Adriano Menis Ferreira

Condition of cleanliness of surfaces close to patients in an intensive care unit

La limpieza de las superficies es reconocidamente una medida de control de la diseminacion de microorganismos en el ambiente hospitalario. Este estudio prospectivo, realizado en una unidad de terapia intensiva, durante 14 dias, tuvo como objetivo describir las condiciones de limpieza/desinfeccion de cuatro superficies proximas al paciente. Cien evaluaciones de las superficies fueron realizadas despues del proceso de limpieza. Se utilizaron tres metodos para evaluar la limpieza: inspeccion visual, adenosin trifosfato (ATP) bioluminiscencia y presencia de Staphylococcus aureus/MSRA. Respectivamente, 20%, 80% y 16% de las evaluaciones por los metodos: visual, ATP y presencia de Staphylococcus aureus/MSRA, fueron consideradas reprobadas. Hubo diferencias estadisticamente significativas (p<0.05) entre las tasas de reprobacion de la limpieza utilizando los metodos ATP, comparado al visual y al microbiologico. La inspeccion visual no se mostro una medida confiable para evaluar la limpieza de las superficies. Los resultados demostraron que la actual rutina de limpieza precisa ser modificada.La limpieza de las superficies es reconocidamente una medida de control de la diseminacion de microorganismos en el ambiente hospitalario. Este estudio prospectivo, realizado en una unidad de terapia intensiva, durante 14 dias, tuvo como objetivo describir las condiciones de limpieza/desinfeccion de cuatro superficies proximas al paciente. Cien evaluaciones de las superficies fueron realizadas despues del proceso de limpieza. Se utilizaron tres metodos para evaluar la limpieza: inspeccion visual, adenosin trifosfato (ATP) bioluminiscencia y presencia de Staphylococcus aureus/MSRA. Respectivamente, 20%, 80% y 16% de las evaluaciones por los metodos: visual, ATP y presencia de Staphylococcus aureus/MSRA, fueron consideradas reprobadas. Hubo diferencias estadisticamente significativas (p<0.05) entre las tasas de reprobacion de la limpieza utilizando los metodos ATP, comparado al visual y al microbiologico. La inspeccion visual no se mostro una medida confiable para evaluar la limpieza de las superficies. Los resultados demostraron que la actual rutina de limpieza precisa ser modificada.

The use of fatty acids in wound care: an integrative review of the Brazilian literature

Os objetivos deste estudo foram caracterizar a producao cientifica nacional da utilizacao topica de acidos graxos no tratamento de feridas e descrever os efeitos da sua acao nesse processo. Trata-se de uma revisao integrativa da literatura indexada nas bases de dados LILACS e BEDEnf. A coleta de dados ocorreu no mes de dezembro de 2010, com descritores de assuntos controlados e sem delimitacao de periodo de busca. A amostra constitui-se de 09 artigos, sendo, a maioria conduzida em modelos animais e utilizando diferentes composicoes de acidos graxos. Diante da escassez de estudos clinicos randomizados controlados em humanos e as limitacoes desta revisao, nao se pode generalizar, na pratica clinica, que os acidos graxos essenciais influenciam o processo de cicatrizacao positivamente ou possuem acao antimicrobiana. Assim, ha necessidade de realizacao de pesquisas com maior rigor metodologico comparando as diferentes formulas disponiveis contendo acidos graxos e sua influencia no processo cicatricial.The objective of this study was to characterize the Brazilian scientific production on the topical use of fatty acids in wound care, and to describe the effects of its administration in this process. This integrative literature review included articles indexed in Lilacs and BEDENF databases. Data collection was carried out in December 2010 using controlled descriptors and without publication date limitations. The sample consisted of nine articles, mostly concerning animal models and the use of different fatty acids mixtures. Due to the lack of randomized clinical trials in human beings and the limitations of this review, it is not possible to generalize that essential fatty acids have a positive effect on the healing process or have antimicrobial effects on wound healing. Therefore, it is necessary to conduct studies of higher methodological rigor, comparing the different formulas available with fatty acids and their effects on the healing process.

Infection control related to central venous catheter impregnated with antiseptics: an integrative review

The use of central venous catheter is pointed out as a risk factor to blood stream infection. The objective of this study was to reach scientific evidence on infection control related to central venous catheter impregnated with antiseptics, used in hospitalized adult patients. Studies were selected from the LILACS, CINAHL and MEDLINE databases. Nine articles were selected by means of integrative literature review. The publications on the use of catheters impregnated with antiseptics showed statistically significant differences regarding the reduction of microbial colonization; however, only one study showed reduction in the occurrence of infection. The analysis of the studies revealed there is a need for further research in different patient populations in order to obtain general conclusions.El uso de cateter venoso central es senalado como uno de los principales factores de infeccion de la corriente sanguinea. El estudio objetiva buscar evidencias cientificas sobre control de infeccion relacionada con cateter venoso central impregnado con antisepticos utilizado en pacientes adultos hospitalizados. Para seleccionar estudios se utilizaron las bases de datos LILACS, CINAHL y MEDLINE. Se totalizaron 9 articulos mediante revision integradora de literatura. Las publicaciones referidas a utilizacion de cateteres impregnados con antisepticos mostraron diferencias estadisticamente significantes en lo referente a reduccion de colonizacion microbiana, mientras apenas un estudio demostro reduccion de ocurrencia de infeccion. Ante el analisis de los estudios, existe necesidad de investigaciones adicionales en diferentes poblaciones de pacientes con la finalidad de efectuar generalizaciones.

Conhecimento e prática de acadêmicos de enfermagem sobre cuidados com portadores de feridas

Resumen The present cross-sectional study aimed to identify the knowledge, practice and sources of information of undergraduate nursing students in care to wounds. Participants were 68 undergraduate nursing students in their 9th period at a Public University in Mato Grosso do Sul State, Brazil. Data were collected from two classes in 2008 and 2009. An instrument, with items on wound handling, was adapted and validated for data collection. Only six (54,5%) items had more than 50% of correct answers. From these, 4 (36.3%) did not reach 70% correct answers, however, the rate did not reach 70%. Only two (11.1%) items were correctly answered by all students. It was evidenced that most students do not use sources of information for updating on the topic. Results showed that the level of knowledge, concerning care to wounds, is low, thus evidencing the need of investments in undergraduate teaching in the mentioned university program.Este estudio transversal objetivo identificar el conocimiento, la practica y las fuentes de informaciones de estudiantes graduandos de enfermeria sobre el cuidado con heridas. Participaron 68 estudiantes del noveno periodo de una Universidad Publica en el Estado de Mato Grosso do Sul, Brasil. Los datos fueron recolectados de dos clases en los anos de 2008 y 2009. Un instrumento con items acerca del manejo de heridas fue adaptado y validado para la recolecta de las informaciones. Solo 6 (54,5%) items tuvieron aciertos de mas del 50%. De ellos, cuatro (36,3%) no alcanzan el 70% de respuestas correctas. Solo 2 (11,1%) items fueron respondidos correctamente por todos los estudiantes. La mayoria de Estudiantes no utiliza fuentes de informacion para actualizacion sobre el tema. Los resultados demostraron que el nivel de conocimiento acerca del cuidado con heridas es bajo y, por lo tanto, inversiones en la ensenanza de la graduacion del referido curso son necesarias.

Condições de limpeza de superfícies próximas ao paciente, em uma unidade de terapia intensiva

La limpieza de las superficies es reconocidamente una medida de control de la diseminacion de microorganismos en el ambiente hospitalario. Este estudio prospectivo, realizado en una unidad de terapia intensiva, durante 14 dias, tuvo como objetivo describir las condiciones de limpieza/desinfeccion de cuatro superficies proximas al paciente. Cien evaluaciones de las superficies fueron realizadas despues del proceso de limpieza. Se utilizaron tres metodos para evaluar la limpieza: inspeccion visual, adenosin trifosfato (ATP) bioluminiscencia y presencia de Staphylococcus aureus/MSRA. Respectivamente, 20%, 80% y 16% de las evaluaciones por los metodos: visual, ATP y presencia de Staphylococcus aureus/MSRA, fueron consideradas reprobadas. Hubo diferencias estadisticamente significativas (p<0.05) entre las tasas de reprobacion de la limpieza utilizando los metodos ATP, comparado al visual y al microbiologico. La inspeccion visual no se mostro una medida confiable para evaluar la limpieza de las superficies. Los resultados demostraron que la actual rutina de limpieza precisa ser modificada.La limpieza de las superficies es reconocidamente una medida de control de la diseminacion de microorganismos en el ambiente hospitalario. Este estudio prospectivo, realizado en una unidad de terapia intensiva, durante 14 dias, tuvo como objetivo describir las condiciones de limpieza/desinfeccion de cuatro superficies proximas al paciente. Cien evaluaciones de las superficies fueron realizadas despues del proceso de limpieza. Se utilizaron tres metodos para evaluar la limpieza: inspeccion visual, adenosin trifosfato (ATP) bioluminiscencia y presencia de Staphylococcus aureus/MSRA. Respectivamente, 20%, 80% y 16% de las evaluaciones por los metodos: visual, ATP y presencia de Staphylococcus aureus/MSRA, fueron consideradas reprobadas. Hubo diferencias estadisticamente significativas (p<0.05) entre las tasas de reprobacion de la limpieza utilizando los metodos ATP, comparado al visual y al microbiologico. La inspeccion visual no se mostro una medida confiable para evaluar la limpieza de las superficies. Los resultados demostraron que la actual rutina de limpieza precisa ser modificada.

Methicillin-resistant Staphylococcus aureus on surfaces of an Intensive Care Unit

TM e para a triagem de resistencia a meticilina, o agar Mueller-Hinton adicionado de 4% de cloreto de sodio e 6 μg/ml oxacilina. Analises descritivas foram empregadas para determinar a frequencia (n) e porcentagem (%) de contaminacao das superficies ambientais. Resultados: Das 48 amostras positivas para Staphylococcus aureus, 29 (60,4%) foram resistentes a meticilina. A incidencia em grades e manivelas da cama, mesa, botoes da bomba de infusao e aventais foi, respectivamente, 55,5%, 57,1%, 57,1%, 60,0% e 75,0%. Conclusao: Os resultados sugerem que as superficies ao redor do paciente constitui-se uma importante ameaca, visto que representam reservatorios secundarios de MRSA. Descritores: Staphylococcus aureus; Contaminacao de equipamentos; Infeccao hospitalar; Resistencia a meticilinaABSTRACT Objective: To evaluate the presence of methicillin-resistant Staphylococcus aureus (MRSA) in areas close to patients in a General Intensive Care Unit. Methods: This is a cross-sectional study, in which microbiological samples were collected from five surfaces (left / right bed siderails, bed crank,table, buttons on the infusion pump, and cotton gowns) from each of ten patient rooms, totaling 63 samples. To collect samples, the Petri Film TM Staph Express Count System 3M TM was used to screen for methicillin resistance, with the Mueller-Hinton agar supplemented with 4% sodiumchloride and 6 μg / ml of oxacillin. Descriptive analysis was conducted to determine the frequency (n) and percentage (%) of contamination ofenvironmental surfaces. Results: Of 48 samples positive for Staphylococcus aureus , 29 (60.4%) were resistant to methicillin. The incidence on thesiderails and bed cranks, table, buttons on the infusion pumps and aprons were, respectively, 55.5%, 57.1%, 57.1%, 60.0% and 75 .0%.

Staphylococcus aureus resistente à meticilina em superfícies de uma Unidade de Terapia Intensiva

TM e para a triagem de resistencia a meticilina, o agar Mueller-Hinton adicionado de 4% de cloreto de sodio e 6 μg/ml oxacilina. Analises descritivas foram empregadas para determinar a frequencia (n) e porcentagem (%) de contaminacao das superficies ambientais. Resultados: Das 48 amostras positivas para Staphylococcus aureus, 29 (60,4%) foram resistentes a meticilina. A incidencia em grades e manivelas da cama, mesa, botoes da bomba de infusao e aventais foi, respectivamente, 55,5%, 57,1%, 57,1%, 60,0% e 75,0%. Conclusao: Os resultados sugerem que as superficies ao redor do paciente constitui-se uma importante ameaca, visto que representam reservatorios secundarios de MRSA. Descritores: Staphylococcus aureus; Contaminacao de equipamentos; Infeccao hospitalar; Resistencia a meticilinaABSTRACT Objective: To evaluate the presence of methicillin-resistant Staphylococcus aureus (MRSA) in areas close to patients in a General Intensive Care Unit. Methods: This is a cross-sectional study, in which microbiological samples were collected from five surfaces (left / right bed siderails, bed crank,table, buttons on the infusion pump, and cotton gowns) from each of ten patient rooms, totaling 63 samples. To collect samples, the Petri Film TM Staph Express Count System 3M TM was used to screen for methicillin resistance, with the Mueller-Hinton agar supplemented with 4% sodiumchloride and 6 μg / ml of oxacillin. Descriptive analysis was conducted to determine the frequency (n) and percentage (%) of contamination ofenvironmental surfaces. Results: Of 48 samples positive for Staphylococcus aureus , 29 (60.4%) were resistant to methicillin. The incidence on thesiderails and bed cranks, table, buttons on the infusion pumps and aprons were, respectively, 55.5%, 57.1%, 57.1%, 60.0% and 75 .0%.

Health care service for ostomy patients: profile of the clientele

The study aimed to identify the profile of ostomy patients in a Health Care Service in Sao Jose do Rio Preto, Sao Paulo, Brazil. This is an exploratory, descriptive and retrospective study. Data were obtained by registration forms of patients assisted from January 1st, 2000, to December 31st, 2010. Out of the 252 ostomy patients, 51.1% were females and 48.9% were males; the age group with the highest concentration was from 68 to 78 years old (26.3%) for both genders, with mean age of 73 years old. The main reason for making the stoma was rectal (35.0%) and colon neoplasm (14.1%). The prevalent stoma was temporary colostomy (41.4%) and the period of permanence of the collecting equipment was longer than 36 months. Even though the service provides full assistance to the ostomy patients, it is necessary to review human resources aspects to provide appropriate assistance to its clientele.

Integrative review of the clean and sterile technique: agreement and disagreement in the execution of dressing

OBJECTIVE: This study aimed to describe, analyze, and categorize the evidence associated to the use of the clean and sterile technique in wounds. METHODS: It is an integrative literature review using Lilacs, Medline and Cinahl databases. RESULTS: Seven publications were found,, of which four compare the clean and sterile technique, regarding the occurrence of infection; two evaluate the microbiological safety of gloves, and one analyzed the cleansing solution. CONCLUSION: There is consensus that the clean technique reduces costs. Considering the scarcity of studies, we stress the need to perform more level I and II research, according to the evidence hierarchy.Objective: This study aimed to describe, analyze, and categorize the evidence associated to the use of the clean and sterile technique in wounds. Methods: It is an integrative literature review using Lilacs, Medline and Cinahl databases. Results: Seven publications were found,, of which four compare the clean and sterile technique, regarding the occurrence of infection; two evaluate the microbiological safety of gloves, and one analyzed the cleansing solution. Conclusion: There is consensus that the clean technique reduces costs. Considering the scarcity of studies, we stress the need to perform more level I and II research, according to the evidence hierarchy.

Utilização dos ácidos graxos no tratamento de feridas: uma revisão integrativa da literatura nacional

Os objetivos deste estudo foram caracterizar a producao cientifica nacional da utilizacao topica de acidos graxos no tratamento de feridas e descrever os efeitos da sua acao nesse processo. Trata-se de uma revisao integrativa da literatura indexada nas bases de dados LILACS e BEDEnf. A coleta de dados ocorreu no mes de dezembro de 2010, com descritores de assuntos controlados e sem delimitacao de periodo de busca. A amostra constitui-se de 09 artigos, sendo, a maioria conduzida em modelos animais e utilizando diferentes composicoes de acidos graxos. Diante da escassez de estudos clinicos randomizados controlados em humanos e as limitacoes desta revisao, nao se pode generalizar, na pratica clinica, que os acidos graxos essenciais influenciam o processo de cicatrizacao positivamente ou possuem acao antimicrobiana. Assim, ha necessidade de realizacao de pesquisas com maior rigor metodologico comparando as diferentes formulas disponiveis contendo acidos graxos e sua influencia no processo cicatricial.The objective of this study was to characterize the Brazilian scientific production on the topical use of fatty acids in wound care, and to describe the effects of its administration in this process. This integrative literature review included articles indexed in Lilacs and BEDENF databases. Data collection was carried out in December 2010 using controlled descriptors and without publication date limitations. The sample consisted of nine articles, mostly concerning animal models and the use of different fatty acids mixtures. Due to the lack of randomized clinical trials in human beings and the limitations of this review, it is not possible to generalize that essential fatty acids have a positive effect on the healing process or have antimicrobial effects on wound healing. Therefore, it is necessary to conduct studies of higher methodological rigor, comparing the different formulas available with fatty acids and their effects on the healing process.