Higiene de manos, su aprendizaje mediante la utilización de medios de enseñanza

Fundamento: mejorar la higiene de las manos de manera eficaz y sostenida se consigue mediante la aplicación de múltiples medidas para abordar diferentes obstáculos, así como barreras conductuales, es por ello que se hace necesario crear medios que permitan su aprendizaje. Objetivo: diseñar medios de enseñanza que contribuyan al aprendizaje de la higiene de manos tanto en estudiantes de Lic. en Enfermería como en la comunidad. Métodos: se desarrolló una investigación cualicuantitativa, durante el período de estudio de junio 2018 a julio 2021. Los escenarios fueron el Círculo Infantil Marineritos del Sur, Escuela Primaria Guerrillero Heroico y la Universidad de Ciencias Médicas en el municipio de Cienfuegos. Se realizaron grupos de discusión en los tres escenarios, de lo cual emergieron las categorías capacitación y medios de enseñanza, que fueron creados y validados por la metodología de Barraza. Resultados: se diseñó una página web, una aplicación para móvil, juegos didácticos para los niños y trípticos. Todos fueron validados satisfactoriamente. Conclusiones: el diseño de medios de enseñanza, sustentados científicamente, se corresponde con las necesidades de los estudiantes la carrera de Licenciatura en Enfermería y de la comunidad para el logro de los conocimientos teóricos y prácticos en la adherencia a la técnica correcta de higiene de manos.

Summary: Introduction: The improvement of effective and sustained hand hygiene is achieved through the application of multiple measures to address different obstacles, as well as behavioral barriers, which is why it is necessary to create means that allow the learning of it, in such a way. In this sense, the objective is to design teaching means that contribute to the learning of hand hygiene both in Nursing students and in the community, Method; a qualitative-quantitative investigation was developed, Results the qualitative phase was evidenced when a discussion group was carried out from which the category training and teaching aids emerged, which allowed the design of a web page, a mobile application, didactic games for children and triptychs, and the quantitative phase when said teaching aids were validated by the Barraza methodology.

Response of Saudi Population to Strict Preventive Measures against COVID-19.

The Saudi ministry of health (MOH) started the preventive measures very early on before having a single case of COVID-19. There were very few studies regarding the awareness and adherence to the preventive measures against COVID-19 among the Saudi population in the literature. Objectives: The study aims to examine the awareness and commitment to the strict Saudi government preventive measures against COVID-19. Methods: A cross-sectional online survey targeted Saudi and non-Saudi populations aged 18+ in March-April 2020. The online questionnaire was designed to explore the participant's sociodemographic data, washing hygiene habits, the general level of awareness regarding COVID-19, and the extent to which they adhere to the government's strict instructions. Results: Out of the 2958 participants in the survey, 23% washed their hands for between 20 and 30 s, 59.6% washed their hands after shaking hands with other people, 67.9% washed their hands after use of other's utilities, 65.9% had appropriately followed the MOH recommended guidelines for home quarantine and social distancing. People in different age groups differed significantly on their practiced hygienic practices score p < 0.001. Respondents' educational level had converged considerably and positively on their clean proper prevention practices score, f(2838.3) = 15.70. Conclusion: The majority of the participants adhere to the strict government instructions regarding COVID-19 as they have to obey the law. Health sector employees measured significantly greater hygienic preventive measures and precautions in comparison to other sectors. More public health efforts should increase hygienic best practice scores to achieve the best outcome.

[The role of hospital environment and the hands of medical staff in the transmission of the Clostridioides (Clostridium) difficile infection]. / Rola srodowiska szpitalnego i rak personelu medycznego w szerzeniu sie zakazen Clostridioides (Clostridium) difficile.

This paper attempts to determine the role of the hospital environment in the spread of Clostridioides/Clostridium (C.) difficile infections based on a review of studies published in the medical literature and in the light of the authors' own experiences. Clostridioides/Clostridium difficile has recently attracted more and more attention, not only as an etiological factor of pseudomembranous intestinal inflammation and antibiotic associated diarrhea, but also as an etiologic factor of healthcare-associated infections (HAI) because of the possibility to survive in the hospital environment for a long time. This is caused by the production of spores, whose eradication options are limited. Clostridioides/Clostridium difficile spores are present not only on bedding of infected patients and their other belongings, but also on medical equipment and the hands of medical personnel, constituting a potential source of infection for other patients and some of the staff. The introduction of appropriate procedures for hand hygiene as well as for cleaning and disinfection of hospital surfaces makes it possible to reduce the number of spores and/or eradicate them. These procedures must be strictly followed to reduce the occurrence of spores in the hospital environment and to prevent further spread of C. difficile infections (CDI). Monitoring the presence of the C. difficile spores in a hospital environment using appropriate media (C diff Banana BrothTM) provides additional opportunities for culturing of C. difficile strains and determining ribotypes, especially hyperepidemic ones, which is extremely important from an epidemiological point of view. Med Pr. 2019;70(6):739-45.

Healthcare-associated Clostridium difficile infection: role of correct hand hygiene in cross-infection control.

INTRODUCTION: Clostridium difficile (CD) is the most common cause of health-care-associated infectious diarrhea with increasing incidence and severity in recent years. The main cause of hospital's acquired cross infections can be attributed to incorrect hand hygiene. We described the epidemiology of CD infection (CDI) in a teaching hospital in Southern Italy during a two years surveillance period and evaluated the health-care workers compliance to hand hygiene. METHODS: CDI Incidence rates were calculated as the number of patients with positive C. difficile toxin assay per 10,000 patient-days. Compliance with hand hygiene was the ratio of the number of performed actions to the number of opportunities observed. Approximately 400 Hand Hygiene (HH) opportunities/year /ward were observed. We finally checked out if any correlation could be found. RESULTS: From January 2015 to December 2016 a total number of 854 CD determinations were performed in patients with clinical symptoms of diarrhea. The search for toxins A and B was positive in 175 cases (21,2%), confirming the diagnosis of CDI. Compliance to hand hygiene was significantly inversely associated with the number of CDIs: the lower the compliance of health-care workers with hand hygiene the higher was the number of cases of CDIs (p = 0.003). CONCLUSIONS: According to our results proper handwashing of health-care workers appears to be a key intervention in interrupting CD cross infections regardless of age and type of department in which the patient is admitted.

Hands hygiene and the use of gloves by nursing team in hemodialysis service / Higiene de las manos y el uso de guantes por la enfermería en hemodiálises / Higiene das mãos e uso de luvas pela enfermagem em hemodiálise

ABSTRACT Objective: to analyze the adhesion of the nursing team to the practice of hands hygiene (HH) and the use of latex gloves in a hemodialysis service. Method: this is a descriptive-exploratory study with a quantitative approach, performed between August and October 2016 in a hemodialysis service in the countryside of São Paulo State, Brazil, where the nursing team adhered to HH and the use of gloves. All ethical aspects have been contemplated. Results: there were 1090 opportunities for HH, with the adhesion rate being only 16.6%. Regarding the use of gloves, of the 510 opportunities observed, there was correct use in 45%, reuse in 25% and absence of latex gloves in 29% of the time. Conclusion: the rate of HH and adherence to gloves is far from ideal, contributing to the increased risk of infection for both the user and the professional.

RESUMEN Objetivo: analizar la adhesión del equipo de enfermería a la práctica de higienización de las manos (HM) y al uso de guantes en un servicio de hemodiálisis. Método: el estudio descriptivo-exploratorio y cuantitativo, realizado entre agosto y octubre de 2016 en un servicio de hemodiálisis del interior del estado de São Paulo, Brasil, donde se observó la adhesión del equipo de enfermería a la HM y al uso de guantes. Todos los aspectos éticos fueron contemplados. Resultados: se observó 1090 oportunidades de HM, siendo la tasa de adhesión de apenas el 16,6%. En cuanto al uso de guantes, de las 510 oportunidades observadas, hubo utilización correcta en un 45%, la reutilización en un 25% y ausencia del uso de guantes en un 29%. Conclusion: la tasa de HM y la adhesión al uso de guantes están muy por debajo del ideal, contribuyendo al aumento del riesgo de infección, tanto para el usuario y para el profesional.

RESUMO Objetivo: analisar a adesão da equipe de enfermagem à prática de higienização das mãos (HM) e ao uso de luvas em um serviço de hemodiálise. Método: estudo descritivo-exploratório de abordagem quantitativa, realizado entre agosto e outubro de 2016 em um serviço de hemodiálise do interior do Estado de São Paulo, Brasil, onde foi observada a adesão da equipe de enfermagem à HM e ao uso de luvas. Todos os aspectos éticos foram contemplados. Resultados: observou-se 1090 oportunidades de HM, sendo a taxa de adesão de apenas 16,6%. Quanto ao uso de luvas, das 510 oportunidades observadas, houve utilização correta em 45%, a reutilização em 25% e ausência do uso de luvas em 29% das vezes. Conclusão: a taxa de HM e a adesão ao uso de luvas estão muito aquém do ideal, contribuindo para o aumento do risco de infecção, tanto para o usuário como para o profissional.

Adequação de um instrumento de monitoramento de higienização das mãos de um hospital do Rio de Janeiro / Adequacy of an instrument to monitor the hygiene of the hands of a hospital in Rio de Janeiro / Adecuación de un instrumento de monitoreo de higienización de las manos de un hospital de Río de Janeiro

Justificativa e Objetivos: Apesar da presença de indicadores obrigatórios nos protocolos de higiene das mãos, presentes no Programa Nacional de Segurança do Paciente do Brasil, não foram recomendados instrumentos de monitoramento, com indicadores que avaliem os componentes estruturais, de processo e resultado que permitam análise periódica e construção de ações de melhoria no âmbito da prevenção de controle das infecções relacionadas à assistência à saúde. O objetivo foi adequar um instrumento de monitoramento da higienização das mãos dos profissionais de saúde de um hospital do Rio de Janeiro. Métodos: um questionário foi aplicado aos auditores que avaliam o desempenho da política de qualidade do hospital para verificar a adequação de um instrumento de verificação da prática de higienização das mãos. Os achados deste questionário e os dados do levantamento na literatura - sobre a segurança do paciente, infecções relacionadas à assistência à saúde e instrumentos de monitoramento - possibilitaram a criação de um novo instrumento, que foi submetido ao julgamento de especialistas, usando a técnica de consenso Delphi. Resultados: em duas rodadas foi obtido um consenso dos especialistas. As questões que não atingiram 75% de concordância foram modificadas. Conclusão: O novo instrumento validado por especialistas permite a avaliação e monitoramento de implantação do protocolo de higienização das mãos, comparação entre sistemas e avanços nas metodologias e processos de trabalho, permitindo que sejam cada vez mais seguros.(AU)

Background and Objectives: Despite the presence of mandatory indicators in the hand hygiene protocols present in Brazil's National Patient Safety Program, monitoring instruments were not recommended, with indicators that evaluate the structural, process and outcome components that allow periodic analysis and construction of improvement actions in the prevention of control of infections related to health care. The objective was to adapt an instrument to monitor health professionals hands hygiene in a high complexity hospital of Rio de Janeiro. Methods: a questionnaire was applied to auditors who evaluate the performance of the hospital's quality policy to verify the suitability of an instrument to verify the practice of hand hygiene. The findings of this questionnaire and the survey data in the literature - on patient safety, health care related infections and monitoring instruments - enabled the creation of a new instrument, which was submitted to the judgment of specialists, using the Delphi consensus technique. Results: in only two rounds, a consensus of experts was obtained, allowing the construction of a new hand hygiene monitoring instrument. Issues that did not reach 75% agreement were modified. Conclusion: The new instrument validated by specialists allows the evaluation and monitoring of the implementation of the protocol of hand hygiene, comparison between systems and advances in methodologies and work processes, allowing them to be increasingly safe.(AU)

Justificación y objetivos: Apesar de la presencia de indicadores obligatorios em los protocolos de higiene de las manos, presentes en el Programa Nacional de Seguridad del Paciente de Brasil, no fueron recomendados instrumentos de monitoreo, con indicadores que evalúen los componentes estructurales, de proceso y resultado que permitan análisis periódico y construcción de acciones de mejora en el ámbito de la prevención de control de las infecciones relacionadas com la asistencia a la salud. El objetivo fue adecuar un instrumento de monitoreo de la higienización de las manos de los profesionales de salud de un hospital de Río de Janeiro. Métodos: un cuestionario fue aplicado a los auditores que evalúan el desempeño de la política de calidad del hospital para verificar la adecuación de un instrumento de verificación de la práctica de higienización de las manos. Los hallazgos de este cuestionario y los datos del levantamiento em la literatura - sobre la seguridad del paciente, infecciones relacionadas com la asistencia a la salud e instrumentos de monitoreo ­ posibilitar la creación de un nuevo instrumento, que fue sometido al juicio de especialistas, usando la técnica de consenso Delphi. Resultados: en apenas dos rondas se obtuvo un consenso de los expertos. Las cuestiones que no alcanzaron el 75% de concordancia se modificaron. Conclusiones: evidencias científicas y regulaciones ya han demostrado no ser suficiente para reducir las infecciones hospitalarias si no hay preocupación con la evaluación de la práctica asistencial. El nuevo instrumento validado por especialistas permite la evaluación y monitoreo de implantación del protocolo de higienización de las manos, comparación entre sistemas y avances en las metodologías y procesos de trabajo, permitiendo que sean cada vez más seguros.(AU)

Tolerância da pele às preparações alcoólicas: subsídios para melhoria das práticas de higiene das mãos / Skin tolerance to alcohol-based preparations: basis for improvement of hand hygiene practices / Tolerancia de la piel a las preparaciones alcohólicas: subsidios para mejorar las prácticas de higiene de las manos

Objetivo: avaliar a tolerância da pele de profissionais de enfermagem em relação às duas preparações alcoólicas com a aplicação do protocolo da "Estratégia Multimodal para melhoria da HM". Método: estudo cross-over, randomizado e duplo-cego com 42 profissionais de enfermagem de um hospital público de média complexidade. Resultados: não houve tolerância positiva para o handrub para a característica aparência, porém destacaram-se aspectos relacionados à integridade e à umidade. Para o álcool em gel, houve tolerância positiva para aparência e sensação. Evidenciou-se maior tolerância, após a utilização do álcool em gel. Na autoavaliação, para o handrub, somente a característica aparência não apresentou tolerância positiva. Para as avaliações objetivas, houve diminuição dos casos pele seca e/ou vermelha, e muito seca com aparência esbranquiçada após a utilização de ambas as preparações alcoólicas. Conclusão: devem-se considerar as singularidades dos profissionais com a promoção de processo decisório participativo para garantir a criação de um verdadeiro clima de segurança institucional.(AU)

Objective: to evaluate the tolerance of the skin of nursing professionals to two alcohol-based preparations with the implementation of the protocol "Multimodal Strategy for improving HH". Method: cross-over, randomized and double-blind study with 42 nursing professionals from a public hospital of medium complexity. Results: the use of handrub did not have positive tolerance for the characteristic appearance, but aspects related to integrity and humidity stood out. I the case of to alcohol gel, here was positive tolerance for appearance and sensation. Higher tolerance was observed after using alcohol gel. For handrub, appearance was the only characteristic that did not show positive tolerance in the self-assessment. In the objective evaluations, there was a decrease of cases of dry and/or red skin and very dry skin with whitish appearance after the use of both alcohol-based preparations. Conclusion: singularities of professionals must be considered, with promotion of participatory decision-making in order to ensure the creation of a true atmosphere of institutional safety.(AU)

Objetivo: evaluar la tolerancia de la piel de profesionales de enfermería en relación a las dos preparaciones alcohólicas con la aplicación del protocolo de la "Estrategia Multimodal para mejoría de HM". Método: estudio cross-over, aleatorio y duplo-ciego con 42 profesionales de enfermería de un hospital público de media complejidad. Resultados: no hubo tolerancia positiva para el handrub para la característica apariencia, sin embargo se destacaron aspectos relacionados a la integridad y a la humidad. Para el alcohol en general, hubo tolerancia positiva para apariencia y sensación. Se evidenció mayor tolerancia, después de la utilización del alcohol en general. En la auto-evaluación, para el handrub, solamente la característica apariencia no presentó tolerancia positiva. Para las evaluaciones objetivas, hubo disminución de los casos de piel seca y/o roja, y muy seca con apariencia blanqueada después de la utilización de ambas preparaciones alcohólicas. Conclusión: se deben considerar las singularidades de los profesionales con la promoción del proceso decisivo participativo para garantizar la creación de un verdadero clima de seguridad institucional.(AU)

Hands Hygiene Inspection Results Analysis among Medical Personnel in Hospital for Infectious Diseases / 中华医院感染学杂志

OBJECTIVE To analyze the medical personnel hand hygiene inspection results by biological detection in order to confirm the effect of seven-step hand-washing method by flow water and soft soap.METHODS The biological detection was used to insepct the hands hygiene ofter washing among medical personnel and the results were compered between males and females and doctors and nurses.RESULTS The qualification rate of hand hygiene among male doctors was 8.7%,among female doctors was 21.4%,among all doctors was 17.3%,and among all nurses was 60.87%.CONCLUSIONS Hand-washing effect medical personnel has obvious differences,female better than male,and nurse better than doctor.Throug education,supervision,and detection,the medical personnel′s hand-washing compliancecan be improved,and the dissemination of disease can be decrease.