Camila Eugenia Roseira

Hand hygiene in hospital environments: use of conformity indicators

An exploratory descriptive study with a quantitative approach whose objective was to use indicators to evaluate the frequency and infrastructure for hand hygiene, as well as the nursing teams knowledge about the subject. Systematized observation was carried out at hospital in the state of São Paulo, Brazil of the routine activities of 33 participating professionals (nurses and technicians) as well as the application of an individual questionnaire about the subject. 1206 opportunities for hand hygiene were identified, though it was effected in only 481 (39.9%) of them. Alcohol solution was not used at any opportunity. The infrastructure indicatorfor hand hygiene was close to the ideal value (83.30%). The professionals reported a high frequency of hand hygiene, demonstrating knowledge in relation to its importance, yet contradicting the findings of the observation. It was concluded that, despite the adequate infrastructure, hand hygiene was below that expected, requiring actions and strategies to overcomes these barrier and increase the use of alcohol solution.

HIGIENIZAÇÃO DAS MÃOS EM AMBIENTE HOSPITALAR: USO DE INDICADORES DE CONFORMIDADE

An exploratory descriptive study with a quantitative approach whose objective was to use indicators to evaluate the frequency and infrastructure for hand hygiene, as well as the nursing teams knowledge about the subject. Systematized observation was carried out at hospital in the state of São Paulo, Brazil of the routine activities of 33 participating professionals (nurses and technicians) as well as the application of an individual questionnaire about the subject. 1206 opportunities for hand hygiene were identified, though it was effected in only 481 (39.9%) of them. Alcohol solution was not used at any opportunity. The infrastructure indicatorfor hand hygiene was close to the ideal value (83.30%). The professionals reported a high frequency of hand hygiene, demonstrating knowledge in relation to its importance, yet contradicting the findings of the observation. It was concluded that, despite the adequate infrastructure, hand hygiene was below that expected, requiring actions and strategies to overcomes these barrier and increase the use of alcohol solution.

Adaptation and validation of indicators concerning the sterilization process of supplies in Primary Health Care services.

Objetivos: adaptar y validar para uso en el ambito de la APS, por medio de consenso de especialistas, un conjunto de indicadores para evaluacion del procesamiento de articulos medicos odontologicos hospitalarios. Metodo: estudio metodologico cuantitativo, realizado en dos fases subsecuentes. En la primera fase, un grupo focal fue creado con especialistas con la finalidad de adaptar los indicadores para ser usados en la Atencion Primaria de la Salud. En la segunda fase, los indicadores fueron sometidos a validacion por los jueces a traves de una escala tipo Likert de 4 puntos, considerandose el Indice de Validez de Contenido ≥ 0,75 para aprobacion de los indicadores. Resultados: las adaptaciones del grupo focal se refirieron principalmente a la: estructura fisica, insercion de profesionales de odontologia, inclusion de desinfeccion quimica y sustitucion de metodos de esterilizacion de calor seco por calor humedo. La fase de validacion resulto en un total de 0,96 de indice para los componentes de los indicadores, variando entre 0,90 y 1,00. Conclusion: los indicadores despues de la adaptacion fueron considerados validados por los jueces. A pesar de que puede haber diferencias entre los productos de procesamiento en todo el mundo, ciertamente caracteristicas comunes pueden ser encontradas, principalmente en paises con ambiente economico y cultural similar. Se debe considerar la inclusion de esos indicadores para evaluar la seguridad de los productos para la salud en la atencion primaria.Descriptores: Atencion Primaria de Salud; Esterilizacion; Enfermeria; Indicadores de Servicios; Estudios de Validacion como Tema.OBJECTIVES: to adapt and validate, by expert consensus, a set of indicators used to assess the sterilization process of dental, medical and hospital supplies to be used in PHC services. METHOD: qualitative methodological study performed in two stages. The first stage included a focal group composed of experts to adapt the indicators to be used in PHC. In the second stage, the indicators were validated using a 4-point Likert scale, which was completed by judges. A Content Validity Index of ≥ 0.75 was considered to show approval of the indicators. RESULTS: the adaptations implemented by the focal group mainly referred to the physical structure, inclusion of dental care professionals, inclusion of chemical disinfection, and replacement of the hot air and moist heat sterilization methods. The validation stage resulted in an index of 0.96, which ranged from 0.90 to 1.00, for the components of the indicators. CONCLUSION: the judges considered the indicators after adaptation to be validated. Even though there may be differences among items processed around the world, there certainly are common characteristics, especially in countries with economic and cultural environments similar to Brazil. The inclusion of these indicators to assess the safety of healthcare supplies used in PHC services should be considered.

Assessment of the patient safety culture in primary health care

Objective: Assess the professionals’ perception on the patient safety culture in primary health care. Methods: quantitative, cross-sectional, descriptive survey, using the questionnaire “Pesquisa sobre Cultura de Segurança do Paciente para Atenção Primária”, which assesses 12 dimensions of the patient safety culture. Dimensions scoring 75% or higher were considered positive. Results: The dimensions “information exchange with other institutions” (79%), “teamwork” (79%), “patient care tracking/follow-up” (80%), “patient safety and quality problems” (83%), while “leadership support for patient safety” (47%) showed to be a weak area. A signifi cant difference was found when comparing the variables length of experience and professional category with the average percentages of positive answers. Conclusion: The results showed that the Primary Health Care professional perceived the dimensions of the patient safety culture positively, and only “leadership support for patient safety” was considered as a weak area. Resumen Objetivo: Evaluar la percepción de los profesionales sobre la cultura de seguridad del paciente en la atención primaria a la salud. Métodos: Investigación Cuantitativa, transversal, descriptiva del tipo survey, utilizando el cuestionario “Encuesta sobre Cultura de Seguridad del Paciente de Atención Primaria”, el cual evalúa 12 dimensiones de la cultura de seguridad del paciente. Se consideraron positivas las puntuaciones superiores o igual al 75%. Resultados: Las dimensiones de “intercambio de información con otras instituciones” (79%), “trabajo en equipo” (79%), “monitoreo de la atención al paciente” (80%), “ seguridad del paciente y problemas de calidad” (83 (%) fueron consideradas positivas para la cultura de seguridad del paciente, mientras que el “soporte del liderazgo” (47%) se demostró como área débil. Hubo una diferencia signifi cativa en la comparación de las variables tiempo de servicio y categoría profesional con el promedio de los porcentajes de respuestas positivas. Conclusión: Los resultados mostraron que los profesionales de Atención Primaria a la Salud tuvieron una percepción positiva sobre las dimensiones de la cultura de seguridad del paciente, y solo el “ apoyo del liderazgo” se consideró como zona frágil. Descritores Segurança do paciente; Cultura organizacional; Qualidade da assistência à saúde; Atenção primária à saúdeUniversidade Federal de São Carlos, São Carlos, SP, Brazil. Confl icts of interest: Taken from the thesis “Assessment of the patient safety culture in primary health care” Graduate Nursing Program Universidade Federal de São Carlos, year of defense 2017. Abstract Objective: Assess the professionals’ perception on the patient safety culture in primary health care. Methods: quantitative, cross-sectional, descriptive survey, using the questionnaire “Pesquisa sobre Cultura de Segurança do Paciente para Atenção Primária”, which assesses 12 dimensions of the patient safety culture. Dimensions scoring 75% or higher were considered positive. Results: The dimensions “information exchange with other institutions” (79%), “teamwork” (79%), “patient care tracking/follow-up” (80%), “patient safety and quality problems” (83%), while “leadership support for patient safety” (47%) showed to be a weak area. A signifi cant difference was found when comparing the variables length of experience and professional category with the average percentages of positive answers. Conclusion: The results showed that the Primary Health Care professional perceived the dimensions of the patient safety culture positively, and only “leadership support for patient safety” was considered as a weak area.

Evaluación de la cultura de seguridad del paciente en la atención primaria a la salud

Objective: Assess the professionals’ perception on the patient safety culture in primary health care. Methods: quantitative, cross-sectional, descriptive survey, using the questionnaire “Pesquisa sobre Cultura de Segurança do Paciente para Atenção Primária”, which assesses 12 dimensions of the patient safety culture. Dimensions scoring 75% or higher were considered positive. Results: The dimensions “information exchange with other institutions” (79%), “teamwork” (79%), “patient care tracking/follow-up” (80%), “patient safety and quality problems” (83%), while “leadership support for patient safety” (47%) showed to be a weak area. A signifi cant difference was found when comparing the variables length of experience and professional category with the average percentages of positive answers. Conclusion: The results showed that the Primary Health Care professional perceived the dimensions of the patient safety culture positively, and only “leadership support for patient safety” was considered as a weak area. Resumen Objetivo: Evaluar la percepción de los profesionales sobre la cultura de seguridad del paciente en la atención primaria a la salud. Métodos: Investigación Cuantitativa, transversal, descriptiva del tipo survey, utilizando el cuestionario “Encuesta sobre Cultura de Seguridad del Paciente de Atención Primaria”, el cual evalúa 12 dimensiones de la cultura de seguridad del paciente. Se consideraron positivas las puntuaciones superiores o igual al 75%. Resultados: Las dimensiones de “intercambio de información con otras instituciones” (79%), “trabajo en equipo” (79%), “monitoreo de la atención al paciente” (80%), “ seguridad del paciente y problemas de calidad” (83 (%) fueron consideradas positivas para la cultura de seguridad del paciente, mientras que el “soporte del liderazgo” (47%) se demostró como área débil. Hubo una diferencia signifi cativa en la comparación de las variables tiempo de servicio y categoría profesional con el promedio de los porcentajes de respuestas positivas. Conclusión: Los resultados mostraron que los profesionales de Atención Primaria a la Salud tuvieron una percepción positiva sobre las dimensiones de la cultura de seguridad del paciente, y solo el “ apoyo del liderazgo” se consideró como zona frágil. Descritores Segurança do paciente; Cultura organizacional; Qualidade da assistência à saúde; Atenção primária à saúdeUniversidade Federal de São Carlos, São Carlos, SP, Brazil. Confl icts of interest: Taken from the thesis “Assessment of the patient safety culture in primary health care” Graduate Nursing Program Universidade Federal de São Carlos, year of defense 2017. Abstract Objective: Assess the professionals’ perception on the patient safety culture in primary health care. Methods: quantitative, cross-sectional, descriptive survey, using the questionnaire “Pesquisa sobre Cultura de Segurança do Paciente para Atenção Primária”, which assesses 12 dimensions of the patient safety culture. Dimensions scoring 75% or higher were considered positive. Results: The dimensions “information exchange with other institutions” (79%), “teamwork” (79%), “patient care tracking/follow-up” (80%), “patient safety and quality problems” (83%), while “leadership support for patient safety” (47%) showed to be a weak area. A signifi cant difference was found when comparing the variables length of experience and professional category with the average percentages of positive answers. Conclusion: The results showed that the Primary Health Care professional perceived the dimensions of the patient safety culture positively, and only “leadership support for patient safety” was considered as a weak area.

Diagnosis of compliance of health care product processing in Primary Health Care

Objetivo: identificar la conformidad del procesamiento de productos para la salud en la Atención Primaria a la Salud y evaluar una posible diferencia en la conformidad entre las unidades caracterizadas: Unidad Básica de Salud y Unidad Salud de la Familia. Método: estudio cuantitativo, observacional, descriptivo e inferencial; se aplicaron indicadores de estructura, proceso y resultado, referentes al procesamiento de productos para la salud en diez unidades de un municipio del interior de Sao Paulo, Brasil. Resultados: todos los indicadores obtuvieron índice de conformidad inferior a lo ideal. No hubo diferencia estadísticamente significativa de los indicadores entre los dos tipos de unidades investigadas, siendo el indicador de limpieza de productos para la salud el de menor índice de conformidad; por otro lado, como indicador de recursos técnico-operacionales para preparación, acondicionamiento, desinfección/esterilización, almacenamiento y distribución de productos para la salud, fue el de mejor índice. Conclusión: el diagnóstico de conformidad del procesamiento de productos para la salud en las unidades evaluadas indica que está comprometida la calidad del proceso, ya que no fueron obtenidos resultados próximos al valor ideal en ninguna unidad. Además de eso, no hubo diferencia estadísticamente significativa de esos indicadores entre los dos tipos de unidades estudiadas.ABSTRACT Objective: identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service. Method: quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil. Results: for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index. Conclusion: the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied.

Adaptación y validación de indicadores para el procesamiento de productos en la atención primaria a la salud

Objetivos: adaptar y validar para uso en el ambito de la APS, por medio de consenso de especialistas, un conjunto de indicadores para evaluacion del procesamiento de articulos medicos odontologicos hospitalarios. Metodo: estudio metodologico cuantitativo, realizado en dos fases subsecuentes. En la primera fase, un grupo focal fue creado con especialistas con la finalidad de adaptar los indicadores para ser usados en la Atencion Primaria de la Salud. En la segunda fase, los indicadores fueron sometidos a validacion por los jueces a traves de una escala tipo Likert de 4 puntos, considerandose el Indice de Validez de Contenido ≥ 0,75 para aprobacion de los indicadores. Resultados: las adaptaciones del grupo focal se refirieron principalmente a la: estructura fisica, insercion de profesionales de odontologia, inclusion de desinfeccion quimica y sustitucion de metodos de esterilizacion de calor seco por calor humedo. La fase de validacion resulto en un total de 0,96 de indice para los componentes de los indicadores, variando entre 0,90 y 1,00. Conclusion: los indicadores despues de la adaptacion fueron considerados validados por los jueces. A pesar de que puede haber diferencias entre los productos de procesamiento en todo el mundo, ciertamente caracteristicas comunes pueden ser encontradas, principalmente en paises con ambiente economico y cultural similar. Se debe considerar la inclusion de esos indicadores para evaluar la seguridad de los productos para la salud en la atencion primaria.Descriptores: Atencion Primaria de Salud; Esterilizacion; Enfermeria; Indicadores de Servicios; Estudios de Validacion como Tema.OBJECTIVES: to adapt and validate, by expert consensus, a set of indicators used to assess the sterilization process of dental, medical and hospital supplies to be used in PHC services. METHOD: qualitative methodological study performed in two stages. The first stage included a focal group composed of experts to adapt the indicators to be used in PHC. In the second stage, the indicators were validated using a 4-point Likert scale, which was completed by judges. A Content Validity Index of ≥ 0.75 was considered to show approval of the indicators. RESULTS: the adaptations implemented by the focal group mainly referred to the physical structure, inclusion of dental care professionals, inclusion of chemical disinfection, and replacement of the hot air and moist heat sterilization methods. The validation stage resulted in an index of 0.96, which ranged from 0.90 to 1.00, for the components of the indicators. CONCLUSION: the judges considered the indicators after adaptation to be validated. Even though there may be differences among items processed around the world, there certainly are common characteristics, especially in countries with economic and cultural environments similar to Brazil. The inclusion of these indicators to assess the safety of healthcare supplies used in PHC services should be considered.

Higiene de las manos en el hospital: uso de indicadores de cumplimiento

An exploratory descriptive study with a quantitative approach whose objective was to use indicators to evaluate the frequency and infrastructure for hand hygiene, as well as the nursing teams knowledge about the subject. Systematized observation was carried out at hospital in the state of São Paulo, Brazil of the routine activities of 33 participating professionals (nurses and technicians) as well as the application of an individual questionnaire about the subject. 1206 opportunities for hand hygiene were identified, though it was effected in only 481 (39.9%) of them. Alcohol solution was not used at any opportunity. The infrastructure indicatorfor hand hygiene was close to the ideal value (83.30%). The professionals reported a high frequency of hand hygiene, demonstrating knowledge in relation to its importance, yet contradicting the findings of the observation. It was concluded that, despite the adequate infrastructure, hand hygiene was below that expected, requiring actions and strategies to overcomes these barrier and increase the use of alcohol solution.