Portación nasal de Staphylococcus aureus en el personal de salud de áreas críticas de un Hospital Pediátrico durante julio-setiembre 2018 / Nasal carriage of Staphylococcus aureus in health personnel in critical areas of a Pediatric Hospital during July-September 2018 / Transporte nasal de Staphylococcus aureus em profissionais de saúde em áreas críticas de um Hospital Pediátrico durante julho-setembro de 2018

Las infecciones intrahospitalarias (IIH) son causa de elevada morbimortalidad y representan un problema sanitario importante. El personal de salud es reservorio y potencial transmisor de los agentes etiológicos de las mismas. S. aureus es uno de los microorganismos implicados, por lo tanto es importante conocer la frecuencia de portación en el personal de salud y establecer el perfil de susceptibilidad antimicrobiana para contribuir con la elaboración de medidas de prevención incluyendo actividades educativas. Objetivo: Conocer la frecuencia de portación de S. aureus, distribución y antibiotipos de las cepas presentes en el personal sanitario del Hospital Pediátrico de Referencia (HPR). Materiales y métodos: Se realizó un estudio descriptivo durante el periodo julio-setiembre del año 2018. Se incluyeron muestras de hisopados nasales de trabajadores de la salud de distintas áreas de internación que consintieron participar en el estudio. Se excluyeron aquellos que recibieron antibióticos dentro de los 3 meses previos al estudio. Las muestras fueron sembradas en agar sangre ovina al 5% (ASO) y se incubaron a 35-37ºC en aerobiosis por 24-48 horas. La identificación de las colonias sospechosas de Staphylococcus aureus por métodos convencionales y MALDI-TOF. El patrón de resistencia antimicrobiana de S. aureus se detectó por disco-difusión. En los cultivos resistentes a meticilina (SAMR) se determinó la presencia del gen mecA y se realizó la tipificación del SCCmec por pruebas de reacción en cadena de polimerasa. Resultados: Se obtuvieron 225 hisopados a partir de 225 trabajadores, presentaron desarrollo 212. En 49 se recuperaron cultivos de S. aureus. Correspondieron a SAMR 11 de las 49 cepas, todas portaban el gen mecA. Hubo predominio en el personal de enfermería (7/11), en los servicios de hemato-oncología (3/11) y cuidados intensivos neonatales (4/11). Asociaron resistencia a macrólidos y clindamicina 8 de 11 aislamientos SAMR, a gentamicina 2 y a mupirocina uno. El SCCmec más frecuentemente identificado fue el tipo IV (7/11). Conclusiones: Los resultados muestran la presencia de cepas SAMR entre el personal de salud del CHPR y aportan información complementaria para efectuar prevención y control de las IIH, actuando sobre todo en el personal de salud encargado de la atención de pacientes susceptibles.

Hospital-acquired infections (IIH) are a cause of high morbidity and mortality and represent a major health problem. Health personnel are reservoirs and potential transmitters of their etiological agents. S. aureus is one of the microorganisms involved, therefore it is important to know the frequency of carriage in health personnel and establish the antimicrobial susceptibility profile to contribute to the development of prevention measures, including educational activities. Objective: To know the frequency of carriage of S. aureus, distribution and antibiotypes of the strains present in the health personnel of the Reference Pediatric Hospital (HPR). Materials and methods: A descriptive study was carried out during the period July-September 2018. Nasal swab samples from health workers from different hospitalization areas who agreed to participate in the study were included. Those who received antibiotics within 3 months prior to the study were excluded. The samples were seeded in 5% sheep blood agar (ASO) and incubated at 35-37ºC in aerobiosis for 24-48 hours. Identification of suspicious Staphylococcus aureus colonies by conventional methods and MALDI-TOF. The antimicrobial resistance pattern of S. aureus was detected by disc diffusion. In methicillin-resistant cultures (MRSA), the presence of the mecA gene was determined and SCCmec was typified by polymerase chain reaction tests. Results: 225 swabs were obtained from 225 workers, 212 showed development. S. aureus cultures were recovered from 49. 11 of the 49 strains corresponded to MRSA, all of them carried the mecA gene. There was a predominance in the nursing staff (7/11), in the hematology-oncology services (3/11) and neonatal intensive care (4/11). They associated resistance to macrolides and clindamycin in 8 of 11 MRSA isolates, 2 to gentamicin, and 1 to mupirocin. The most frequently identified SCCmec was type IV (7/11). Conclusions: The results show the presence of MRSA strains among the health personnel of the CHPR and provide complementary information to carry out prevention and control of IIH, acting especially on the health personnel in charge of the care of susceptible patients.

As infecções hospitalares (HII) são causa de alta morbidade e mortalidade e representam um importante problema de saúde. Os profissionais de saúde são reservatórios e potenciais transmissores de seus agentes etiológicos. O S. aureus é um dos micro-organismos envolvidos, por isso é importante conhecer a frequência de portadores em profissionais de saúde e estabelecer o perfil de suscetibilidade antimicrobiana para contribuir no desenvolvimento de medidas de prevenção incluindo atividades educativas. Objetivo: Conhecer a frequência de portadores de S. aureus, distribuição e antibiótipos das cepas presentes no pessoal de saúde do Hospital Pediátrico de Referência (HPR). Materiais e métodos: Foi realizado um estudo descritivo durante o período de julho a setembro de 2018. Foram incluídas amostras de swab nasal de profissionais de saúde de diferentes áreas de internação que concordaram em participar do estudo. Aqueles que receberam antibióticos nos 3 meses anteriores ao estudo foram excluídos. As amostras foram semeadas em 5% de ágar sangue de carneiro (ASO) e incubadas a 35-37ºC em aerobiose por 24-48 horas. Identificação de colônias suspeitas de Staphylococcus aureus por métodos convencionais e MALDI-TOF. O padrão de resistência antimicrobiana de S. aureus foi detectado por difusão em disco. Em culturas resistentes à meticilina (MRSA), a presença do gene mecA foi determinada e SCCmec foi tipificado por testes de reação em cadeia da polimerase. Resultados: 225 swabs foram obtidos de 225 trabalhadores, 212 apresentaram desenvolvimento. Culturas de S. aureus foram recuperadas de 49. 11 das 49 cepas correspondiam a MRSA, todas carregavam o gene mecA. Houve predominância na equipe de enfermagem (7/11), nos serviços de hematologia-oncologia (3/11) e de terapia intensiva neonatal (4/11). Eles associaram resistência a macrolídeos e clindamicina em 8 de 11 isolados de MRSA, 2 à gentamicina e 1 à mupirocina. O SCCmec mais frequentemente identificado foi o tipo IV (7/11). Conclusões: Os resultados mostram a presença de cepas de MRSA entre os profissionais de saúde do CHPR e fornecem informações complementares para realizar a prevenção e controle da HII, atuando principalmente sobre os profissionais de saúde responsáveis ​​pelo atendimento de pacientes suscetíveis.

Hepatitis B virus infection and its associated factors among medical waste collectors at public health facilities in eastern Ethiopia: a facility-based cross-sectional study.

BACKGROUND: The risk of hepatitis B virus infection among medical waste handlers who undergo collection, transportation, and disposal of medical wastes in the health institutions is higher due to frequent exposure to contaminated blood and other body fluids. There is limited evidence on the seroprevalence of hepatitis B among medical waste handlers in eastern Ethiopia. The study was aimed at studying the seroprevalence of Hepatitis B Virus and associated risk factors among medical waste collectors at health facilities of eastern Ethiopia. METHODS: A facility-based cross-sectional study was conducted among randomly selected medical waste collectors from public health facilities in eastern Ethiopia from March to June 2018. A pre-tested and well-structured questionnaire was used to collect data on socio-demographic characteristics and hepatitis B infection risk factors. A2.5ml venous blood was also collected, centrifuged and the serum was analyzed for hepatitis B surface antigen using the instant hepatitis B surface antigen kit. Descriptive summary measures were done. Chi-square and Fisher exact tests were used to assess the risk of association. Multivariate logistic regression was conducted with 95% CI and all value at P-value < 0.05 was declared statistically significant. RESULTS: From a total of 260 (97.38%) medical waste collectors participated, HBV was detected in 53 (20.4%) of the participants [95%CI; 15.8, 25.6]. No significant differences were observed in the detection rates of HBV with respect to socio-demographic characteristics. In both bivariate and multivariable logistic regression analysis, being unvaccinated (AOR = 6.35; 95%CI = [2.53-15.96], P = 0.001), history of blood transfusion (receiving) (AOR; 3.54; 95%CI; [1.02-12.24], P = 0.046), history of tattooing (AOR = 2.86; 95%CI = [1.12-7.27], p = 0.03), and history of multiple sexual partner (AOR = 10.28; 95%CI = [4.16-25.38], P = 0.001) remained statistically significantly associated with HBsAg positivity. CONCLUSION: This cross-sectional study identified that HBV infection is high among medical waste collectors in eastern Ethiopia. Immunization and on job health promotion and disease prevention measures should be considered in order to control the risk of HBV infection among medical waste collectors in eastern Ethiopia.

Needle Stick and Sharp Injuries Among Healthcare Workers: A retrospective six-year study.

OBJECTIVES: This study aimed to examine the proportion of needle stick and sharp injuries (NSSIs) among healthcare workers at King Hussein Medical Center (KHMC), Amman, Jordan. METHODS: All NSSI reports referred from departments at KHMC to the Preventive Medicine Department between 2013-2018 were retrospectively reviewed. Proportion of NSSIs were calculated and stratified according to age, gender, job title, place and site of injury and the procedure/task during which the injury occurred. RESULTS: There were a total of 393 NSSIs. A significant association was found between the proportion of NSSIs and all tested variables (P <0.001). The reported proportion of NSSIs was highest among nurses (39.7%) followed by cleaners (36.3%), physicians (10.4%), other workers (7.4%) and lab technicians (5.9%) during the study's six-year period. Hospital wards were the most common locations (46.1%) where injuries took place. Injuries also occurred most frequently during medical waste collection (38.2%). CONCLUSION: The proportion of NSSIs was highest among nurses and cleaners. Safety policies and training among high-risk groups should be reviewed to reduce the risk of NSSIs. Multicentre studies at a national level should be conducted to examine whether this study's findings reflect national trends.

Profile of environmental service managers and workers in Brazilian hospitals.

INTRODUCTION: Contamination through the hands of professionals and surfaces is one of the main agents involved in health care-associated infections in health services. Flaws in the execution of hospital housekeeping can lead to the contamination of surfaces and health equipment though, representing a risk for patient safety and highlighting the need to maximize the quality of cleaning processes in these institutions. OBJECTIVE: To describe the profile of managers and environmental service workers (ESWs) in Brazilian hospitals. METHODS: A cross-sectional study was undertaken in January 2018, involving 155 participants, being 12 managers and 143 workers from the housekeeping team of two health institutions, being one private and the other public. RESULTS: Most participants were female (86%), with a mean age of 45 years and primary education level, 52% being outsourced workers. The participants positively assessed their job satisfaction, satisfaction with training, basic knowledge and performance; nevertheless, situations were identified that were perceived as risks for patient safety and occupational health. The questions involving motivational incentives received the lowest scores. CONCLUSION: Inconsistencies were found in the housekeeping professionals'. Preparation, indicating that the institutions studied do not value this type of service and that an investment policy in these workers' motivation is lacking.

Acidentes de trabalho entre profissionais da limpeza hospitalar em uma capital do Nordeste, Brasil / Workplace accidents among hospital cleaning professionals at a hospital in the city of Maranhão, Brazil

Resumo O objetivo deste estudo foi investigar a prevalência e os fatores associados aos acidentes de trabalho entre profissionais da limpeza hospitalar. Foram entrevistados 199 trabalhadores da limpeza de seis hospitais em São Luís, Maranhão, Brasil. Primeiramente, realizou-se análise univariada e, posteriormente, utilizaram-se as análises de regressão de Poisson com variância robusta, com modelagem hierarquizada dos dados a fim de estimar razões de prevalências (RP) entre as variáveis independentes e o desfecho (acidentes de trabalho). Houve prevalência de 13,57% de acidentes de trabalho, destes, 81,48% ocorridos com materiais perfurocortantes. Ao final da análise multivariada, identificaram-se fatores associados á ocorrência de acidentes de trabalho: idade de 18 a 30 anos, ter ensino médio incompleto, tempo de serviço de 2 a 5 anos, segregação inadequada dos resíduos de serviços de saúde (RSS), ter capacitação somente na admissão, não considerar os riscos dos resíduos à saúde e o não uso de equipamento de proteção individual (EPI). Os fatores avaliados apresentaram-se associados significativamente aos acidentes de trabalho e ressaltam a importância da educação permanente em saúde, com ênfase em capacitações periódicas e uso de EPI.

Abstract The goal of this study was to investigate the prevalence and factors associated with workplace accidents among hospital cleaning professionals. This is a cross-sectional, analytical study of a sample of 199 cleaning workers at six hospitals in São Luís, Maranhão, Brazil. We first ran a univariate analysis, and later the Poisson regression analyzes with robust variance were used, with hierarchized modeling of the data in order to estimate the prevalence ratios (PR) between the independent variables and the outcome (workplace accidents). The prevalence of workplace accidents is 13.57%, 81.48% of them with sharps. At the end of the multivariate analysis the following were found to be associated with workplace accidents: age between 18 and 30, not having a high-school degree, on the job for 2 to 5 years, inadequate segregation of health service waste (HSW), training only on admission, failure to consider the health hazards of hospital waste and failure to use personal protective equipment (PPE). Our findings reinforce the importance of continued health education, stressing periodic training and the use of PPE.

Workplace accidents among hospital cleaning professionals at a hospital in the city of Maranhão, Brazil. / Acidentes de trabalho entre profissionais da limpeza hospitalar em uma capital do Nordeste, Brasil.

The goal of this study was to investigate the prevalence and factors associated with workplace accidents among hospital cleaning professionals. This is a cross-sectional, analytical study of a sample of 199 cleaning workers at six hospitals in São Luís, Maranhão, Brazil. We first ran a univariate analysis, and later the Poisson regression analyzes with robust variance were used, with hierarchized modeling of the data in order to estimate the prevalence ratios (PR) between the independent variables and the outcome (workplace accidents). The prevalence of workplace accidents is 13.57%, 81.48% of them with sharps. At the end of the multivariate analysis the following were found to be associated with workplace accidents: age between 18 and 30, not having a high-school degree, on the job for 2 to 5 years, inadequate segregation of health service waste (HSW), training only on admission, failure to consider the health hazards of hospital waste and failure to use personal protective equipment (PPE). Our findings reinforce the importance of continued health education, stressing periodic training and the use of PPE.

O objetivo deste estudo foi investigar a prevalência e os fatores associados aos acidentes de trabalho entre profissionais da limpeza hospitalar. Foram entrevistados 199 trabalhadores da limpeza de seis hospitais em São Luís, Maranhão, Brasil. Primeiramente, realizou-se análise univariada e, posteriormente, utilizaram-se as análises de regressão de Poisson com variância robusta, com modelagem hierarquizada dos dados a fim de estimar razões de prevalências (RP) entre as variáveis independentes e o desfecho (acidentes de trabalho). Houve prevalência de 13,57% de acidentes de trabalho, destes, 81,48% ocorridos com materiais perfurocortantes. Ao final da análise multivariada, identificaram-se fatores associados á ocorrência de acidentes de trabalho: idade de 18 a 30 anos, ter ensino médio incompleto, tempo de serviço de 2 a 5 anos, segregação inadequada dos resíduos de serviços de saúde (RSS), ter capacitação somente na admissão, não considerar os riscos dos resíduos à saúde e o não uso de equipamento de proteção individual (EPI). Os fatores avaliados apresentaram-se associados significativamente aos acidentes de trabalho e ressaltam a importância da educação permanente em saúde, com ênfase em capacitações periódicas e uso de EPI.

Compared efficiency of trauma versus scheduled orthopaedic surgery operating rooms in a university hospital.

BACKGROUND: The objective of this study was to contribute to an OR efficiency optimisation effort by comparing a trauma OR versus a scheduled surgery OR in a lower limb orthopaedic surgery department. HYPOTHESIS: The main hypothesis is that efficiency is lower in the trauma OR than in the scheduled surgery OR. The secondary hypothesis is that efficiency of the trauma OR is lower during weekends. MATERIAL AND METHODS: This prospective study was conducted in 2016 in the orthopaedic surgery department of a university hospital. Patients were divided into three groups based on whether they underwent scheduled surgery (SchOS), trauma surgery on a weekday (TSwk), or trauma surgery on a weekend (TSwkend). Actual OR occupancy time, allocated OR block time (BT), OR occupancy rate, patient entrance-to-incision time, incision-to-closure time, closure-to-post-anaesthesia care unit (PACU) entrance time, and clean-up/set-up time (T4) were measured. RESULTS: We included 691 patients in the SchOS group, 819 in the TSwk group, and 327 in the TSwkend group. OR efficiency was lower in the TSwk group compared to the SchOS group (occupancy rate, 86% vs. 88%; p=10-4). All occupancy time components were longer in the TSwk group. However, each component accounted for similar total occupancy time proportions in the two groups, except for clean-up/set-up time, which was longer in the TSwk group (p<0.05). On average, entrance-to-incision time accounted for 31%, incision-to-closure time for 34%, closure-to-PACU time for 18%, and clean-up/set-up time for 17% of total occupancy time. Efficiency was lower in the TSwkend group than in the TSwk group (occupancy rate, 75% vs. 86%; p=10-4). The TSwkend group had shorter entrance-to-incision and incision-to-closure times (p<0.05) and a nearly 10% longer clean-up/set-up time (p<0.05). CONCLUSION: Efficiency of the trauma OR, although lower compared to the scheduled orthopaedic surgery OR, was nevertheless satisfactory as assessed based on standard indicators. Of the four total occupancy time components, the first three accounted for similar proportions of the total; differences occurred only for clean-up/set-up time. Efforts to improve OR efficiency should focus on arrival of the first patient and turnover time. LEVEL OF EVIDENCE: II, prospective cohort study.

Musculoskeletal symptoms among hospital cleaners.

Studies have indicated that cleaners are at risk for musculoskeletal symptoms (MSS). In 2001, the Norwegian Labor Inspectorate suggested improvements in cleaners' work environment to reduce MSS. We estimate prevalence of MSS among cleaners in a Norwegian hospital that had implemented improvements to reduce risk of MSS and calculate relative risk of MSS among cleaners compared to a group of office workers. Data were collected from 255 participants. MSS were investigated using the Nordic Questionnaire for Analysis of Musculoskeletal Symptoms. Cleaners reported a significantly higher prevalence of MSS compared to office workers but a lower prevalence compared to similar studies among cleaners in other countries. This may indicate that working conditions in Norway are better than in other countries; further studies are needed to compare MSS and working conditions in different settings.

Evaluating the impact of continuous quality improvement methods at hospitals in Tanzania: a cluster-randomized trial.

OBJECTIVE: To evaluate the impact of implementing continuous quality improvement (CQI) methods on patient's experiences and satisfaction in Tanzania. DESIGN: Cluster-randomized trial, which randomly allocated district-level hospitals into treatment group and control group, was conducted. SETTING: Sixteen district-level hospitals in Kilimanjaro and Manyara regions of Tanzania. PARTICIPANTS: Outpatient exit surveys targeting totally 3292 individuals, 1688 in the treatment and 1604 in the control group, from 3 time-points between September 2011 and September 2012. INTERVENTION: Implementation of the 5S (Sort, Set, Shine, Standardize, Sustain) approach as a CQI method at outpatient departments over 12 months. MAIN OUTCOME MEASURES: Cleanliness, waiting time, patient's experience, patient's satisfaction. RESULTS: The 5S increased cleanliness in the outpatient department, patients' subjective waiting time and overall satisfaction. However, negligible effects were confirmed for patient's experiences on hospital staff behaviours. CONCLUSIONS: The 5S as a CQI method is effective in enhancing hospital environment and service delivery; that are subjectively assessed by outpatients even during the short intervention period. Nevertheless, continuous efforts will be needed to connect CQI practices with the further improvement in the delivery of quality health care.

An analysis of hospital cleaning staff's attitudes and conduct regarding hand hygiene and cleaning.

OBJECTIVE: The aim of this study was to analyze the attitudes and conduct of hospital cleaning staff regarding cleaning and hand hygiene. METHODS: In May and June 2014, the cleaning staff of Elazig Training and Research Hospital participated in this descriptive research. Data was collected by a survey prepared by the researchers. The SPSS program was used to analyze the data. RESULTS: Of the participants, 70.3% of them were male and their mean age was 38.69 ± 6.61. The percentage of those hand washing before starting work was 29.8% for primary school graduates or those with lower education. For those with higher levels of education, the percentage was 68.2% (p < 0.001). The percentage of participants who wash their hands after work was 54.3% for primary school graduates and those with lower levels of education. For those with a higher level of education, the percentage was 84.1% (p < 0.001). The participants' use of personal protective equipment during work was that 97.8% of them used gloves, 39.9% bonnets and 56.5% medical masks. CONCLUSIONS: The attitudes and conduct of the cleaning staff are not sufficiently hygienic. These employees need training before and throughout their employment.

Prevalência e fatores associados aos acidentes de trabalho no serviço hospitalar de limpeza / Prevalencia y factores asociados a los accidentes de trabajo en el servicio hospitalario de limpieza / Prevalence and associated factors to occupational accidents in the hospital housekeeping

Objective: Identify the prevalence and factors associated with the occurrence of accidents at work with hospital housekeeping personnel. Method: Cross-sectional study involving 157 workers from a public university hospital of Rio Grande do Sul, Brazil. Data collection occurred in 2013, it was used a form for socio-demographic, labor, habits, health and occupational accidents characterization. Results: In the last worked year, prevalence of occupational accidents was of 17,8%. Occurred with the highest percentage of male workers (26.3%), those with between 19 and 34 years (21.6%). Sharps injuries and falls stood out, his hands and fingers were the body parts most affected. Conclusion: None of evaluated factors presented itself meaningfully associated to occupational accidents. The population size may have affected this result.

Objetivo: Identificar a prevalência e os fatores associados à ocorrência dos acidentes de trabalho com os trabalhadores do serviço hospitalar de limpeza. Método: Estudo transversal, envolvendo 157 trabalhadores do serviço hospitalar de limpeza atuantes em um hospital universitário do Rio Grande do Sul, Brasil. A coleta de dados ocorreu em 2013, utilizando-se um formulário para caracterização sociodemográfica, laboral,hábitos, saúde e dos acidentes de trabalho. Resultados: No último ano trabalhado, a prevalência de acidentes foi de 17,8%. O maior percentual de acidentes ocorreu com trabalhadores do sexo masculino(26,3%), entre 19 e 34 anos (21,6%). Os acidentes com perfurocortantes e as quedas se destacaram, sendo as mãos e os dedos as partes do corpo mais atingidas. Conclusão: Nenhum dos fatores avaliados apresentou-se associado significativamente aos acidentes de trabalho. O número de sujeitos pesquisados pode ter interferido nesse resultado.

Objetivo: Determinar la prevalencia y los factores asociados a la ocurrencia de accidentes de trabajo con el personal del servicio hospitalario de limpieza. Método: Estudio transversal con 157 trabajadores en un hospital universitario del Rio Grande do Sul, Brasil. Los datos fueron recogidos en 2013, mediante un formulario de características sociodemográficas, laborales, hábitos, salud y de los accidentes de trabajo. Resultados: En el último año trabajado, la prevalencia de accidentes fue de 17,8%. El mayor porcentaje ocurrió con los trabajadores del sexo masculino (26,3%), los que tienen entre 19 y 34 años (21,6%). Los accidentes con objetos punzantes y las caídas se destacaron, las manos y los dedos fueron las partes del cuerpo más afectadas. Conclusión: Ninguno de los factores evaluados se asoció significativamente a los accidentes. El tamaño de la población puede haber afectado en esto resultado.

Characterization of cleaning and disinfecting tasks and product use among hospital occupations.

BACKGROUND: Healthcare workers have an elevated prevalence of asthma and related symptoms associated with the use of cleaning/disinfecting products. The objective of this study was to identify and characterize cleaning/disinfecting tasks and products used among hospital occupations. METHODS: Workers from 14 occupations at five hospitals were monitored for 216 shifts, and work tasks and products used were recorded at five-minute intervals. The major chemical constituents of each product were identified from safety data sheets. RESULTS: Cleaning and disinfecting tasks were performed with a high frequency at least once per shift in many occupations. Medical equipment preparers, housekeepers, floor strippers/waxers, and endoscopy technicians spent on average 108-177 min/shift performing cleaning/disinfecting tasks. Many occupations used products containing amines and quaternary ammonium compounds for >100 min/shift. CONCLUSIONS: This analysis demonstrates that many occupations besides housekeeping incur exposures to cleaning/disinfecting products, albeit for different durations and using products containing different chemicals.

Evaluating the impact of pluridisciplinary training on proper glove use in hospital.

OBJECTIVE: The authors of this randomized study had for aim to evaluate the impact of training on proper glove use by comparing compliance to glove use recommendations between trained and untrained healthcare personnel according to healthcare professional groups. PATIENTS AND METHODS: A random selection of trained and untrained nurses, nurse aids, and hospital housekeepers was performed in a French University hospital, using a listing of healthcare personnel. The audits were conducted by two infection control nurses, in series of 10 observations, with a maximum time limit of two hours. The evaluation criteria were compliance or non-compliance of glove-wearing practices with internal hospital recommendations, disclosed to professionals during training. RESULTS: Overall, 111 professionals were audited and 794 acts were observed. Hand hygiene was significantly better in trained vs. untrained healthcare professionals (P < 0.01). Proper glove use practices were similar between trained and untrained nurses (85% of compliance), whereas the difference was statistically significant in favor of trained healthcare personnel for the other categories (P < 0.001 for nurse aids and P = 0.02 for housekeepers). CONCLUSION: We demonstrated the impact of pluridisciplinary training on proper glove use practices in hospital settings, but with different benefits found according to professional groups. The lower the initial training level, the greater the overall benefit appeared to be.

Rate of healthcare worker-patient interaction and hand hygiene opportunities in an acute care setting.

OBJECTIVE: Identify factors affecting the rate of hand hygiene opportunities in an acute care hospital. DESIGN: Prospective observational study. SETTING: Medical and surgical in-patient units, medical-surgical intensive care unit (MSICU), neonatal intensive care unit (NICU), and emergency department (ED) of an academic acute care hospital from May to August, 2012. PARTICIPANTS: Healthcare workers. METHODS: One-hour patient-based observations measured patient interactions and hand hygiene opportunities as defined by the "Four Moments for Hand Hygiene." Rates of patient interactions and hand hygiene opportunities per patient-hour were calculated, examining variation by room type, healthcare worker type, and time of day. RESULTS: During 257 hours of observation, 948 healthcare worker-patient interactions and 1,605 hand hygiene opportunities were identified. Moments 1, 2, 3, and 4 comprised 42%, 10%, 9%, and 39% of hand hygiene opportunities. Nurses contributed 77% of opportunities, physicians contributed 8%, other healthcare workers contributed 11%, and housekeeping contributed 4%. The mean rate of hand hygiene opportunities per patient-hour was 4.2 for surgical units, 4.5 for medical units, 5.2 for ED, 10.4 for NICU, and 13.2 for MSICU (P < .001). In non-ICU settings, rates of hand hygiene opportunities decreased over the course of the day. Patients with transmission-based precautions had approximately half as many interactions (rate ratio [RR], 0.55 [95% confidence interval (CI), 0.37-0.80]) and hand hygiene opportunities per hour (RR, 0.47 [95% CI, 0.29-0.77]) as did patients without precautions. CONCLUSIONS: Measuring hand hygiene opportunities across clinical settings lays the groundwork for product use-based hand hygiene measurement. Additional work is needed to assess factors affecting rates in other hospitals and health care settings.

Does improving surface cleaning and disinfection reduce health care-associated infections?

Contaminated environmental surfaces provide an important potential source for transmission of health care-associated pathogens. In recent years, a variety of interventions have been shown to be effective in improving cleaning and disinfection of surfaces. This review examines the evidence that improving environmental disinfection can reduce health care-associated infections.

Needlestick and sharps injuries among housekeeping workers in hospitals of Shiraz, Iran.

BACKGROUND: Needlestick and sharps injuries (NSSIs) are one of the major risk factors for blood-borne infections (BBPs) at healthcare facilities. This study examines the current prevalence of NSSIs among housekeeping workers engaged in the handling and disposal of biomedical waste (BMW) at government and private hospitals in Shiraz, Iran, and furthermore, explores strategies for preventing these injuries. FINDINGS: Using a cross-sectional study design, NSSI's and associated protective measures for housekeeping workers throughout hospitals in Shiraz were evaluated from 2009 onwards. Using a questionnaire, data was collected for 92 workers who had engaged directly with BMW. Data was analyzed using Chi-square, student t-test and where appropriate, SPSS version 12. 90.2 % of housekeeping workers were warned of the dangers associated with waste, 87.5 % in government and 93.2 % in private hospitals (P = 0.0444). 83.7 % had attended educational programs on biomedical waste (BMW) management and injury prevention at their hospital in the preceding year. 16.3 % had not been trained in biomedical waste management (P = 0.0379) and 88.9 % had a sufficient supply of safety wear. CONCLUSIONS: NSSIs are a common risk factor for infection among health care workers within hospitals in Iran. For the effective prevention of these injuries, health boards and hospital trusts need to formulate strategies to improve the working conditions of health care workers, discourage the excessive use of injections, and increase their adherence to universal precautions.

Work organisation and gender among hospital cleaners in Quebec after the merger of 'light' and 'heavy' work classifications.

In Québec, Canada, cleaning tasks were once divided into 'light' or 'heavy' cleaning, assigned respectively to women and men. These categories are being merged; in principle, both genders are assigned the same tasks. Activity analysis using observations and interviews examined work activity of male and female cleaners in two hospitals. In one hospital, work activity could be compared before (time 1) and after the work reorganisation (time 2). Some gender segregation of tasks appeared to have persisted at time 2, in both hospitals. Some route assignments contained components that were difficult for all cleaners, especially women of average strength. Only about one-third of the recommendations for improvement made at time 1 had been carried out by time 2, 12 years later. In a low-status job, it may be hard to meet equality, health and efficiency goals because commitment to improving equipment and worksite design may be lacking. PRACTITIONER SUMMARY: Current attempts to desegregate jobs should be accompanied by attention to physical job demands in order to protect employee health and access to equal employment. The study also shows the need to follow up ergonomic interventions, particularly in low-status jobs such as cleaning, where recommendations can be forgotten.

Measuring quality indicators in the operating room: cleaning and turnover time.

This exploratory-descriptive study was carried out in the Surgical Center Unit of a university hospital aiming to measure time spent with concurrent cleaning performed by the cleaning service and turnover time and also investigated potential associations between cleaning time and the surgery's magnitude and specialty, period of the day and the room's size. The sample consisted of 101 surgeries, computing cleaning time and 60 surgeries, computing turnover time. The Kaplan-Meier method was used to analyze time and Pearson's correlation to study potential correlations. The time spent in concurrent cleaning was 7.1 minutes and turnover time was 35.6 minutes. No association between cleaning time and the other variables was found. These findings can support nurses in the efficient use of resources thereby speeding up the work process in the operating room.

Measuring quality indicators in the operating room: cleaning and turnover time / Mensuração de indicadores de qualidade em centro cirúrgico: tempo de limpeza e intervalo entre cirurgias / Mensuración de indicadores de calidad en un centro quirúrgico: tiempo de limpieza e intervalo entre cirugías

This exploratory-descriptive study was carried out in the Surgical Center Unit of a university hospital aiming to measure time spent with concurrent cleaning performed by the cleaning service and turnover time and also investigated potential associations between cleaning time and the surgery's magnitude and specialty, period of the day and the room's size. The sample consisted of 101 surgeries, computing cleaning time and 60 surgeries, computing turnover time. The Kaplan-Meier method was used to analyze time and Pearson's correlation to study potential correlations. The time spent in concurrent cleaning was 7.1 minutes and turnover time was 35.6 minutes. No association between cleaning time and the other variables was found. These findings can support nurses in the efficient use of resources thereby speeding up the work process in the operating room.

Este estudo exploratório-descritivo foi conduzido na unidade de centro cirúrgico de um hospital de ensino, tendo por objetivos: mensurar o tempo despendido para limpeza concorrente pelo Serviço de Higiene e Limpeza, em sala de operação, e o intervalo entre as cirurgias, e investigar a associação entre o tempo de limpeza e porte e especialidade da cirurgia, período de ocorrência e tamanho da sala. A amostra foi constituída por 101 (estudo tempo de limpeza) e 60 cirurgias (estudo intervalo entre cirurgias). O método de Kaplan-Meier foi utilizado para análise do tempo e a correlação de Pearson para o estudo das associações. O tempo da limpeza concorrente da sala foi de 7,1 minutos e o do intervalo entre cirurgias de 35,6 minutos. Não se encontrou correlação entre tempo de limpeza e demais variáveis. Esses achados instrumentalizam os enfermeiros no uso eficiente de recursos, agilizando o processo de trabalho em centro cirúrgico.

Este estudio exploratorio y descriptivo fue conducido en la Unidad de Centro Quirúrgico de un hospital de enseñanza teniendo por objetivos mensurar el tiempo utilizado para limpieza concurrente en sala de operación (por el Servicio de Higiene y Limpieza) y el intervalo entre las cirugías; e, investigar las asociaciones entre: tiempo de limpieza, porte de la cirugía, especialidad de la cirugía, período de ocurrencia y tamaño de la sala. El estudio fue constituido de 101 casos de limpieza (estudio de tiempo de limpieza) y 60 cirugías (estudio de intervalo entre cirugías). El método de Kaplan-Meier fue utilizado para el análisis del tiempo y la correlación de Pearson para el estudio de las asociaciones. El tiempo promedio de limpieza concurrente de la sala fue de 7,1 minutos y el del intervalo entre cirugías de 35,6 minutos. No fue encontrada correlación entre el tiempo de limpieza y las demás variables. Estos hallazgos instrumentalizan a los enfermeros en el uso eficiente de recursos, agilizando el proceso de trabajo en el Centro Quirúrgico.