the presence of E. coli and Salmonella spp. in Microbiology laboratory of Birendra Multiple Campus by conventional microbiological techniques. RESULTS: Out of 216 samples, 66 samples (35.2%) showed the presence of Salmonella spp. whereas E. coli was recovered from 29 (13.4%) samples of which 3 samples harbored E. coli O157: H7. Antibiotic susceptibility testing revealed that 9 (13.6%) Salmonella and 4 (13.8%) E. coli isolates were detected as multi-drug resistant. Total ESBL producers reported were 5 (7.57%) Salmonella and 4 (13.8%) E. coli. The study also assessed a significant association between occurrence of E. coli and Salmonella with different grades of hotels and restaurants, personal hygiene and literacy rate of chefs and with the type of cleaning materials used to wash knives and chopping boards (p < 0.05). The findings suggest an immediate need of attention by the concerned authorities to prevent the emergence and transmission of food-borne pathogens and infections antimicrobial resistance among them.


Assuntos
Farmacorresistência Bacteriana Múltipla , Escherichia coli O157/isolamento & purificação , Saladas/microbiologia , Salmonella/isolamento & purificação , Verduras/microbiologia , beta-Lactamases/metabolismo , Antibacterianos/farmacologia , Escherichia coli O157/efeitos dos fármacos , Escherichia coli O157/metabolismo , Contaminação de Alimentos/prevenção & controle , Doenças Transmitidas por Alimentos/microbiologia , Doenças Transmitidas por Alimentos/prevenção & controle , Higiene das Mãos/normas , Habitação/normas , Habitação/estatística & dados numéricos , Humanos , Testes de Sensibilidade Microbiana , Nepal , Restaurantes/normas , Restaurantes/estatística & dados numéricos , Salmonella/efeitos dos fármacos , Salmonella/metabolismo
19.
Microb Drug Resist ; 25(9): 1347-1356, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31364923

RESUMO

We evaluated the effects of enhanced infection control measures (ICMs) on carriage and infections of carbapenem-resistant Gram-negative bacteria (CRGNB) in a pediatric intensive care unit. We conducted a quasi-experimental study, including patients with infections of CRGNB retrospectively for 13 months and those participating in an active surveillance program prospectively for 22 months. Active surveillance (weekly rectal swabs) was implemented during a 63-week subperiod with standard ICMs and a subsequent 27-week subperiod with enhanced ICMs (intensified ICMs supplemented with audits and feedback). Prevalence, colonization pressure, incidence, and infections of CRGNB and compliance with ICMs and enhanced ICMs were recorded. Evaluation of results was performed using time series (TS) and interrupted TS. Compliance with hand hygiene improved during the second subperiod of active surveillance compared with the first; prevalence, colonization pressure, and incidence of CRGNB decreased significantly. The linear trend of centered moving average for carbapenem-resistant Klebsiella pneumoniae (CRKP) decreased from 1.2 to 0.1 infections/1,000 bed-days (IBD) (p = 0.046), while it remained unchanged for carbapenem-resistant Acinetobacter baumannii (CRAB) and increased for carbapenem-resistant Pseudomonas aeruginosa (CRPA) from 0.0 to 2.1 IBD (p < 0.001). Enhanced ICMs can reduce CRKP infections in endemic units, in contrast to CRPA and CRAB infections, which are more difficult to eradicate.


Assuntos
Portador Sadio/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Infecções por Bactérias Gram-Negativas/epidemiologia , Conduta Expectante , Adolescente , Antibacterianos/farmacologia , Carbapenêmicos/farmacologia , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Feminino , Bactérias Gram-Negativas/efeitos dos fármacos , Infecções por Bactérias Gram-Negativas/microbiologia , Higiene das Mãos/normas , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica , Análise de Séries Temporais Interrompida , Masculino , Prevalência , Estudos Prospectivos , Estudos Retrospectivos
20.
BMC Health Serv Res ; 19(1): 547, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382968

RESUMO

BACKGROUND: Effective hand hygiene is one of the most important measures for protecting nursing home residents from nosocomial infections. Infections with multi-resistant bacteria's, associated with healthcare, is a known problem. The nursing home setting differs from other healthcare environments in individual and organisational factors such as knowledge, behaviour, and attitude to improve hand hygiene and it is therefore difficult to research the influential factors to improve hand hygiene. Studies have shown that increasing knowledge, behaviour and attitudes could enhance hand hygiene compliance in nursing homes. Therefore, it may be important to examine individual and organisational factors that foster improvement of these factors in hand hygiene. We aim to explore these influences of individual and organisational factors of hand hygiene in nursing home staff, with a particular focus on the function of role modelling by nursing managers. METHODS: We conducted a mixed-methods study surveying 165 nurses and interviewing 27 nursing managers from nursing homes in Germany. RESULTS: Most nurses and nursing managers held the knowledge of effective hand hygiene procedures. Hygiene standards and equipment were all generally available but compliance to standards also depended upon availability in the immediate work area and role modelling. Despite a general awareness of the impact of leadership on staff behaviour, not all nursing managers fully appreciated the impact of their own consistent role modelling regarding hand hygiene behaviours. CONCLUSION: These results suggest that improving hand hygiene should focus on strategies that facilitate the provision of hand disinfectant materials in the immediate work area of nurses. In addition, nursing managers should be made aware of the impact of their role model function and they should implement this in daily practice.


Assuntos
Higiene das Mãos/normas , Conhecimentos, Atitudes e Prática em Saúde , Recursos Humanos de Enfermagem/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Competência Clínica/normas , Infecção Hospitalar/enfermagem , Infecção Hospitalar/prevenção & controle , Estudos Transversais , Feminino , Alemanha , Desinfecção das Mãos/normas , Higiene das Mãos/métodos , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Enfermeiras Administradoras/normas , Casas de Saúde/normas , Inquéritos e Questionários , Adulto Jovem
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