Diseño y validación de un instrumento para medir compromiso con el lavado de manos en menores de edad / Design and Validation of an Instrument to Measure Commitment to Handwashing in Minors

Introducción: Los beneficios de lavarse las manos con agua y jabón son reconocidos en salud pública. En la actualidad es una de las acciones recomendadas para evitar la propagación de la COVID-19. No obstante, según datos de la Organización de las Naciones Unidas, a nivel mundial solo una de cada cinco personas lo realiza con la frecuencia y técnica adecuada. Se evidencia que el conocimiento no es el mejor predictor de la conducta, se le da mayor peso al compromiso. A la fecha, no se conoce un instrumento que determine esta actitud en menores de edad. Objetivo: Validar un instrumento electrónico diseñado para medir el grado de compromiso con el lavado de manos en menores de edad. Métodos: Estudio cuantitativo de validación en tres fases: a) diseño de los ítems del instrumento; b) validación de contenido por expertos; c) validación de constructo, confiabilidad y consistencia. Fue realizado en Mérida, Yucatán, México, entre septiembre de 2019 y marzo de 2020, con una selección a conveniencia de menores de edad escolarizados en 25 instituciones de educación primaria. Resultados: En la validación interna, el alfa de Cronbach obtuvo un valor aceptable (0,801), y la mayoría de los componentes arrojaron una confiabilidad por arriba de 0,70. La varianza total obtenida fue de 69,60 por ciento; en la prueba Kaiser-Meyer-Olkin el nivel general obtenido fue de 0,712. Conclusiones: Se diseñó un instrumento con validez interna, confiabilidad y aplicabilidad para medir el grado de compromiso frente al lavado de manos en menores de edad(AU)

Introduction: The benefits of hand washing with soap and water are recognized in public health. It is currently one of the recommended actions to prevent the spread of VOCID-19. However, according to data from the United Nations, worldwide only one in five people do it with adequate frequency and technique. It is evident that knowledge is not the best predictor of behavior, but that greater weight is given to commitment. To date, there is no known instrument to determine this attitude in minors. Objective: To validate an electronic instrument designed to measure the degree of commitment to handwashing in minors. Methods: Quantitative validation study in three phases: 1) design of the instrument items; 2) content validation by experts; 3) construct validation, reliability and consistency. It was conducted in Merida, Yucatan, Mexico, between September 2019 and March 2020, with a convenience selection of school-aged children in 25 elementary schools. Results: In the internal validation, Cronbach's alpha obtained an acceptable value (0.801), and most of the components yielded a reliability above 0.70. The total variance obtained was 69.60 percent; in the Kaiser-Meyer-Olkin test the overall level obtained was 0.712. Conclusions: An instrument with internal validity, reliability and applicability was designed to measure the degree of commitment to handwashing in minors(AU)

Conocimientos, actitudes y prácticas sobre la adherencia al lavado de manos en personal de salud / Knowledge, attitudes and practices related to the adherence of handwashing in health personnel

Introducción: El lavado de manos deficiente, sigue siendo un problema hospitalario. Cumplir con las recomendaciones internacionales ofrece seguridad en el cuidado. Objetivo: Identificar el nivel de conocimiento, actitudes y prácticas en la técnica del lavado de manos en personal de salud en un hospital pediátrico de La Habana. Metodología: Estudio descriptivo a 145 trabajadores (31,7 por ciento médicos, 35,2 por ciento enfermeros, 22,8 por ciento médicos residentes y 10,3 por ciento estudiantes). De 13 servicios el cuerpo de guardia, sala de respiratorio, cirugía, neurocirugía y quemados, fueron los que más participación tuvieron. El estudio se realizó en tres etapas: 1. Observación directa de la técnica del lavado de manos. 2. Observación de la calidad del lavado de manos mediante lámpara fluorescente. 3. Medida del conocimiento acerca del lavado de manos y actitud mediante encuesta. Resultados: En la primera etapa, el 51,7 por ciento calificó de inadecuado, en la segunda etapa el 64,8 por ciento también tuvo una evaluación inadecuada y en las encuestas, el conocimiento alcanzó solo 52,4 por ciento, considerado inapropiado. La actitud ante esta actividad fue calificada de inadecuado en el 53,1 por ciento, con un mejor porcentaje en el personal de enfermería. Conclusiones: Los conocimientos, actitudes y prácticas sobre el lavado de manos es deficiente, por lo que debe diseñarse un programa de capacitación en todos los niveles, sea pregrado, posgrado o formación continua, donde exista responsabilidad individual de cada profesional sanitario, y se insista en ello(AU)

Introduction: Deficient handwashing is still a problem in hospitals. The compliance of the international recommendations on this matter provides security in the care. Objective: To identify the level of knowledge, attitudes and practices in the technique of handwashing in a pediatric hospital in Havana. Methodology: Descriptive study applied to 145 workers (31.7 percent doctors, 35.2 percent nurses, 22.8 percent residents, and 10.3 percent students) of 13 services. Emergencies, Respiratory, Surgery, Neurosurgery and Caumatology were the services with more participation. The study was conducted in three stages: 1. Direct observation of the technique of handwashing. 2. Quality observation of the handwashing using fluorescent lamp. 3. Extent of knowledge on handwashing and attitudes through survey. Results: In the first stage, the 51.7 percent the handwashing was assessed as inappropriate, in the second stage the 64.8 percent was also evaluated as inadequate, and in the surveys, the 52.4 percent had an incorrect knowledge; the attitude towards this activity was described as inappropriate in the 53.1 percent , with a better percentage in the nursing staff. Conclusions: The knowledge, attitudes and practices on handwashing were poor, so it must be designed a training program at all levels, whether undergraduate, graduate or continuing training, where individual responsibility of each healthcare professional exists, and should be highlithed(AU)

Efectividad de un programa educativo en el lavado de manos del personal de salud / Effectiveness of an Educational Program in Handwashing for the Health Personnel

Introducción: Las infecciones asociadas a la asistencia sanitaria están entre las causas más frecuentes de morbi-mortalidad de pacientes hospitalizados. El lavado de manos parece un tema sencillo dentro de la sanidad, sin embargo, no siempre funciona como debería. Objetivo: Evaluar la efectividad de un programa educativo en el lavado de manos del personal de salud. Métodos: Estudio cuasiexperimental desarrollado en tres etapas (diagnóstica, intervención y evaluación) en el Hospital "Lucía Íñiguez", Holguín, durante 2016, con 50 trabajadores seleccionados al azar. La información se obtuvo antes y después de aplicado el programa educativo mediante una guía de observación y un cuestionario. Se realizó análisis descriptivo de la información, que incluyó frecuencias absolutas y porcentajes para variables cualitativas; medias, medianas, desviaciones estándar con intervalos de confianza (95 por ciento para variables cuantitativas). Para estudiar la efectividad del programa educativo se compararon los resultados obtenidos antes y después de su aplicación mediante la prueba exacta de Wilcoxon para datos apareados. Se valoraron niveles de significación inferiores al 0,05. Resultados: Predominó el personal de enfermería (70 por ciento), después de aplicado el programa educativo todos los parámetros evaluados sobre el lavado de manos mejoraron y disminuyó la cantidad de trabajadores en los que se aisló algún tipo de germen en los cultivos de las manos realizados. Conclusiones: El lavado de manos de los trabajadores, luego de las acciones realizadas varió favorablemente, aumentó el tiempo utilizado aunque no siempre se llegó al establecido. Los gérmenes disminuyeron, se logró modificar conductas y disminuir el riesgo de infecciones(AU)

Introduction: Infections associated with healthcare are among the most frequent causes of morbidity and mortality in hospitalized patients. Handwashing seems like a simple issue in healthcare; however, not always does it work as it should. Objective: To assess the effectiveness of an educational program in washing for the health personnel. Methods: Quasiexperimental study carried out in three stages (diagnosis, intervention, and evaluation) at Lucía Íñiguez Hospital in Holguín, during 2016, with 50 randomly selected workers. The information was obtained through an observation guide and a questionnaire, before and after the educational program was applied. Descriptive analysis of the information was carried out, which included absolute frequencies and percentages for qualitative variables; means, medians, standard deviations with confidence intervals (95 percent) for quantitative variables. To study the effectiveness of the educational program, the results obtained before and after its application were compared using the paired data Wilcoxon test. Significance levels below 0.05 were assessed. Results: There was a predominance of the nursing staff (70 percent). After applying the educational program, all evaluated parameters on handwashing improved and the number of workers in whom some type of germ was isolated in the cultures carried out was reduced. Conclusions: Handwashing among the workers, after the actions carried out, varied favorably. The time used increased, although the established one was not always reached. Germs decreased, behaviors were modified, and the risk of infections decreased(AU)

Flora bacteriana después del lavado de manos quirúrgico. Estudio piloto / Bacterial flora after surgical hand scrubbing. A pilot study

RESUMEN Introducción: La técnica de lavado de manos quirúrgico es imprescindible para la prevención de las infecciones posoperatorias en el sitio de la intervención, lo que constituye un problema actual y en evolución. Objetivo: Determinar la técnica de lavado de manos quirúrgico con mayor eficacia sobre la flora bacteriana en estudiantes de cirugía. Métodos: Ensayo controlado, aleatorio, de tratamientos no farmacológicos. Se seleccionaron 12 estudiantes de cirugía de la Facultad de Odontología, Universidad de San Martín de Porres, que cumplían con los criterios de inclusión y exclusión. Los estudiantes se dividieron en dos grupos y se les asignó una técnica de lavado de manos quirúrgico: Grupo A: técnica de una fase, y Grupo B: técnica tradicional (tres fases); para ambas técnicas se utilizó escobilla y jabón en barra. Resultados: En el medio de cultivo agar manitol salado, la técnica tradicional presentó una mediana de 52 000 UFC/mL con un mínimo de 10 000 UFC/mL y un máximo de 56 800 UFC/mL, en comparación con la técnica de una fase que presentó 19 600 UFC/mL con un mínimo de 4 400 UFC/mL y un máximo de 38 000 UFC/mL, con un valor de p= 0,117. En el agar MacConkey, la técnica tradicional presentó una mediana de 300 UFC/mL con un mínimo de 0 UFC/mL y un máximo de 18 000 UFC/mL, en comparación con la técnica de una fase que presentó 0 UFC/mL, con un valor de p= 0,054. Conclusiones: No se mostraron diferencias estadísticamente significativas en ambos grupos(AU)

ABSTRACT Introduction: Surgical hand scrubbing is indispensable to prevent postoperative infection at the intervention site, a problem both current and in progress. Objective: Determine the most effective surgical hand scrubbing technique against bacterial flora among surgery students. Methods: A controlled randomized study was conducted of non-pharmacological treatments. Twelve surgery students were selected from the School of Dentistry at the University of San Martín de Porres who met the inclusion and exclusion criteria. The students were divided into two groups and assigned one of two surgical hand scrubbing techniques: Group A: one-step technique and Group B: traditional technique (three steps). Both techniques used bar soap and a brush. Results: In the culture medium mannitol salt agar, the traditional technique obtained a median of 52 000 CFU/mL, with a minimum 10 000 CFU/mL and a maximum 56 800 CFU/mL, whereas the one-step technique obtained a median of 19 600 CFU/mL, with a minimum of 4 400 CFU/mL and a maximum of 38 000 CFU/mL (p= 0.117). In MacConkey agar, the traditional technique obtained a median of 300 UFC/mL, with a minimum of 0 CFU/mL and a maximum of 18 000 CFU/mL, whereas the one-step technique obtained 0 UFC/mL (p= 0.054). Conclusions: No statistically significant differences were found in the groups(AU)

Método pedagógico para el lavado de manos en estudiantes de Odontología. Facultad de Odontología-UNA. Paraguay 2017 / Pedagogical method for washing hands in dentistry student. School of Dentistry-UNA. Paraguay 2017

Objetivo: Evaluar un método pedagógico para la enseñanza del lavado de manos en estudiantes de Odontología. Metodología: Se recurrió a un diseño cuasi experimental, realizado en 2017 en el que participaron 26 estudiantes del 2do año de la cátedra de Odontología de la Facultad de Odontología de la UNA, previa presentación del consentimiento informado, siendo 92% del sexo femenino y 96% diestros. Se realizó la evaluación del lavado de manos utilizando témpera de la marca Artetesco® de color rojo, la cual fue administrada para que se realice un lavado de uso corriente por el estudiante con los ojos cerrados, el resultado fue registrado y posteriormente se enseñó la técnica sistematizada de lavado de manos y se repitió el procedimiento con el mismo material y aplicando la técnica enseñada. Se aplicaron las pruebas de McNemar y Wilcoxon con un nivel de confianza del 95%. Resultados: Las regiones que demostraron diferencia estadísticamente significativa fueron: Dorso interdigital meñique y anular izquierdo (p=0,021), Dorso interdigital medio e índice izquierdo (p=0,039), Dorso interdigital pulgar-índice derecho (p=0,031), Dorso muñeca izquierda (p0,001), Dorso muñeca derecha (p0,001), Dorso uña medio derecha (p=0,012), Dorso interdigital medio-anular derecha (p=0,012), Palmar muñeca izquierda (p0,001), Palmar muñeca derecha (p0,001).Fue estadísticamente significativa la diferencia a favor de que se mejoró el lavado de manos posterior a la intervención. Conclusiones: Todo procedimiento odontológico está ligado en forma inherente a las prácticas de control de higiene, empezando por la higiene de las manos, una de las formas de incluir en la enseñanza de esta práctica, podría ser la utilización de la témpera, pues visibiliza la calidad de la técnica del lavado de manos. Palabras claves: Estudiantes de Odontología, Lavado de manos, Higiene de las manos.

Aim: To evaluate a pedagogical method for the teaching of handwashing in dentistry students. Methodology: A quasi-experimental design was used, made in 2017,in which 26 students from the 2nd year of the Dentistry Department of the Faculty of Dentistry of the National University of Asunción participated, after presentation of informed consent, being 92% female and 96% right-handed. Hand washing evaluation was performed using the Artetesco® brand of red paint, which was administered to perform a current washing by the student with eyes closed, the result was recorded and later the technique was taught systematized handwashingan drepeated handwashing with the same material and applying the technique taught.TheMcNemar and Wilcoxon tests were applied with a confidence level of 95%. Results: The regions that showed a statistically significant difference were: Interdigital dorsum and left annulus (p=0.021), middle interdigital dorsu. The difference in favor of improving hand washing after the intervention was statistically significant. Conclusions: Every dental procedure is inherently linked to hygiene control practices, starting with hand hygiene, one of the ways to include in the teaching of this practice could be the use of tempera, quality of the handwashing technique. and left index (p=0.039), right interdigital dorsum (p0.001), right side of the wrist (p0.001), right side of the wrist (p0.001), right side of the wrist (p0.001), right side of the wrist (p0.001). Key words: Dentistry students, Hand washing, Hand hygiene

Lavado en seco y carga bacteriana en manos de personal hospitalario / Dry cleaning and bacterial load in the hands of hospital staff

Introducción: numerosos estudios han confirmado que el lavado de manos en seco con soluciones con una concentración de 60-70% de alcohol reducen significativamente la cantidad de gérmenes. Metodología: se realizó un estudio cuasi experimental con el objetivo de comparar carga bacteriana en manos de personal sanitario antes y después de lavado convencional y lavado en seco. Se incluyó 22 trabajadores sanitarios, divididos en 2 grupos al azar (grupo A y B), a todos se les hizo cultivo en agar sangre y agar McConkey previo al lavado. El grupo A (11 participantes) realizó lavado convencional, tomando cultivos nuevamente, luego realizó lavado en seco, se tomó nueva muestra de cultivos. El grupo B (11 participantes), luego de lavado en seco se realizó nuevo cultivo de manos. Se compararon todos los grupos con prueba T Student. Resultados: se identificaron 1521 UFC previo al lavado de manos convencional (A1), con una reducción del 38% en carga bacteriana después de lavado (A2) sin encontrar diferencia estadísticamente significativa (p 0.052), posterior a lavado convencional más lavado en seco (A3) se encontró reducción de 62.66% de UFC con respecto a A1, encontrando una diferencia estadísticamente significativa (p 0.014). En el lavado en seco se identificaron 1503 UFC previo a lavado de manos con una reducción del 62.72% de UFC posterior a lavado, encontrando diferencia estadísticamente significativa (p 0.0026). Conclusión: El lavado de manos con jabón de base alcohólica es mas eficaz en la reducción de carga bacteriana que lavado de manos convencional con agua y jabón...AU)

Introduction: numerous studies have confirmed that the hand rub with solutions with a concentration of 60% -70% alcohol significantly reduce the amount of germs. Methodology: quasi-experimental study was performed in order to compare bacterial load in the hands of medical personnel before and after conventional washing and alcohol based hand rub. It included 22 health workers, divided randomly into 2 groups (group A and B), all they did blood agar and McConkey agar culture prior to washing. The group A (11 participants) performed conventional washing, taking culture again, then performed alcohol based hand rub, new sample for culture was taken The group B (11 participants), then alcohol based hand rub performed new culture of hands. All groups were compared with Student test. Results: 1521 CFU were identified prior to conventional hand washing (A1) with a 38% reduction in bacterial load after washing (A2) found no statistically significant difference (p 0.052), after conventional washing over alcohol based hand rub (A3) was found 62.66% reduction of CFU with respect to A1, finding a statistically significant (p 0.014). In the dry cleaning UFC 1503 were identified prior to washing hands with a 62.72% reduction of CFU after washing, finding statistically significant difference (p 0.0026). Conclusion: Alcohol based hand rub is more effective in reducing bacterial load than conventional hand washing with soap and water...(AU)

Conocimientos y prácticas del personal de enfermería sobre el lavado de manos en el servicio de cuidados intensivos de tres hospitales de Managua. marzo 2014

El presente estudio de investigación, se realizó con personal de enfermería de tresunidades de cuidados intensivos de tres hospitales de Managua (Alemán Nicaragüense,Antonio Lenin Fonseca y Hospital Roberto Calderón Gutiérrez). La información fuecolectada durante el mes de Marzo del 2014. La muestra estuvo constituida por 30enfermeras y enfermeros activos en sus respectivas salas en los hospitalesinvestigados. Se identificaron conocimientos y prácticas que tiene el personal deenfermería que labora en el mencionado servicio de Cuidados Intensivos. Para lograralcanzar los objetivos propuestos, fue necesario realizar una revisión bibliográfica sobrediferentes autores y consultas a través de Internet en el tema del Lavado de manos, elcual es de suma importancia para evitar la diseminación de microorganismos, que conla aplicación correcta de la técnica del Lavado de manos se puede evitar lacontaminación. Este estudio fue descriptivo, transversal con abordaje cuantitativo dondese describen los conocimientos del Lavado de manos así como la observación directade la puesta en práctica de los conocimientos teóricos del tema en jornadas laboralesde los auxiliares de enfermería. Se aplicó la estadística descriptiva para el análisis delos datos, elaborando al final cuadros y gráficas. Se observó que hay limitacionesestructurales en el Servicio de Cuidados Intensivos para poder aplicar la técnicacorrecta del Lavado de manos. Dentro de las principales conclusiones se encuentraque la mayoría del personal de enfermería de Unidad de Cuidados Intensivos nomaneja la información correcta de la técnica del lavado de manos lo cual se confirma enla práctica de dicho procedimiento. No existe congruencia entre lo que se conoce de laimportancia y ventaja del lavado de manos con la práctica de dicho procedimiento yaque no cumplen con los pasos establecidos en la técnica.

[Audit on the quality of school vaccination in the region of Monastir [Tunisia]]

We conducted a clinical audit by observing 55 vaccinators in schools in the governorate of Monastir in 2014. We used a set of criteria by referring to the national immunization programme. The cold chain was respected in most cases. Accumulators, the collector of syringes and needles, cotton balls soaked in alcohol and emergency box were available in 85.5%, 76.4%, 98.2% and 41.8% of cases respectively. Hand washing before immunization session was performed in 29.1% of cases. Waste disposal according to the hygiene rules was done by 40 agents. Health education of students regarding the interest of vaccination was done in 67.3% of cases. Therefore, improvements in hand hygiene practice and education are recommended

Competências da equipe multiprofissional para as medidas de prevenção da infecção da corrente sanguínea relacionada ao cateter venoso central

Cateteres venosos centrais são essenciais na assistência à saúde, particularmente em unidade de terapia intensiva. Contudo, apesar de seus benefícios podem causar complicações, e dentre elas a infecção da corrente sanguínea, implicando em uma elevada morbidade e mortalidade, prolongamento do tempo e aumento dos custos de internação. No entanto, essa infecção pode ser prevenida por meio de intervenções realizadas no momento da inserção e manipulação do cateter. Este estudo teve como objetivo avaliar a competência da equipe multiprofissional da unidade de terapia intensiva adulto para as medidas de prevenção da infecção da corrente sanguínea relacionada ao cateter venoso central. Tratou-se de um estudo quase experimental, realizado em uma unidade de terapia intensiva de um hospital público e de urgência e emergência de Belo Horizonte, Minas Gerais. A população foi composta pela equipe médica e de enfermagem responsável pela inserção e manutenção dos cateteres venosos centrais. A coleta de dados ocorreu em três fases distintas: Período pré-intervenção + observação direta das práticas dos profissionais; Período de intervenção e Período pós-intervenção. Para análise estatística utilizou-se o programa Data Analysis and Statistical Software, versão 14...

Central venous catheters are essential in health care, particularly in the intensive care unit. However, despite its benefits, it can cause complications including bloodstream infection, resulting in high morbidity and mortality, prolongation of time and increased costs of hospitalization. However, such infection can be prevented by interventions performed at the time of catheter’s insertion and manipulation. This study aimed to evaluate the competence of multiprofessional team from adult’s intensive unit care for the measures to prevent bloodstream infection related to central venous catheter. It was a quasi-experimental study, performed in an intensive care unit of a public hospital and urgency and emergency in Belo Horizonte, Minas Gerais. The population was composed of the medical and nursing team responsible for insertion and maintenance of central venous catheters. Data collection took place in three distinct phases: Pre-intervention period + direct observation of the professionals' practices; Period of intervention and period after intervention. Statistical analysis was performed using the Data Analysis and Statistical Software program, version 14...

Atitudes de risco de consumidores em restaurante self service no município de Picos - PI / Risk attitudes of consumers in self service restaurant in the city of Picos - PI

As transformações no mundo contemporâneo provocaram mudanças significativas no comportamento alimentar dos seres humanos, que passaram a realizar cada vez mais as refeições fora do ambiente doméstico, o que proporcionou um aumento de restaurantes, especialmente os do tipo self service. Este estudo objetivou avaliar as atitudes de risco dos consumidores que podem favorecer a contaminação dos alimentos durante o autosserviço em um restaurante self service da cidade de Picos - PI. A coleta de informações foi realizada por meio de observação direta de 13 atitudes de risco praticadas pelos consumidores (n=384), no horário de maior movimento do estabelecimento, utilizando instrumento que relacionava as possíveis atitudes de risco de contaminação no momento em que cada consumidor montava sua refeição. Verificou-se que a atitude de risco mais cometida pelos consumidores foi a de não lavar as mãos imediatamente antes do autosserviço (76,3%), sendo o sexo masculino o que mais a praticou (77,6%). Em 33,3% dos casos os consumidores levavam objetos para o balcão de distribuição e 32,6% conversavam no momento em que estavam se servindo. Concluiu-se que é comum a prática de atitudes que põem em risco a segurança dos alimentos durante o autosserviço, sendo necessário conscientizar os consumidores a fim de evitar a contaminação de alimentos e o desenvolvimento de doenças transmitidas por alimentos.

The changes in the contemporary world brought significant changes in food and eating habits of people who now enjoy fewer meals made at their homes, and this made the number of restaurants increase, especially fast food restaurants and self-services. This study aimed to evaluate some risk attitudes of consumers who may get food contamination during their self-service in a self-service restaurant of Picos ­ PI. The collection of information was conducted by observing 13 risk attitudes practiced by consumers (n = 384) in the busiest time of the establishment, using an instrument that attitudes related to the possible risk of contamination at the time that each costumer was serving themselves their meal. According to the results obtained, it was found that the risk attitude by consumers was more committed to the ones who didn't wash their hands immediately before self-servicing (76.3%) which the most people who practiced this attitude were men (77, 6%). In 33.3% of cases consumers took objects to the counter distribution and 32.6% were talking at the time they were serving themselves. This research concludes that it is common to practice those attitudes that endanger food safety during the self-service, it is necessary to make consumers aware to avoid food contamination and the development of foodborne diseases.

Actualización en técnica aséptica y uso de antibióticos profilácticos en procedimientos quirúrgicos ambulatorios que comprometan piel y mucosas / Aseptic techniques for minor surgical procedures: an update

Aseptic techniques are those practices designed to reduce the risk of surgical site infection (SSI), defined as such, all those that occur within the first 30 days of the procedure. While the patient’s risk of developing an SSI in dermatologic surgery is low since many of the procedures are considered sterile, there are different factors associated with an increased or decreased risk of developing SSI. The characteristics of the surgical wound (such as involving infected or inflamed tissue or when breaks in the aseptic technique occur), patient characteristics (such as age, comorbidities, medication use and smoking) and procedure factors (such as setting, surgical technique, type of procedure, duration and body region involved). In this article we discuss the management of potential sources of infections such as personnel (hand washing, dressing), preparation of the patient, maintenance of a clean surgical environment, sterilization and the use of antiseptic solutions. Similarly, the current indications for prophylactic antibiotics for these procedures are considered.

Relación de la técnica de lavado de manos quirúrgico y las infecciones post operatorias en el Hospital de Apoyo San Francisco Ayacucho - 2016 / Relationship of the surgical hands washing technique and the postoperative infections in the Support Hospital San Francisco, Ayacucho - 2016

El lavado de mano quirúrgico, es el método básico más eficaz para la prevención de una infección, más aún dentro del área quirúrgica donde la herida operatoria de los pacientes está expuesta y en contacto con agentes extraños al organismo; por tal motivo se ha desarrollado la presente investigación. Objetivo: Determinar la relación de la técnica de lavado de manos quirúrgico y las infecciones post operatorias en el Hospital de Apoyo San Francisco, Ayacucho-2016. Metodología: El estudio es de tipo cuantitativo, nivel aplicativo, método descriptivo de corte transversal. Población: Fueron 19 profesionales que laboran en sala de operaciones y 19 pacientes post operados; la técnica fue la observación y se utilizó como instrumento un cuestionario. Resultados: Del 100 por ciento (19) de profesionales de la salud, el 52.6 por ciento (10) realiza el lavado de manos quirúrgico de forma inadecuada, y el 47.4 por ciento (9) se lavan adecuadamente. Con respecto a los pacientes, del 100 por ciento (19), ninguno presentan infecciones postoperatorias. Conclusión: En el presente estudio se muestra que no hay relación entre la técnica de lavado de manos con la presencia de infecciones post operatorias.

Surgical hand washing is the most effective for the prevention of infection, even within the surgical area where surgical wound patients are exposed and in contact with foreign agents to the body basic method; for this reason has developed this research in order to determine the relationship of the washing technique of surgical hands and postoperative infections Support Hospital San Francisco, Ayacucho-2016. Methodology: The study is quantitative, application level, descriptive method of cross section. Population: There were 19 professionals working in operating room and 19 patients post-surgery; the technique was observation and was used as instrument a questionnaire. Results: 100 per cent (19) of health professionals, 52.6 per cent (10) performs surgical scrub improperly, and 47.4 per cent (9) is properly washed. Regarding patients, 100 per cent (19), none have postoperative infections. Conclusion: This study shows that there is no relationship between hands washing technique with the presence of postoperative infections.

Impacto da estratégia multimodal na adesão a higiene de mãos entre a equipe multiprofissional / Impact of multimodal strategy on helthcare workers adherence to hand hygiene

A higienização das mãos (HM) destaca-se entre as medidas de prevenção e controle das infecções relacionadas à assistência em saúde (IRAS), devido a sua praticidade, baixo custo e superior benefício. Contudo, observa-se que a taxa de adesão à HM pelos profissionais assistenciais encontra-se aquém do desejado em todo o mundo. Algumas atividades vêm sendo implantadas com a finalidade de aumentar as taxas de adesão à HM. A Organização Mundial de Saúde (OMS) recomenda o uso de uma estratégia multimodal. Diante disto, este estudo teve como objetivo avaliar o impacto da estratégia multimodal na adesão à higienização das mãos entre a equipe multiprofissional. Tratou-se de um estudo do tipo antes e depois, realizado em duas unidades de terapia intensiva de um hospital universitário, de cuidado terciário, público e de grande porte. Fizeram parte da população todos os profissionais que prestavam assistência direta aos pacientes, entre agosto de 2013 e julho/2015. As intervenções seguiram os cinco componentes propostos pela estratégia multimodal da Organização Mundial de Saúde, a saber: mudanças no sistema, treinamento/educação, avaliação/feedback, lembretes no ambiente de trabalho e clima organizacional seguro. Foram utilizadas para a coleta de dados: questionário estruturado (com questões referentes ao conhecimento dos profissionais no que diz respeito à higienização das mãos e a taxa de adesão da equipe a HM) e observação direta (das oportunidades de HM). Os dados foram processados no Statistical Package for Social Sciences. Foram realizadas análises descritivas, univariada (teste de McNemar, qui-quadrado de Pearson ou exato de Fisher e teste t ou Mann Whitney) e multivariada (regressão logística). Considerou-se um intervalo de confiança de 95% com nível de significância de 5%. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da UFMG (COEP) (CAAE: 18477913.1.0000.5149). Fizeram parte do estudo 127 profissionais, totalizando...

Hand hygiene (HH) is the most important measure of prevention and control of healthcare associated infections (HAIs) due to its convenience, low cost and greater benefit. However, it is observed that the compliance to HH by healthcare workers is bellow the desired worldwide. Some strategies have been implemented in order to increase rates of adherence to HH. The World Health Organization (WHO) recommends the use of a multimodal strategy. In order to this, this study aimed to evaluate the impact of multimodal strategy in adherence to hand hygiene among the multidisciplinary team. It was a before and after study, held in two intensive care units of a university, tertiary care, public and large hospital. All professionals who provided direct care to patients between August 2013 and May 2015 were part of the population. Interventions followed the five key components proposed by the multimodal strategy of World Health Organization, named: changes in the system, training/education, evaluation/feedback, reminders in the organizational environment and safety climate. Two different data collection techniques were used: self-resported questionnaire (with questions regarding the knowledge of professionals about hand hygiene and the self-reported rates of HCW of HH), direct observation (opportunities of HH). Data were processed using SPSS. Descriptive, univariate analyzes (McNemar test, chi-square test or Fisher's exact test and t test or Mann Whitney test) and multivariate analyzes (logistic regression) were performed. It was considered a confidence interval of 95% with a significance level of 5%. The project was approved by the Ethics Committee of UFMG (COEP) (CAAE: 18477913.1.0000.5149). Study participants were 127 professionals, totalling 9,500 opportunities of HH (divided into three different observation moments). The HCW rates of adherence to HH by direct observation was 20.8% and the self-reported rate was 88.3% at baseline. However, the perception...

Hand washing practices and techniques among health professionals in a tertiary hospital in Kano

Background: The simple act of hand washing has been proven to reduce the risk of acquiring hospital infection; especially with the current concern of Ebola viral disease. Hospital acquired infections have contributed significantly to overall mortality and morbidity and health care cost. They report that hand washing remains at an unacceptable low level in most medical environments; with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients. Transmission of health-care-associated infections often occurs via the contaminated hands of health care workers. Materials and Methods: It was a descriptive cross-sectional study carried out among randomly selected doctors and nurses in Aminu Kano Teaching Hospital; Kano. The questionnaires were administered to the respondents during their ward rounds or clinic sessions. Results: One hundred and forty health professionals comprising 98 nurses and 42 doctors were studied. About 64.4% of them were aware of the World Health Organization (WHO) global hand washing day but only 15% stated the date correctly. About 99.3% of them believed that if hand washing is done correctly it can reduce the risk of infection. All (100%) of the health professionals use water and soap or hand rubs as agents of hand washing. About 93.6% were taught hand washing technique and 47% were aware of the five moments in hand washing but only 17% of them could list the five moments in hand washing. Only 25.7% health professionals knew the correct steps of hand washing (?2 = 2.444; df = 2; P = 0.295). Ninety-one percent of the health professionals had seen posters on hand washing. Majority (72.1%) adhered to principles of hand washing (?2 = 0.015; df = 1; P = 0.902) while 82.1% wash their hands before touching patients (?2 = 2.841; df = 1; P = 0.092). However; most of them (95%) washed their hands after touching patients and 97% washed their hands after handling body fluids or secretions from patients. On the other hand; only 39% health professionals washed hands before wearing hand gloves (?2 = 0.321; df = 1; P = 0.571) but 95% washed hands after removing the hand gloves. Ninety-nine percent washed their hands after visiting or using the restroom. Conclusion: This study underscores the need for continuous information and education of health professionals on the importance WHO global hand washing day. As doctors and nurses are important in the health care team; it is important to provide the appropriate knowledge and training regarding preventive practices of infectious diseases. Training and retraining of health professionals on correct steps of hand washing will encourage and remind them on the importance of washing hands before wearing gloves and before touching patients to reduce the risk of infection and cross infection

Conocimiento, actitudes y prácticas del personal de salud relacionados con el lavado de manos clínico en una unidad de cuidados intensivos / Knowledge, attitudes and practices of health personnel regarding hand washing in a clinical intensive care unit

Introducción: A pesar del considerable progreso en el manejo de complicaciones, las infecciones intrahospitalariascontinúan siendo una importante causa de morbimortalidad en Unidades de Cuidados Intensivos.Objetivos: Determinar el nivel de conocimiento y el cumplimiento de la práctica sobre el lavado de manos frente alos procedimientos y manipulación de pacientes que tiene el personal de salud que participa en el estudio.Material y Métodos: Estudio descriptivo transversal y estudio analítico intervencionista prospectivo, ambos realizadosdurante 4 meses mediante encuestas y observaciones directas de la técnica de la higiene de manos antes y despuésde una charla educativa.Resultados: El 60% de los encuestados fueron médicos de los cuales 80% conoce la correcta técnica del lavado demanos; se pudo constatar mediante las observaciones directas que el cumplimiento del lavado de las manos por partede éstos fue de un 56% antes y 78% después de la intervención; el 16% fueron enfermeros de los cuales el 50%conoce la correcta técnica del lavado de manos y el cumplimiento del lavado fue del 45,7% antes y 55,7% despuésde la intervención.Conclusiones: solo 61,2% de los encuestados conoce la correcta técnica del lavado de manos. Existe una mejoríasignificativa en el impacto de la intervención educativa para promover el lavado de manos antes y después de brindaratención a los pacientes

Introduction: Despite considerable progress in the management of complications, nosocomial infections remain an importantcause of morbidity and mortality in intensive care units. The present study tried to determine the level of knowledge andcompliance with the practice of handwashing procedures and handling of patients among Health Personnel in an ICU.Material and Methods: A descriptive cross-sectional and interventional prospective analytical study, conducted over fourmonths both through surveys and direct observations of the technique of hand hygiene before and after an educational talk.Results: 60% of respondents were physicians, of which 80% knew the correct hand washing technique; direct observations confirmed that compliance with handwashing was 56% before and 78% after the intervention; 16% were nurses of which50% knew the correct technique of hand washing; and among them washing compliance was 45.7% before and 55.7%after the intervention.Conclusions: Only 61.2% of respondents knew the correct hand washing technique. There is a significant improvementfollowing educational intervention to promote hand washing before and after providing care to patients