[Experimental study. Reduction of pressure in areas of risk of developing pressure ulcers with a hydrocellular dressing]. / Estudio experimental. Reducción de la presión en zonas de riesgo para desarrollar úlceras por presión con un apósito hidrocelular.

INTRODUCTION: The handling of pressure is a basic measure in the prevention and treatment of bed sores. It is possible to reduce and ease pressure by various means including changes in posture, use of special surfaces for handling pressure as well as the use of local applications or external applications which reduce pressure. Today nurses have a large quantity of external applications available to use although only some hydrocellular ones are capable to reduce pressure due to their hydrocellular structure. METHODS AND MATERIALS: An experimental study was designed to calculate the level of pressure before and after applying an Allevyn hydrocellular external application in the area of the sacrum, ischium, and heel of three healthy volunteers; first, Volunteer A, a 85 kg. 170 cm man; second, Volunteer B, a 54.3 kg. 159 cm woman; and third, Volunteer C, a 69.4 kg 164 cm man. Measures were taken on two types of surfaces: a viscoelastic foam mattress and a conventional hospital mattress. All measurements were repeated at 0, 30, 45 and 60 degrees of inclination. Pressure was determined by means of a Talley pressure monitor, Oxford Pressure Monitor MK II. RESULTS: A total of 144 pressure reading were taken. The overall average reduction after applying a external hydrocellular application on all volunteers, at all inclinations and on all surfaces for each of the three zones were 19.5% in the sacrum, 13.8% in the ischium and 20.15% in the heel. COMMENTARY: Even though our study has its limitations, such as young, healthy volunteers, we can establish that the external hydrocellular application studied does have a local reducing effect on pressure. Since every external hydrocellular application has its own specific structure, the results of our study can not be applied with certainty to other external applications inside the hydrocellular group.

[Evaluation of a hand hygiene technique in healthcare workers]. / Evaluación de la técnica de higiene de manos en profesionales asistenciales.

OBJECTIVE: To evaluate the quality of hand hygiene in healthcare workers and the influence of wearing jewellery. METHODS: A sample of 293 healthcare professionals of different categories and on different shifts was studied. Hand hygiene was evaluated by a fluorescent agent that allowed us to determine the areas of the hand that had been in contact with the solution. Each hand was divided into 6 zones to quantify the quality of hygiene, the maximum score was 12 points. The wearing of jewellery was quantified. RESULTS: The mean score obtained was 8.3 (SD 2.0) out of 12 points. At least one untreated area of the hand was found in 95.2% of subjects. The results in fingers, thumbs and wrists were significantly lower than those obtained in other areas of the hand (p<.001), being dirty in over 50% of the participants. A dirty wrist was observed in 90% of those who wore a watch and in 92.7% of those wearing a bracelet,and the 84.3% of subjects who wore a ring had dirty fingers. CONCLUSIONS: Healthcare workers did not apply the technique of hand hygiene effectively. Areas where the alcoholic solution did not act as often were: thumbs, fingers and wrist. The use of watches, bracelets and rings prevent good hygiene.

[Pressure sores: evaluation of the systematic use of special surfaces for managing pressure sores in the intensive care unit of the Tarrasa Hospital, Spain]. / Ulceras por presión: evaluación de la utilización sistemática de un parque de superficies especiales para el manejo de la presión en la unidad de cuidados intensivos del Hospital de Tarrasa.

Pressure sores are a major challenge for healthcare systems. Patients admitted to intensive care units are an important risk group for pressure sores. Systematic use of a protocol employing special surfaces to manage pressure is a basic measure for preventing pressure sores in institutionalized patients. In a study carried out in the Intensive Care Unit of the Hospital of Terrassa (Spain), the incidence of pressure sores before and after introducing a prevention protocol that included the systematic use of special surfaces to manage pressure was compared. The incidence of pressure sores in patients admitted in 1998 and 1999 was studied. Sore locations were recorded. The results of three periods were examined: before introducing the protocol (6.4% incidence), after introducing a protocol (1.1%), and after use of the protocol was consolidated (0%). The results of the study suggest that the systematic use of special surfaces to manage pressure, in accordance with a prevention protocol, is a basic measure for reducing the incidence of pressure sores in patients admitted to intensive care units.

Evaluación de la técnica de higiene de manos en profesionales asistenciales / Evaluation of a hand hygiene technique in healthcare workers

Objetivo. Evaluar la calidad de la técnica de la higiene de manos en el personal asistencial en su lugar de trabajo y cuantificar el uso de pulseras, anillos y reloj y su influencia en el resultado de la higiene. Métodos. Se estudió una muestra de 293 profesionales asistenciales de diferentes categorías y turnos. Para la valoración de la higiene de manos se utilizó un agente fluorescente, que permitió determinar las zonas de la mano que habían estado en contacto con la solución. Se dividió cada mano en 6 zonas a fin de cuantificar la calidad de la técnica de higiene. La máxima puntuación esperada fue de 12. Se cuantificaron las pulseras, anillos y/o reloj que llevaban los participantes. Resultados. Tras practicar la higiene se obtuvo una media de 8,3 (DE: 2,0) sobre 12 puntos. El 95,2% de los participantes dejó alguna zona de las manos por tratar. Los resultados obtenidos en dedos, muñeca y pulgar fueron significativamente inferiores a los obtenidos en las otras zonas de la mano (p<0,001), resultando sucios en más del 50% de los participantes. El 90% de los que llevaban reloj mostraron la muñeca sucia, así como el 92,7% de los que llevaban pulsera. El 84,3% de los que llevaban anillo tenían los dedos sucios. Conclusión. El personal asistencial no aplica la técnica de higiene de manos de forma efectiva. Las zonas donde, con más frecuencia, no actuó la solución alcohólica fueron: pulgar, dedos y muñeca. El uso de reloj, pulsera y anillos impiden una buena higiene(AU)

Objective. to evaluate the quality of hand hygiene in healthcare workers and the influence of wearing jewellery. Methods. A sample of 293 healthcare professionals of different categories and on different shifts was studied. Hand hygiene was evaluated by a fluorescent agent that allowed us to determine the areas of the hand that had been in contact with the solution. Each hand was divided into 6 zones to quantify the quality of hygiene, the maximum score was 12 points. The wearing of jewellery was quantified. Results. The mean score obtained was 8.3 (SD 2.0) out of 12 points. At least one untreated area of the hand was found in 95.2% of subjects. The results in fingers, thumbs and wrists were significantly lower than those obtained in other areas of the hand (p <.001), being dirty in over 50% of the participants. A dirty wrist was observed in 90% of those who wore a watch and in 92.7% of those wearing a bracelet,and the 84.3% of subjects who wore a ring had dirty fingers. Conclusions. Healthcare workers did not apply the technique of hand hygiene effectively. Areas where the alcoholic solution did not act as often were: thumbs, fingers and wrist. The use of watches, bracelets and rings prevent good hygiene(AU)

Úlceras por presión: evaluación de la utilización sistemática de un parque de superficies especiales para el manejo de la presión en la unidad de cuidados intensivos del hospital de tarrasa / Pressure sores: evaluation of the systematic use of special surfaces for managing pressure sores in the intensive care unit of the Tarrasa Hospital (Spain)

Las úlceras por presión son un importante reto para el sistema de salud. Los pacientes ingresados en unidades de cuidados intensivos constituyen un importante grupo de riesgo para dicho problema. La utilización sistemática dentro de un protocolo de las superficies especiales para el manejo de la presión, es una medida básica para la prevención de las úlceras por presión en pacientes institucionalizados. El estudio ha sido realizado en la Unidad de Cuidados Intensivos del Hospital de Terrassa comparando la incidencia de úlceras por presión antes y después de la implantación de un protocolo de prevención que incluye la utilización sistemática de superficies especiales para el manejo de la presión. Para ello se ha monitorizado la incidencia de úlceras por presión en todos los pacientes ingresados durante los años 1998 y 1999. Para los casos incidentes se ha registrado la localización de las lesiones.Se presentan resultados correspondientes a tres períodos, antes de la intervención con una incidencia del 6,4 por ciento, después de la puesta en práctica del protocolo con una incidencia del 1,1 por ciento y un tercer período de consolidación del protocolo con una incidencia del 0 por ciento. A tenor de los resultados de nuestro estudio podemos destacar que la utilización sistemática de superficies especiales para el manejo de la presión dentro de un protocolo de prevención es una medida básica para reducir la incidencia de úlceras por presión en pacientes ingresados en unidades de cuidados intensivos. (AU)