Marcelo Alessandro Rigotti

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.

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.

Surface cleaning effectiveness in a walk-in emergency care unit: Influence of a multifaceted intervention

BACKGROUND Cleaning of surfaces is essential in reducing environmental bioburdens and health care-associated infection in emergency units. However, there are few or no studies investigating cleaning surfaces in these scenarios. Our goal was to determine the influence of a multifaceted intervention on the effectiveness of routine cleaning of surfaces in a walk-in emergency care unit. METHODS This prospective, before-and-after interventional study was conducted in 4 phases: phase I (situational diagnosis), phase II (implementation of interventions-feedback on results, standardization of cleaning procedures, and training of nursing staff), phase III (determination of the immediate influence of interventions), and phase IV (determination of the late influence of interventions). The surfaces were sampled before and after cleaning by visual inspection, adenosine triphosphate bioluminescence assay, and microbiologic culture. RESULTS We sampled 240 surfaces from 4 rooms. When evaluated by visual inspection and adenosine triphosphate bioluminescence, there was a progressive reduction of surfaces found to be inadequate in phases I-IV (P < .001), as well as in culture phases I-III. However, phase IV showed higher percentages of failure by culture than phase I (P = .004). CONCLUSIONS The interventions improved the effectiveness of cleaning. However, this effect was not maintained after 2 months.

EVALUATION OF THREE SURFACE FRICTION TECHNIQUES FOR THE REMOVAL OF ORGANIC MATTER

The objective of this study was to assess the effectiveness of three surface friction techniques for the removal of organic material. A quantitative, descrip...Se objetivo evaluar la eficacia de tres tecnicas de friccion de superficie para remocion de materia organica. Se trata de un estudio cuantitativo, descriptivo y exploratorio sobre evaluacion de la presencia o no de materia organica antes y despues del proceso de limpieza/desinfeccion de la superficie de mesillas de noche de pacientes internados en una Unidad de Terapia Intensiva. Tres tecnicas de friccion en sentido unidireccional, bidireccional y centrifuga fueron ejecutadas individualmente tres veces para cada mesilla, en semanas alternadas. Para cada unidad de paciente y tecnica de friccion, una unica mesilla y pano, utilizando 3 faces y humedecido con alcohol a 70% (p/v) fueron utilizados. La materia organica fue detectada por la presencia de trifosfato de adenosina por bioluminescencia, utilizando el sistema 3M(tm) Clean-Trace(tm) ATP Systems. Para cada tecnica, 13 muestras fueron recolectadas antes y 13 despues del proceso de limpieza/desinfeccion, totalizando 78 recolectas de trifosfato de adenosina por bioluminescencia. No fueron constatadas diferencias estadisticamente significativas entre las tecnicas en la remocion de materia organica. Este estudio demostro que ningun de los tres metodos de friccion de superficie fue mejor que los otros en la remocion de materia organica. Sin embargo, estudios adicionales son necesarios, considerando otros indicadores de limpieza/desinfeccion y superficies.

Collection of tracheal aspirate: safety and microbiological concordance between two techniques

Objetivo: Avaliar a seguranca da execucao das tecnicas tradicional e protegida de colheita de aspirado traqueal e identificar a concordância qualitativa e quantitativa dos resultados de culturas microbiologicas entre as tecnicas. Metodo: Pesquisa clinica, prospectiva, comparativa, simples-cega. A amostra foi constituida de 54 pacientes com idade ≥18 anos, submetidos a ventilacao mecânica invasiva por periodo ≥48 horas e com suspeita de Pneumonia Associada a Ventilacao Mecânica. As duas tecnicas foram implementadas no mesmo paciente, uma imediatamente seguida da outra, sendo a ordem de execucao aleatoria, segundo randomizacao por software especializado. Resultados: Nao ocorreram eventos significativos de queda da saturacao de oxigenio, instabilidade hemodinâmica e hemorragias traqueobronquicas (p<0,05) e, embora tenham ocorrido divergencias em algumas cepas, houve concordância qualitativa e quantitativa entre as tecnicas (p<0,001). Conclusao: A utilizacao da tecnica protegida nao proporciona vantagem em detrimento da tradicional e a execucao de ambas as tecnicas foi segura para o paciente.OBJECTIVE To evaluate the safety of the performance of the traditional and protected collection techniques of tracheal aspirate and to identify qualitative and quantitative agreement of the results of microbiological cultures between the techniques. METHOD Clinical, prospective, comparative, single-blind research. The sample was composed of 54 patients of >18 years of age, undergoing invasive mechanical ventilation for a period of ≥ 48 hours and with suspected Ventilator Associated Pneumonia. The two techniques were implemented in the same patient, one immediately after the other, with an order of random execution, according to randomization by specialized software. RESULTS No significant events occurred oxygen desaturation, hemodynamic instability or tracheobronchial hemorrhage (p<0.05) and, although there were differences in some strains, there was qualitative and quantitative agreement between the techniques (p<0.001). CONCLUSION Utilization of the protected technique provided no advantage over the traditional and execution of both techniques was safe for the patient.

Colheita de aspirado traqueal: segurança e concordância microbiológica entre duas técnicas

Objetivo: Avaliar a seguranca da execucao das tecnicas tradicional e protegida de colheita de aspirado traqueal e identificar a concordância qualitativa e quantitativa dos resultados de culturas microbiologicas entre as tecnicas. Metodo: Pesquisa clinica, prospectiva, comparativa, simples-cega. A amostra foi constituida de 54 pacientes com idade ≥18 anos, submetidos a ventilacao mecânica invasiva por periodo ≥48 horas e com suspeita de Pneumonia Associada a Ventilacao Mecânica. As duas tecnicas foram implementadas no mesmo paciente, uma imediatamente seguida da outra, sendo a ordem de execucao aleatoria, segundo randomizacao por software especializado. Resultados: Nao ocorreram eventos significativos de queda da saturacao de oxigenio, instabilidade hemodinâmica e hemorragias traqueobronquicas (p<0,05) e, embora tenham ocorrido divergencias em algumas cepas, houve concordância qualitativa e quantitativa entre as tecnicas (p<0,001). Conclusao: A utilizacao da tecnica protegida nao proporciona vantagem em detrimento da tradicional e a execucao de ambas as tecnicas foi segura para o paciente.OBJECTIVE To evaluate the safety of the performance of the traditional and protected collection techniques of tracheal aspirate and to identify qualitative and quantitative agreement of the results of microbiological cultures between the techniques. METHOD Clinical, prospective, comparative, single-blind research. The sample was composed of 54 patients of >18 years of age, undergoing invasive mechanical ventilation for a period of ≥ 48 hours and with suspected Ventilator Associated Pneumonia. The two techniques were implemented in the same patient, one immediately after the other, with an order of random execution, according to randomization by specialized software. RESULTS No significant events occurred oxygen desaturation, hemodynamic instability or tracheobronchial hemorrhage (p<0.05) and, although there were differences in some strains, there was qualitative and quantitative agreement between the techniques (p<0.001). CONCLUSION Utilization of the protected technique provided no advantage over the traditional and execution of both techniques was safe for the patient.

Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods

OBJECTIVE to assess the correlation among the ATP-bioluminescence assay, visual inspection and microbiological culture in monitoring the efficiency of cleaning and disinfection (C&D) of high-touch clinical surfaces (HTCS) in a walk-in emergency care unit. METHOD a prospective and comparative study was carried out from March to June 2015, in which five HTCS were sampled before and after C&D by means of the three methods. The HTCS were considered dirty when dust, waste, humidity and stains were detected in visual inspection; when ≥2.5 colony forming units per cm2 were found in culture; when ≥5 relative light units per cm2 were found at the ATP-bioluminescence assay. RESULTS 720 analyses were performed, 240 per method. The overall rates of clean surfaces per visual inspection, culture and ATP-bioluminescence assay were 8.3%, 20.8% and 44.2% before C&D, and 92.5%, 50% and 84.2% after C&D, respectively (p<0.001). There were only occasional statistically significant relationships between methods. CONCLUSION the methods did not present a good correlation, neither quantitative nor qualitatively.

AVALIAÇÃO DE TRÊS TÉCNICAS DE FRICÇÃO DE SUPERFÍCIE PARA REMOÇÃO DE MATÉRIA ORGÂNICA

The objective of this study was to assess the effectiveness of three surface friction techniques for the removal of organic material. A quantitative, descrip...Se objetivo evaluar la eficacia de tres tecnicas de friccion de superficie para remocion de materia organica. Se trata de un estudio cuantitativo, descriptivo y exploratorio sobre evaluacion de la presencia o no de materia organica antes y despues del proceso de limpieza/desinfeccion de la superficie de mesillas de noche de pacientes internados en una Unidad de Terapia Intensiva. Tres tecnicas de friccion en sentido unidireccional, bidireccional y centrifuga fueron ejecutadas individualmente tres veces para cada mesilla, en semanas alternadas. Para cada unidad de paciente y tecnica de friccion, una unica mesilla y pano, utilizando 3 faces y humedecido con alcohol a 70% (p/v) fueron utilizados. La materia organica fue detectada por la presencia de trifosfato de adenosina por bioluminescencia, utilizando el sistema 3M(tm) Clean-Trace(tm) ATP Systems. Para cada tecnica, 13 muestras fueron recolectadas antes y 13 despues del proceso de limpieza/desinfeccion, totalizando 78 recolectas de trifosfato de adenosina por bioluminescencia. No fueron constatadas diferencias estadisticamente significativas entre las tecnicas en la remocion de materia organica. Este estudio demostro que ningun de los tres metodos de friccion de superficie fue mejor que los otros en la remocion de materia organica. Sin embargo, estudios adicionales son necesarios, considerando otros indicadores de limpieza/desinfeccion y superficies.

EVALUACIÓN DE TRES TÉCNICAS DE FRICCIÓN DE SUPERFICIE PARA REMOCIÓN DE MATERIA ORGÁNICA

The objective of this study was to assess the effectiveness of three surface friction techniques for the removal of organic material. A quantitative, descrip...Se objetivo evaluar la eficacia de tres tecnicas de friccion de superficie para remocion de materia organica. Se trata de un estudio cuantitativo, descriptivo y exploratorio sobre evaluacion de la presencia o no de materia organica antes y despues del proceso de limpieza/desinfeccion de la superficie de mesillas de noche de pacientes internados en una Unidad de Terapia Intensiva. Tres tecnicas de friccion en sentido unidireccional, bidireccional y centrifuga fueron ejecutadas individualmente tres veces para cada mesilla, en semanas alternadas. Para cada unidad de paciente y tecnica de friccion, una unica mesilla y pano, utilizando 3 faces y humedecido con alcohol a 70% (p/v) fueron utilizados. La materia organica fue detectada por la presencia de trifosfato de adenosina por bioluminescencia, utilizando el sistema 3M(tm) Clean-Trace(tm) ATP Systems. Para cada tecnica, 13 muestras fueron recolectadas antes y 13 despues del proceso de limpieza/desinfeccion, totalizando 78 recolectas de trifosfato de adenosina por bioluminescencia. No fueron constatadas diferencias estadisticamente significativas entre las tecnicas en la remocion de materia organica. Este estudio demostro que ningun de los tres metodos de friccion de superficie fue mejor que los otros en la remocion de materia organica. Sin embargo, estudios adicionales son necesarios, considerando otros indicadores de limpieza/desinfeccion y superficies.

Recolección de aspirado traqueal: seguridad y concordancia microbiológica entre dos técnicas

Objetivo: Avaliar a seguranca da execucao das tecnicas tradicional e protegida de colheita de aspirado traqueal e identificar a concordância qualitativa e quantitativa dos resultados de culturas microbiologicas entre as tecnicas. Metodo: Pesquisa clinica, prospectiva, comparativa, simples-cega. A amostra foi constituida de 54 pacientes com idade ≥18 anos, submetidos a ventilacao mecânica invasiva por periodo ≥48 horas e com suspeita de Pneumonia Associada a Ventilacao Mecânica. As duas tecnicas foram implementadas no mesmo paciente, uma imediatamente seguida da outra, sendo a ordem de execucao aleatoria, segundo randomizacao por software especializado. Resultados: Nao ocorreram eventos significativos de queda da saturacao de oxigenio, instabilidade hemodinâmica e hemorragias traqueobronquicas (p<0,05) e, embora tenham ocorrido divergencias em algumas cepas, houve concordância qualitativa e quantitativa entre as tecnicas (p<0,001). Conclusao: A utilizacao da tecnica protegida nao proporciona vantagem em detrimento da tradicional e a execucao de ambas as tecnicas foi segura para o paciente.OBJECTIVE To evaluate the safety of the performance of the traditional and protected collection techniques of tracheal aspirate and to identify qualitative and quantitative agreement of the results of microbiological cultures between the techniques. METHOD Clinical, prospective, comparative, single-blind research. The sample was composed of 54 patients of >18 years of age, undergoing invasive mechanical ventilation for a period of ≥ 48 hours and with suspected Ventilator Associated Pneumonia. The two techniques were implemented in the same patient, one immediately after the other, with an order of random execution, according to randomization by specialized software. RESULTS No significant events occurred oxygen desaturation, hemodynamic instability or tracheobronchial hemorrhage (p<0.05) and, although there were differences in some strains, there was qualitative and quantitative agreement between the techniques (p<0.001). CONCLUSION Utilization of the protected technique provided no advantage over the traditional and execution of both techniques was safe for the patient.