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1.
BMC Oral Health ; 23(1): 8, 2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36611143

RESUMO

BACKGROUND: COVID-19 has impacted and increased risks for all populations, including orthodontic patients and providers. It also changes the practice management and infection control landscape in the practices. This study aimed to investigate the COVID-19 infection and vaccination status of orthodontic providers and mitigation approaches in orthodontic practices in the United States during 2021. METHODS: A validated 50-question research electronic data capture (REDCap) browser-based questionnaire was distributed to 12,393 orthodontists and pediatric dentists who reported actively providing orthodontic treatment. Questions were designed to collect demographic data of respondents, evaluate the COVID-19 mitigation approaches, and evaluate the history of COVID-19 infection and vaccination status of the orthodontic providers. Associations of demographic and the COVID-19 mitigation approaches were assessed using chi-square tests at the significance level of 0.05. RESULTS: Four hundred fifty-seven returned the survey (response rate 3.69%) for analysis. Most respondents were vaccinated, and increased infection control measures in response to the pandemic. Half of the respondents practiced teledentistry and switched to digital impression systems. Two-thirds reported difficulties in attaining PPEs due to the increased cost and scarcity of PPEs. About 6% of respondents reported a history of COVID-19 infection, and 68.9% of their staff had COVID-19 infection. Statistically significant associations were found between increased practice experience with difficulties in acquiring PPE (p = .010). There were no significant associations between races of respondents, geographic location, and years of practicing when cross-tabulated with vaccination status or COVID-19 infection rate (p > .05). CONCLUSION: Increased infection control strategies were employed in almost all orthodontic practices in addition to existing universal precaution. Most of the orthodontic providers and their staff members were vaccinated. While staff's infection rates were an issue, doctors' infection rates remained low.


Assuntos
COVID-19 , Criança , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Ortodontistas , Odontólogos , Controle de Infecções , Precauções Universais , Inquéritos e Questionários
2.
N Engl J Med ; 387(21): 1935-1946, 2022 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-36351262

RESUMO

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


Assuntos
COVID-19 , Política de Saúde , Máscaras , Serviços de Saúde Escolar , Precauções Universais , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Incidência , Pobreza/estatística & dados numéricos , Instituições Acadêmicas/legislação & jurisprudência , Instituições Acadêmicas/estatística & dados numéricos , Estudantes/legislação & jurisprudência , Estudantes/estatística & dados numéricos , Política de Saúde/legislação & jurisprudência , Máscaras/estatística & dados numéricos , Serviços de Saúde Escolar/legislação & jurisprudência , Serviços de Saúde Escolar/estatística & dados numéricos , Categorias de Trabalhadores/legislação & jurisprudência , Categorias de Trabalhadores/estatística & dados numéricos , Precauções Universais/legislação & jurisprudência , Precauções Universais/estatística & dados numéricos , Massachusetts/epidemiologia , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/estatística & dados numéricos
4.
Harm Reduct J ; 19(1): 74, 2022 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-35799296

RESUMO

BACKGROUND: Delivery of effective health care is hampered by stigma, the social processes that attach negative judgement and response to some attributes, conditions, practices and identities. Experiencing or anticipating stigma can lead to a range of practical impacts, including avoidance of health care. While we are concerned about the stigma that is attached to HIV, this commentary makes the argument that the health system is burdened by stigma of many origins. MAIN BODY: Reducing stigma is a key issue in improving quality of health care. Our focus on HIV is about providing better care in a non-judgemental, respectful and dignified manner which enhances the health and well-being of individuals as well as delivering benefit to society at large through better population health outcomes. However, the same could be said for the numerous possible attributes, conditions, practices and identities that attract stigma. It is unrealistic to expect health systems to respond to siloed appeals for change and action. A unifying logic is needed to propel concerns about stigma to the front of the queue for action by health systems. CONCLUSION: This commentary suggests the need for a universal precautions approach to stigma in health care, that focuses on recognising that all people may experience stigma and discrimination targeted at one or more aspects of their identities, attributes, practices and health conditions. Drawing on health system precepts of equity, access and quality of care, we argue that a universal precautions approach to reducing stigma of all origins can effect everyday aspects of policy, procedure and practice to improve outcomes for individuals and for population health.


Assuntos
Infecções por HIV , Precauções Universais , Atitude do Pessoal de Saúde , Infecções por HIV/prevenção & controle , Humanos , Estigma Social
5.
Enferm. glob ; 21(65): 1-14, ene. 2022.
Artigo em Espanhol | IBECS | ID: ibc-203697

RESUMO

Objetivo: Evaluar el cumplimiento de las precauciones estándar por parte de los profesionales de lasalud en dos hospitales.Método: Se trata de un estudio descriptivo, con abordaje cuantitativo, realizado en dos hospitales delEstado de Rio de Janeiro. La muestra está compuesta por profesionales de la salud que trabajan en laasistencia. Estudio desarrollado en el período comprendido entre febrero de 2019 y febrero de 2020.Para la recolección de datos se utilizó lo siguiente: 1- Formulario de información individual yprofesional; 2- Versión en portugués brasileño de la Escala de Cumplimiento de PrecaucionesEstándar. Los datos se analizaron mediante estadística descriptiva y pruebas de hipótesis.Resultados: El estudio incluyó a 366 (100,0%) profesionales de la salud. La puntuación global decumplimiento de las precauciones estándar fue de 13,4 (66,8%), con un rango de 4 a 20. En cuanto ala media de las puntuaciones entre las instituciones, los profesionales del hospital 1 tuvieron una mediade 12,6 y el hospital 2 mostró un cumplimiento de 13,6.Conclusiones: El cumplimiento de las precauciones estándar entre los profesionales de la salud no seprodujo en su totalidad(AU)


Objective: To assess compliance with standard precautions by health professionals in two hospitals.Method: This is a descriptive study, with a quantitative approach, conducted in two hospitals in theState of Rio de Janeiro. The sample is composed of health professionals who work in health care. Studydeveloped in the period between February 2019 and February 2020. In order to collect data, the weused: 1- Individual and professional information form; 2- Brazilian Portuguese version of the Compliancewith Standard Precautions Scale. Data were analyzed using descriptive statistics and hypothesis tests.Results: The study was attended by 366 (100.0%) health professionals. The overall score ofcompliance with standard precautions was 13.4 (66.8%), ranging from 4 to 20. As for the average of thescores between the institutions, the professionals from hospital 1 had an average of 12.6 and thosefrom hospital 2 showed a compliance of 13.6.Conclusions: Compliance with standard precautions among health professionals did not happen in itsentirety(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Precauções Universais , Controle de Infecções/normas , Recursos Humanos em Hospital/estatística & dados numéricos , Fidelidade a Diretrizes
6.
Am J Obstet Gynecol ; 226(5): 671-677, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34418349

RESUMO

In the United States, about 1 in 5 women have experienced childhood sexual abuse, and a similar proportion experience rape as adults. Childhood sexual abuse and other forms of trauma have serious impacts on our patients' reproductive health. The American College of Obstetricians and Gynecologists recommends universal screening for a history of sexual abuse and universal application of a trauma-informed approach to care. Despite these recommendations, universal screening is far from universally practiced, and trauma-informed care, despite being the standard of care, is far from standard. Given the high prevalence of trauma in the United States, its impact on perinatal outcomes, the sensitive nature of reproductive healthcare, and the likelihood that many patients may not disclose their trauma history, we advocate for trauma-informed reproductive healthcare as the standard of care.


Assuntos
Delitos Sexuais , Precauções Universais , Adulto , Criança , Atenção à Saúde , Feminino , Humanos , Masculino , Gravidez , Prevalência , Saúde Reprodutiva , Estados Unidos
7.
Rev. enferm. UFSM ; 12: 51, 2022.
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-1400669

RESUMO

Objetivo: adaptar a escala Factors Influencing Adherence to Standard Precautions Scale para o português do Brasil. Método: estudo metodológico, compreendendo a tradução, consenso das versões, comitê de juízes, retrotradução, obtenção da versão em português, análise semântica e pré-teste. Enfermeiros compuseram o comitê de juízes na etapa de validação de conteúdo; para a validade semântica do instrumento e pré-teste, a amostra foi composta por enfermeiros e técnicos de enfermagem. Realizado entre dezembro de 2020 e março de 2021. Para análise adotou-se o Índice de validade de conteúdo. Resultados: as pontuações do Índice de validade de conteúdo variaram de 0,77 a 1, enquanto a pontuação total foi de 0,95. Na análise semântica, nenhum profissional apresentou incerteza quanto a escala. Conclusão: os itens do instrumento foram considerados representativos e relevantes para a prática clínica, necessitando a continuidade da pesquisa com a realização das propriedades psicométricas.


Objective: to adapt the Factors Influencing Adherence to Standard Precautions Scale into Brazilian Portuguese. Method: methodological study, comprising the translation, consensus versions, committee of judges, back-translation, obtaining the Portuguese version, semantic analysis and pre-test. Nurses composed the committee of judges in the content validation stage; for the semantic validity of the instrument and pre-test, the sample consisted of nurses and nursing technicians. It was conducted between December 2020 and March 2021. For analysis, the Content Validity Index was adopted. Results: Content Validity Index scores ranged from 0.77 to 1, while the total score was 0.95. In the semantic analysis, no professional showed uncertainty about the scale. Conclusion: the items of the instrument were considered representative and relevant to clinical practice, requiring the continuity of the research with the achievement of psychometric properties.


Objetivo: adaptar la escala Factores que Influyen en la Adherencia a las Precauciones Estándar al portugués brasileño. Método: estudio metodológico, que comprende la traducción, el consenso de las versiones, el comité de jueces, la retranscripción, la obtención de la versión en portugués, el análisis semántico y el ensayo. Los enfermeros componen el comité de jueces en la etapa de validación del conteo; para la validación semántica del instrumento y la prueba previa, la muestra fue compuesta por enfermeros y técnicos de enfermería. Se llevó a cabo entre diciembre de 2020 y marzo de 2021. Para el análisis, se adoptó el Índice de Validez de Contenido. Resultados: las puntuaciones del índice de validez del contenido oscilaron entre 0,77 y 1, mientras que la puntuación total fue de 0,95. En el análisis semántico, ningún profesional presentó incertidumbre sobre la escala. Conclusión: Los ítems del instrumento fueron considerados representativos y relevantes para la práctica clínica, requiriendo la continuidad de la investigación con la realización de propiedades psicométricas.


Assuntos
Humanos , Riscos Ocupacionais , Precauções Universais , Estudo de Validação , Assistência ao Paciente , Equipe de Enfermagem
8.
Antimicrob Resist Infect Control ; 10(1): 148, 2021 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-34666836

RESUMO

BACKGROUND: Escherichia coli sequence type (ST) 131 H30 is an emerging multidrug resistant subclone, known to spread and cause outbreaks in long-term care facilities (LTCFs). OBJECTIVES AND METHODS: From 2010 through 2020, we performed 11 yearly surveillance studies for determining the prevalence of digestive carriage of ESBL-producing E. coli (ESBL-EC) among residents in a university-affiliated LCTF. Sequencing and genotyping of selected isolates were performed to characterize temporal trends in the prevalence and epidemic potential of ESBL-EC subclones, and for evaluating a potential rebound effect following discontinuation of contact precautions for ESBL-EC carriers in January 2019. RESULTS: This study included 2'403 LTCF residents, with 252 (10.5%) positive for ESBL-EC. Among the 236 ESBL-EC isolates available for typing, 58.0% belonged to the ST131 lineage, including 94/137 (68.6%) ST131 H30 isolates. An increasing yearly prevalence was observed for ESBL-EC (from 4.6 to 9.4%; p = 0.11), but not for the ST131 H30 subclone, which peaked in 2015 and declined thereafter. Multiple previously unnoticed ESBL-EC outbreaks occurred in the LTCF. Since 2018, we noted the clonal expansion of a rare ST131 H89 subclone (O16:H5) harboring CTX-M-14 and CTX-M-24. No rebound effect was observed in ESBL-EC prevalence nor in the different subclones following discontinuation of contact precautions for ESBL-EC carriers since 2019. CONCLUSION: Clonal fluctuation was observed for ST131 H30 ESBL-EC with a current decline in prevalence. Surveillance should include the evolution of ST131 non-H30 subclones, which may spread in LTCFs. Our findings suggest that discontinuation of contact precautions for ESBL-EC carriers in LTCFs may be safely implemented, in support of European recommendations to limit ESBL-producing Enterobacteriaceae control measures in endemic settings to non-E. coli.


Assuntos
Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/enzimologia , beta-Lactamases/metabolismo , Estudos Transversais , Reservatórios de Doenças/microbiologia , Resistência a Múltiplos Medicamentos , Escherichia coli/classificação , Escherichia coli/genética , Infecções por Escherichia coli/prevenção & controle , Fezes/microbiologia , Humanos , Assistência de Longa Duração , Prevalência , Reto/microbiologia , Precauções Universais
9.
Vasc Health Risk Manag ; 17: 445-459, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34385818

RESUMO

BACKGROUND: Transvenous lead extraction (TLE) is now a first-line technique for the treatment of complications related to cardiac implantable electronic devices. The aim of the study was to demonstrate that it is possible to safely perform difficult TLE procedures with a maximum reduction of peri-procedural major complications. METHODS: A total of 1000 consecutive patients undergoing TLE in a single high-volume center from 2016 to 2019 were studied. All procedures were performed in a hybrid room or operating room by a specialized TLE team. TLE was performed under general anesthesia and monitored by transesophageal echocardiography, and the operating room was suitably equipped for immediate surgical intervention. The effectiveness and safety of the procedures were assessed, with particular emphasis on major complications. RESULTS: In all, 1952 leads with the mean implant duration of 111.7 ± 77.6 months had been extracted. Complete procedural success of patients was achieved in 95.9% and clinical success in 99.1%. Major complications, predominantly cardiac tamponade (63.3%), occurred in 22 patients (2.2%). Rapid diagnosis and immediate intervention were the key to a 100% survival in patients with this complication. CONCLUSION: Performing procedures in a hybrid operating room under general anesthesia in the presence of a cardiac surgeon and with the use of transesophageal echocardiography significantly improves the safety of transvenous lead extraction.


Assuntos
Desfibriladores Implantáveis/efeitos adversos , Remoção de Dispositivo/métodos , Marca-Passo Artificial/efeitos adversos , Valva Tricúspide/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Estudos Retrospectivos , Resultado do Tratamento , Precauções Universais
11.
Mayo Clin Proc ; 96(4): 912-920, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33714601

RESUMO

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


Assuntos
COVID-19 , Controle de Doenças Transmissíveis , Fidelidade a Diretrizes/estatística & dados numéricos , Distanciamento Físico , Saúde Pública , Idoso , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Teste para COVID-19/métodos , Teste para COVID-19/estatística & dados numéricos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/estatística & dados numéricos , Estudos Transversais , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Humanos , Masculino , Minnesota/epidemiologia , Prevalência , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Comportamento de Redução do Risco , Precauções Universais/métodos , Precauções Universais/estatística & dados numéricos , Virologia/métodos
13.
Emergencias (Sant Vicenç dels Horts) ; 33(1): 59-61, feb. 2021.
Artigo em Espanhol | IBECS | ID: ibc-202136

RESUMO

FUNDAMENTO: El personal sanitario que trata a pacientes con infecciones como el coronavirus (COVID-19) corre el riesgo de infectarse. Este utiliza equipos de protección individual (EPI) para protegerse de las gotas de la tos, los estornudos u otros fluidos corporales de los pacientes infectados y de las superficies contaminadas que puedan infectarlos. El EPI puede incluir delantales, batas o monos (un traje de una sola pieza), guantes, máscaras y equipo de respiración (respiradores) y gafas protectoras. El EPI debe ser puesto correctamente; puede ser incómodo de usar, y los trabajadores de la salud pueden contaminarse cuando se lo quitan. Algunos se han adaptado, por ejemplo, añadiendo pestañas para facilitar su retirada. Las organizaciones como los Centros para el Control y la Prevención de Enfermedades (CDC) de Estados Unidos ofrecen orientación sobre el procedimiento correcto para ponerse y quitarse el EPI. Esta es la actualización de 2020 de una revisión publicada por primera vez en 2016 y actualizada previamente en 2019. ¿QUÉ SE QUERÍA DESCUBRIR?: Se quería saber qué tipo de EPI o combinación de EPI confiere a los trabajadores de la salud la mejor protección; si la modificación del EPI para facilitar su retirada es efectiva; si seguir la guía para retirar el EPI reduce la contaminación; y si el entrenamiento reduce la contaminación. ¿QUÉ SE ENCONTRÓ?: Se encontraron 24 estudios relevantes con 2.278 participantes que evaluaron los tipos de EPI, EPI modificado, procedimientos para poner y quitar el EPI y tipos de entrenamiento. Dieciocho de los estudios no evaluaron a los trabajadores sanitarios que trataban a pacientes infectados, sino que simularon el efecto de la exposición a la infección mediante el uso de marcadores fluorescentes o virus o bacterias inofensivos. La mayoría de los estudios fueron pequeños, y solo 1 o 2 estudios abordaron cada una de las preguntas. TIPOS DE EPI: Cubrir más el cuerpo lleva a una mejor protección. Sin embargo, como esto suele estar asociado con una mayor dificultad para ponerse y quitarse el EPI y una menor comodidad, puede conducir a una mayor contaminación. Los monos son los EPI más difíciles de quitar, pero pueden ofrecer la mejor protección, seguida de los vestidos largos, batas y delantales. Los respiradores que se usan con los monos pueden proteger mejor que una máscara que se usa con una bata, pero son más difíciles de poner. Los tipos de EPI más transpirables pueden conducir a niveles similares de contaminación, pero son más cómodos. La contaminación fue común en la mitad de los estudios a pesar de la mejora del EPI. EPI MODIFICADO: Las batas que tienen guantes adheridos al puño, de manera que los guantes y la bata se quitan juntos y cubren la zona de la muñeca, y las batas que se modifican para que se ajusten bien al cuello pueden reducir la contaminación. Además, añadir lengüetas a los guantes y mascarillas también puede conducir a una menor contaminación. Sin embargo, un estudio no encontró menos errores al ponerse o quitarse las batas modificadas. ORIENTACIÓN SOBRE EL USO DEL EPI: Seguir la guía de los CDC para la eliminación del delantal o la bata, o cualquier instrucción para eliminar el EPI en comparación con las propias preferencias de un individuo, pueden reducir la autocontaminación. Quitarse la bata y los guantes en un solo paso, usar 2 pares de guantes y limpiar los guantes con lejía o desinfectante (pero no con alcohol) también puede reducir la contaminación. ENTRENAMIENTO DE LOS USUARIOS: El entrenamiento en persona, la simulación por computadora y el entrenamiento por video condujeron a menos errores en la extracción del EPI, tanto un entrenamiento entregado como material escrito solamente o una conferencia tradicional. CERTEZA DE LA EVIDENCIA: La certeza (confianza) en las evidencias es limitada porque los estudios simularon la infección (es decir, no fue real), y tuvieron un número de participantes pequeño. ¿QUÉ FALTA DESCUBRIR?: No hubo estudios que investigaran las gafas o las pantallas faciales. No queda claro cuál es la mejor manera de quitarse los EPI después de su uso y el mejor tipo de entrenamiento a largo plazo. Los hospitales deben organizar más estudios, y los investigadores deben ponerse de acuerdo sobre la mejor manera de simular la exposición a un virus. En el futuro, los estudios de simulación deben tener al menos 60 participantes cada uno, y utilizar la exposición a un virus inofensivo para evaluar qué tipo y combinación de EPI protege más. Sería útil que los hospitales pudieran registrar el tipo de EPI utilizado por sus trabajadores para proporcionar información urgente de la vida real. FECHA DE LA BÚSQUEDA: Esta revisión incluye pruebas publicadas hasta el 20 de marzo de 2020


No disponible


Assuntos
Humanos , Equipamento de Proteção Individual/provisão & distribuição , Controle de Doenças Transmissíveis/métodos , Líquidos Corporais/microbiologia , Secreções Corporais/microbiologia , Doenças Transmissíveis/epidemiologia , Precauções Universais/métodos , Capacitação Profissional
14.
Emergencias (Sant Vicenç dels Horts) ; 33(1): 62-64, feb. 2021.
Artigo em Espanhol | IBECS | ID: ibc-202137

RESUMO

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


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Assuntos
Humanos , Controle de Doenças Transmissíveis/métodos , Fidelidade a Diretrizes/estatística & dados numéricos , Infecções Respiratórias/transmissão , Pessoal de Saúde/estatística & dados numéricos , Infecções Respiratórias/prevenção & controle , Precauções Universais/estatística & dados numéricos , Equipamento de Proteção Individual/provisão & distribuição
15.
Emerg Infect Dis ; 27(2): 404-410, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33395382

RESUMO

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


Assuntos
Teste para COVID-19/estatística & dados numéricos , COVID-19/diagnóstico , Testes Diagnósticos de Rotina/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Precauções Universais/estatística & dados numéricos , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Teste para COVID-19/métodos , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , SARS-CoV-2 , Suíça/epidemiologia , Precauções Universais/métodos
17.
J Epidemiol Glob Health ; 11(1): 60-68, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32959614

RESUMO

BACKGROUND AND OBJECTIVES: Corona Virus Disease 2019 (COVID-19) pandemic is a global health emergency. Health Care Workers (HCWs) with sound knowledge and practices can help curb the pandemic. This study aimed to assess the knowledge, attitude and practices of HCWs about COVID-19 and compare physicians and non-physicians in Saudi Arabia. METHODS: An online survey was conducted among HCWs in Saudi Arabia in March and April 2020. Data were collected using a structured questionnaire having four sections including; socio-demographic and professional profile, knowledge, attitude and practices regarding COVID-19. Questionnaire link was sent through social media. Descriptive analysis was used for assessment of knowledge, attitude and practice and Chi-square test was used for comparing physicians and non-physicians. Data were analyzed using SPSS version 21.0. RESULTS: A total of 398 HCWs completed the questionnaire. Only 45% of the participants had correct knowledge about the agent while about 97% knew that close contact with infected person is the most important risk factor. Only 63% had correct knowledge about the role of antibiotics in COVID-19 treatment. Majority of the HCWs were worried and most frequently reported worry was risk to family. Carrying infection to home was most commonly reported fear, 92%. Cleaning hands often or always was 11.5% and 87% respectively. About 71% wore mask during work. Knowledge was better among physicians compared to non-physicians while attitude and practices were comparable between the two groups. CONCLUSION: We found that there was poor knowledge about causative agent and role of antibiotics for COVID-19 but for mode of transmission and prevention there was good knowledge. There were widely prevalent worries and fears among the participants. Overall, there were good infection control practices among the HCWs. Interventions are needed to improve knowledge and address worries and fears of HCW.


Assuntos
COVID-19 , Pessoal de Saúde , Controle de Infecções/métodos , Médicos , SARS-CoV-2/patogenicidade , Precauções Universais/métodos , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Estudos Transversais , Demografia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Humanos , Masculino , Determinação de Necessidades de Cuidados de Saúde , Médicos/psicologia , Médicos/normas , Arábia Saudita/epidemiologia , Fatores Sociológicos , Inquéritos e Questionários
18.
Am J Infect Control ; 49(5): 653-654, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33011335

RESUMO

This retrospective, cross-sectional study was conducted in four community hospitals in Los Angeles County, California. The assumption of this study was, coronavirus disease-19 (COVID-19) contributed to the increase in healthcare workers compliance with infection prevention measures. IP initiatives fostered among HCWs have increased awareness of effective hand washing, cleaning equipment after use and appropriate personal protective equipment use which has subsequently decreased healthcare acquired infections with multidrug-resistant organisms.


Assuntos
COVID-19/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Fidelidade a Diretrizes/estatística & dados numéricos , Desinfecção das Mãos , Pessoal de Saúde/estatística & dados numéricos , Controle de Infecções , Equipamento de Proteção Individual , Guias de Prática Clínica como Assunto , Adulto , COVID-19/epidemiologia , COVID-19/transmissão , Estudos Transversais , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Controle de Infecções/métodos , Controle de Infecções/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Estudos Retrospectivos , SARS-CoV-2 , Precauções Universais
20.
Esc. Anna Nery Rev. Enferm ; 25(3): e20200193, 2021. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1149305

RESUMO

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


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


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


Assuntos
Humanos , Masculino , Feminino , Adulto , Precauções Universais/estatística & dados numéricos , Enfermeiras e Enfermeiros , Estudos Transversais , Exposição Ocupacional/prevenção & controle , Controle de Infecções/estatística & dados numéricos , Técnicos de Enfermagem
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