Miyeko Hayashida

Acidentes perfurocortantes entre trabalhadores de enfermagem de um hospital universitário do interior paulista

The risk presented by health care workers of acquiring bloodborne pathogens is well documented by the literature, which shows that Aids and Hepatitis acquired in the work setting is a real fact. This descriptive retrospective study was conducted in a university hospital in 1998 and aimed at analyzing needlestick injuries in nursing workers. Results showed that of the 398 officially reported occupational accidents, 125 (30.40%) were needlestick injuries and that 89 (71.20%) occurred among nursing workers. The most frequent occurrences took place during medication administration (25.78%). Authors concluded that nursing workers were the most frequently victimized workers by occupational accidents involving needlestick injuries.Como mostra a literatura, o risco de trabalhadores da area da saude adquirirem patogenos veiculados pelo sangue ja esta bem documentado e demonstra que a Aids e a hepatite B e C, adquiridas de maneira ocupacional, sao, hoje, um fato concreto. Este estudo retrospectivo, de natureza descritiva, realizado em um Hospital Universitario, no ano de 1998, objetivou analisar os acidentes perfurocortantes que acometeram os trabalhadores de enfermagem. Os resultados evidenciaram que, dos 398 acidentes ocupacionais notificados oficialmente, 125 (30,40%) foram perfurocortantes e 89 (71,20%) ocorreram entre trabalhadores de enfermagem. As situacoes mais frequentes de ocorrencia se deram quando da administracao de medicamentos (25,78%). Concluiu-se que os trabalhadores de enfermagem foram os mais atingidos pelos acidentes ocupacionais envolvendo material perfurocortante.

Prevalence of methicillin-resistant and methicillin-susceptible s. aureus in the saliva of health professionals

INTRODUCTION: S. aureus is one of the main agents of nosocomial infection and is sometimes difficult to treat with currently available active antimicrobials. PURPOSE: To analyze the prevalence of methicillin-susceptible S.aureus (MSSA) and methicillin-resistant S. aureus (MRSA) as well as the MRSA antimicrobial susceptibility profile isolated in the saliva of health professionals at a large public education hospital. MATERIALS AND METHODS: The project was approved by the research and ethics committee of the institution under study. Three samples of saliva from 340 health professionals were collected. The saliva analysis used to identify S. aureus was based on mannitol fermentation tests, catalase production, coagulase, DNAse, and lecithinase. In order to detect MRSA, samples were submitted to the disk diffusion test and the oxacillin agar screening test. In order to identify the minimum inhibitory concentration, the Etest® technique was used. RESULTS: The prevalence of MSSA was 43.5% (148/340), and MRSA was 4.1% (14/340). MRSA detected by the diffusion disk test, was 100% resistant to penicillin and oxacillin, 92.9% resistant to erythromycin, 57.1% resistant to clindamycin, 42.9% resistant to ciprofloxacin and 57.1% resistant to cefoxetin. CONCLUSION: This subject is important for both the education of health professionals and for preventative measures. Standard and contact-precautions should be employed in professional practice.

Accidents with biological material and immunization against hepatitis B among students from the health area

O manuseio de instrumentos perfurocortantes por estudantes da area da saude e frequente na atividade academica, o que os expoe ao risco de adquirir infeccao. Este estudo teve como objetivo analisar os acidentes com material biologico, ocorridos com alunos de graduacao da area da saude. Dos 170 acidentes registrados, 83 (48,8%) ocorreram com alunos do curso de odontologia, 69 (40,6%) de medicina, 11 (6,5%) de enfermagem e em 6 (3,5%) nao havia a informacao na ficha de atendimento. A maioria (106-62,4%) ocorreu com alunos de escolas privadas e 55(32,3%) de escolas publicas. Os acidentes percutâneos ocorreram em 133 (78,2%) exposicoes e em apenas 38 (21,3%) acidentes a procura pelo atendimento especializado foi imediata. Em 127 (74,7%) acidentes o esquema vacinal contra hepatite B estava completo. Assim, torna-se imprescindivel que as escolas oferecam cursos e/ou disciplinas especificas sobre medidas de biosseguranca, incluindo aspectos relacionados a vacinacao e em especial a vacina contra hepatite B.Undergraduate students from the health area often handle piercing-cutting instruments in their academic activities, which exposes them to the risk of contracting infections. This study aimed to analyze accidents with biological material among these students. Out of 170 accidents registered, 83 (48.8%) occurred with Dentistry students, 69 (40.6%) with Medical students, 11 (6.5%) with Nursing students and in 06 (3.5%) of the cases there was no such information in the files. Most accidents, 106 (62.4%), occurred with students from private schools and 55 (32.3%) with those from public schools. Percutaneous accidents occurred in 133 (78.2%) exposures and there was immediate search for specialized health care in only 38 (21.3%) accidents. In 127 (74.7%) accidents, the immunization schedule against hepatitis B was complete. Therefore, schools need to offer courses and specific class subjects regarding biosafety measures, including aspects related to immunization, especially the vaccine against hepatitis B.

Causas de subnotificação de acidentes do trabalho entre trabalhadores de enfermagem

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Fatores de risco para complicações em extremidades inferiores de pessoas com diabetes mellitus

O estudo analisou fatores de risco para complicacoes em pes de pessoas com diabetes em Unidade Ambulatorial. Os dados foram obtidos por meio de entrevista semi-estruturada, avaliacao de pes e exames laboratoriais. Os riscos tiveram a analise segundo Zavala e Braver e Sistema de Classificacao do Consenso Internacional sobre Pe Diabetico, mediante estatistica descritiva. Nos resultados, a idade media foi 53,3±13 anos, tempo da doenca 12,9±9 e 58% tinham ensino fundamental incompleto. Dentre os riscos, identificou-se complicacoes microvasculares, hipertensao arterial, nivel glicemico inadequado, sedentarismo, uso de sapatos inapropriados, somadas as alteracoes dermatologicas e estruturais. No risco para ulceras, obteve-se 19,1% entre as categorias 2 e 3. Os dados reforcaram necessidade de atendimento primario com enfase na avaliacao de riscos e educacao do paciente.

A conduta gerencial da enfermeira: um estudo fundamentado nas teorias gerais da administração

O objetivo desta pesquisa foi identificar a conduta gerencial da enfermeira em uma maternidade privada do interior paulista. Para a coleta de dados utilizamos questionario com 20 proposicoes relativas ao trabalho das enfermeiras que atuam nos diversos setores do hospital. Realizamos analise estatistica descritiva dos dados obtidos. Os resultados mostraram tendencia a democratizacao na conduta das enfermeiras investigadas, pois a maioria das respostas privilegiou questoes acerca do trabalho em equipe, participacao dos trabalhadores e desenvolvimento grupal. Evidenciamos, ainda, que grande parte das respondentes discordou das proposicoes que abordavam os principios norteadores da Teoria Classica da Administracao.

ACIDENTE COM MATERIAL BIOLÓGICO E VACINAÇÃO CONTRA HEPATITE B ENTRE GRADUANDOS DA ÁREA DA SAÚDE

O manuseio de instrumentos perfurocortantes por estudantes da area da saude e frequente na atividade academica, o que os expoe ao risco de adquirir infeccao. Este estudo teve como objetivo analisar os acidentes com material biologico, ocorridos com alunos de graduacao da area da saude. Dos 170 acidentes registrados, 83 (48,8%) ocorreram com alunos do curso de odontologia, 69 (40,6%) de medicina, 11 (6,5%) de enfermagem e em 6 (3,5%) nao havia a informacao na ficha de atendimento. A maioria (106-62,4%) ocorreu com alunos de escolas privadas e 55(32,3%) de escolas publicas. Os acidentes percutâneos ocorreram em 133 (78,2%) exposicoes e em apenas 38 (21,3%) acidentes a procura pelo atendimento especializado foi imediata. Em 127 (74,7%) acidentes o esquema vacinal contra hepatite B estava completo. Assim, torna-se imprescindivel que as escolas oferecam cursos e/ou disciplinas especificas sobre medidas de biosseguranca, incluindo aspectos relacionados a vacinacao e em especial a vacina contra hepatite B.Undergraduate students from the health area often handle piercing-cutting instruments in their academic activities, which exposes them to the risk of contracting infections. This study aimed to analyze accidents with biological material among these students. Out of 170 accidents registered, 83 (48.8%) occurred with Dentistry students, 69 (40.6%) with Medical students, 11 (6.5%) with Nursing students and in 06 (3.5%) of the cases there was no such information in the files. Most accidents, 106 (62.4%), occurred with students from private schools and 55 (32.3%) with those from public schools. Percutaneous accidents occurred in 133 (78.2%) exposures and there was immediate search for specialized health care in only 38 (21.3%) accidents. In 127 (74.7%) accidents, the immunization schedule against hepatitis B was complete. Therefore, schools need to offer courses and specific class subjects regarding biosafety measures, including aspects related to immunization, especially the vaccine against hepatitis B.

Situações vivenciadas pelos trabalhadores de enfermagem na assistência ao portador de tuberculose pulmonar

This descriptive study aimed to identify the positive and negative aspects related to nursing care for pulmonary tuberculosis patients, based on the reports of nursing workers at an isolation unit. We categorized the reports of 26 nursing workers (nurses, auxiliaries, technicians and nursing attendants) in terms of positive and negative references. We obtained 24 reports, resulting in 94 (100%) situations, 38 (40.5%) of which were seen as positive and 56 (59.5%) as negative. The most frequent categories of situations were related to treatment orientations, to the patients feelings about the disease and the nursing teams lack of preparedness.This descriptive study aimed to identify the positive and negative aspects related to nursing care for pulmonary tuberculosis patients, based on the reports of nursing workers at an isolation unit. We categorized the reports of 26 nursing workers (nurses, auxiliaries, technicians and nursing attendants) in terms of positive and negative references. We obtained 24 reports, resulting in 94 (100%) situations, 38 (40.5%) of which were seen as positive and 56 (59.5%) as negative. The most frequent categories of situations were related to treatment orientations, to the patients feelings about the disease and the nursing teams lack of preparedness.

Análise dos fatores de risco relacionados à incidência de infecção do sítio cirúrgico em gastrocirurgias

La infeccion hospitalaria es considerada un problema grave, creciendo tanto en incidencia como en complejidad, generando diversos tipos de implicaciones sociales y economicas. La presente investigacion tuvo como objetivo identificar la incidencia de infeccion del sitio quirurgico en pacientes sometidos a cirugias electivas, en la especialidad de Gastroenterologia, realizadas en un hospital publico del interior del estado de Sao Paulo. Los datos fueron recoleccionados por medio de un estudio retrospectivo de los archivos medicos, en el periodo entre enero y diciembre de 1999. En 134 casos estudiados, detectamos la ocurrencia de infeccion del sitio quirurgico en 18 situaciones (13.4%), ocurriendo 9 casos (50%) del tipo considerado infeccion incisional superficial, 8 (44.4%) infeccion incisional profunda y 1 (5.5%) infeccion de organo/espacio. Con relacion a los factores de riesgo presentes en los casos de ISC detectados, los que alcanzaron percentaje mayor or igual a 50% fueron: edad acima de 50 anos, presencia de neoplasias, duracion de la cirugia mayor que dos horas y tricotomia inadecuada.Nosocomial infection is regarded as a serious problem whose incidence and complexity has been increasing, thus generating various types of social and economic implications. This investigation aimed at assessing the incidence of surgical site infection and risk factors in patients submitted to elective surgeries in the specialty of gastroenterology performed in a public hospital in the interior of São Paulo State. Data were collected by means of a retrospective study of medical records from January to December 1999. Of the 134 cases under study, the occurrence of surgery site infection was detected in 18 situations (13.4%). Nine cases (50%) were considered to be superficial incisional infections, 8 (44.4%) were deep incisional infections and 1 (5.5%) was an organ/space infection. With respect to the risk factors, the ones with percentage higher or equal to 50% were: age above 50 years, the presence of neoplasia, surgeries that last more than two hours and inadequate trichotomy.

Atendimento e seguimento clínico especializado de profissionais de enfermagem acidentados com material biológico

O presente trabalho trata-se de estudo de corte transversal, com objetivo de avaliar a conduta dos profissionais de enfermagem vitimas de acidentes com material biologico, do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo, no estado de Sao Paulo, referente ao atendimento e ao seguimento clinico especializado. A populacao foi composta por 1.215 profissionais de enfermagem, entrevistados entre os anos de 2010 e 2011, dos quais 636 (52,3%) sofreram acidentes com material biologico e 182 (28,6%) nao procuraram atendimento no servico especializado. O motivo mais frequentemente relatado foi atribuir pouco risco ao acidente. Assim, acredita-se que os motivos alegados pelos profissionais para nao procurarem o atendimento, para nao completarem a terapeutica e nem o seguimento clinico podem contribuir para a proposicao de estrategias capazes de aumentar a adesao as medidas profilaticas apos exposicao ocupacional a material biologico.