Silvia Rita Marin da Silva Canini

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.

Accidents with biological material among undergraduate nursing students in a public Brazilian university

During their academic activities, undergraduate nursing students are exposed to contamination by bloodborne pathogens, as well as by others found in body fluids, among which are the Human Immunodeficiency (HIV), Hepatitis B and C viruses. We developed a profile of victimized students, characterizing accidents with biological material occurring among undergraduate nursing students at a public university in São Paulo State, Brazil. We identified the main causes and evaluated the conduct adopted by students and their reactions and thoughts concerning the accidents. Seventy-two accidents were identified, of which 17% involved potentially contaminated biological material. Needles were the predominant cause of accidents. The most frequently involved topographic areas were the fingers. Only five students reported the accidents and sought medical care. Among these, two students were advised to begin prophylactic treatment against HIV infection by means of antiretroviral drugs. It was found that the risk of accidents is underestimated and that strategies such as formal teaching and continual training are necessary in order to make students aware of biosafety measures.

Qualidade de vida de indivíduos com HIV/AIDS: uma revisão de literatura

La finalidad de este estudio de revision bibliografica fue la de analizar los resumenes de articulos acerca de la calidad de vida de individuos con VIH/SIDA, indexados en el banco de datos de la National Library of Medicine (MEDLINE) entre 1990 y 2002. La muestra consistio en 124 resumenes, en que analizamos la frecuencia de publicacion, pais donde se realizo el estudio, delineamiento del estudio, tamano de muestra, numero de publicaciones, tipo de instrumentos utilizados para medir calidad de vida y periodico donde fue publicado el estudio. Concluimos que, a pesar del aumento considerable en el numero de publicaciones acerca del tema en Estados Unidos y paises europeos, en Brasil, todavia es muy poco explorado.

ACCIDENTS WITH POTENTIALLY HAZARDOUS BIOLOGICAL MATERIAL AMONG WORKERS IN HOSPITAL SUPPORTING SERVICES

Descriptive study was carried out to characterize the occupational accidents involving potentially contaminated material among workers of hospital supporting services. The study reviewed records of workers involved in these accidents and attended at a specialized outpatient clinic of a large tertiary care hospital between January 1997 and October 2001. A total of 2814 workers from different professional categories were attended during this period. Of these, 147 (5.2%) belonged to the hospital supporting services and were the victims of 156 accidents, auxiliary cleaning personnel (80.2%), and over a third of the workers had not received any dose of hepatitis B vaccine (35.4%). Most accidents were due to sharp injuries (96.8%) caused by inadequately discarded hollow needles. Chemoprophylaxis for HIV was not indicated in only 23.1% of cases. We conclude that these workers are also exposed to the possibility of acquiring blood-borne pathogens and that periodical education programs are needed.Estudo descritivo objetivou caracterizar os acidentes ocupacionais envolvendo material potencialmente contaminado e os trabalhadores dos servicos de Apoio Hospitalar. O estudo revisou dados de trabalhadores envolvidos nestes acidentes e atendidos num ambulatorio especializado de um hospital terciario de grande porte, no periodo de janeiro de 1997 a outubro de 2001. Neste periodo foram atendidos 2814 trabalhadores de diversas categorias profissionais, sendo que destes 147 (5,2%) pertenciam aos Servicos de Apoio e registraram 156 acidentes. A categoria mais atingida foi auxiliar de limpeza (80,2%), e um terco dos trabalhadores nao havia recebido nenhuma dose da vacina contra hepatite B (35,4%). A maioria dos acidentes foi perfurocortante (96,8%), ocasionados por agulhas ocas descartadas em local improprio. A quimioprofilaxia nao foi indicada em apenas 23,1% dos casos. Conclui-se que estes profissionais tambem estao sujeitos a adquirirem patogenos veiculados pelo sangue e programas educacionais periodicos sao necessarios.

ACIDENTES OCUPACIONAIS COM MATERIAL PERFUROCORTANTE EM UM HOSPITAL REGIONAL DE MINAS GERAIS, BRASIL

The frequency of accidents with piercing or cutting material is significant in the hospital environment due to the great extent to which these instruments are manipulated by nursing. This retrospective and descriptive study, which was held at the SCMP between 2000 and 2002, aimed to identify the occurrence of occupational accidents with piercing or cutting material. The results disclosed that, among the 219 officially notified occupational accidents, 139 (63.5%) were caused by piercing or cutting material. The most affected professional category were the nursing aids (43.9%) with less than 05 years on the job (46.8%) and female (74.1%). The sectors were accidents most frequently occurred were the Medical and Surgical clinics and the most frequent situation was discarding in an inappropriate place (21.6%) while the most frequent causing object was the needle (46.8%). It was concluded that knowledge about the situation in which the accident occurs is fundamental in order to guide strategic prevention actions in the institutions.

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.

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.

Adherence to standard precautions of nurses working in intensive care at a university hospital

This study evaluated individual factors relating to work and the organization, related to adherence to standard precautions for nurses working in intensive care. It was a cross-sectional study conducted in a large hospital with 178 professionals. For data collection, Likert-type psychometric scales were used. In the Adherence Scale to Standard Precautions we obtained a score of 4.45 (SD=0.27), classified as intermediate. There was a correlation when compared with the individual risk factors of the Scale of the Risk Personality (r =- 0.169, p=0.024) and the factors related to working with the barriers of the Scale for following standard precautions(r =- 0.359, p=0.000). Adherence to standard precautions among the nursing professionals was intermediate. Individual factors and factors related to work influenced the adherence to standard precautions.This study evaluated individual factors relating to work and the organization, related to adherence to standard precautions for nurses working in intensive care. It was a cross-sectional study conducted in a large hospital with 178 professionals. For data collection, Likert-type psychometric scales were used. In the Adherence Scale to Standard Precautions we obtained a score of 4.45 (SD=0.27), classified as intermediate. There was a correlation when compared with the individual risk factors of the Scale of the Risk Personality (r =- 0.169, p=0.024) and the factors related to working with the barriers of the Scale for following standard precautions (r =- 0.359, p=0.000). Adherence to standard precautions among the nursing professionals was intermediate. Individual factors and factors related to work influenced the adherence to standard precautions.