Environmental cleaning to prevent COVID-19 infection. A rapid systematic review

ABSTRACT BACKGROUND: Faced with a pandemic, all healthcare actions need to reflect best practices, in order to avoid high transmissibility, complications and even hospitalizations. For hospital environments, the products recommended and authorized by regulatory institutions for environmental cleaning and disinfection need to be highly effective. OBJECTIVE: To identify, systematically evaluate and summarize the best available scientific evidence on environmental cleaning to prevent COVID-19 infection. DESIGN AND SETTING: A systematic review of studies analyzing cleaning products that inactivate coronavirus, conducted within the evidence-based health program of a federal university in São Paulo (SP), Brazil. METHODS: A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL and LILACS databases, for articles published up to May 27, 2020, relating to studies evaluating cleaning products that inactivate coronavirus in the environment. RESULTS: Seven studies were selected. These analyzed use of 70% alcohol, detergent, detergent containing iodine, household bleach, sodium hypochlorite, hydrogen peroxide, chlorine dioxide, glutaraldehyde, ultraviolet irradiation and plasma air purifier. The effectiveness of treating sewage with sodium hypochlorite and chlorine dioxide was also evaluated. CONCLUSION: Disinfection of environments, especially those in ordinary use, such as bathrooms, needs to be done constantly. Viral inactivation was achieved using chlorine-based disinfectants, alcohol, detergents, glutaraldehyde, iodine-containing detergents, hydrogen peroxide compounds and household bleaches. Alcohol showed efficient immediate activity. In sewage, sodium hypochlorite had better action than chlorine dioxide. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/YC5P4 in the Open Science Framework.

Environmental cleaning to prevent COVID-19 infection. A rapid systematic review.

BACKGROUND: Faced with a pandemic, all healthcare actions need to reflect best practices, in order to avoid high transmissibility, complications and even hospitalizations. For hospital environments, the products recommended and authorized by regulatory institutions for environmental cleaning and disinfection need to be highly effective. OBJECTIVE: To identify, systematically evaluate and summarize the best available scientific evidence on environmental cleaning to prevent COVID-19 infection. DESIGN AND SETTING: A systematic review of studies analyzing cleaning products that inactivate coronavirus, conducted within the evidence-based health program of a federal university in São Paulo (SP), Brazil. METHODS: A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL and LILACS databases, for articles published up to May 27, 2020, relating to studies evaluating cleaning products that inactivate coronavirus in the environment. RESULTS: Seven studies were selected. These analyzed use of 70% alcohol, detergent, detergent containing iodine, household bleach, sodium hypochlorite, hydrogen peroxide, chlorine dioxide, glutaraldehyde, ultraviolet irradiation and plasma air purifier. The effectiveness of treating sewage with sodium hypochlorite and chlorine dioxide was also evaluated. CONCLUSION: Disinfection of environments, especially those in ordinary use, such as bathrooms, needs to be done constantly. Viral inactivation was achieved using chlorine-based disinfectants, alcohol, detergents, glutaraldehyde, iodine-containing detergents, hydrogen peroxide compounds and household bleaches. Alcohol showed efficient immediate activity. In sewage, sodium hypochlorite had better action than chlorine dioxide. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/YC5P4 in the Open Science Framework.

Implantação de bundles em unidade de terapia intensiva: um relato de experiência / Implementación de bundles en unidad de cuidados intensivos: um relato de experiencia / Implementation of bundles in intensive care unit: an experience report

Objetivo: demonstrar o processo de implantação dos três bundles em unidade de terapia intensiva, relacionados à prevenção de pneumonia associada à ventilação mecânica, infecção de corrente sanguínea associada ao cateterismo venoso central e infecção do trato urinário associado à sondagem vesical de demora; oferecendo subsídios para esta prática. Método: foi realizada a formação de um Comitê Multiprofissional para a elaboração dos procedimentos, em seguida feita a validação dos procedimentos, e por último, realizada a implantação destes nas unidades de terapia intensiva. Resultados:houve diminuição das infecções ao paciente após a implantação das medidas preventivas,com a otimização da qualidade e segurança. Considerações finais: o apoio diretivo,disponibilização de recursos e engajamento dos enfermeiros gestores foram essenciais para o êxito na implantação dos bundles.

Aim: to demonstrate the process of the three bundles in intensive united care, related to the prevention of ventilator-associated pneumonia, bloodstream infections associated with central venous catheterization and urinary tract infection associated with indwelling catheter; offering support for this practice. Method: a multidisciplinary committee to draft the procedures was formed, then procedure were validated, and finally these were implemented intensive care units. Results: there was a decrease of infections to patients after the implementation of preventive measures, with optimization of quality and safety. Final considerations: the directive support,availability of resources and engagement of nurse managers were essential for the successful deployment of bundles.

Objetivo: mostrar el proceso de implementación de los tres bundles en unidadde cuidados intensivos, relacionados con la prevención de neumonía asociada a la ventilación mecánica, infección del torrente sanguíneo asociado al cateterismo venoso central y la infección del tracto urinario asociado a la sonda permanente, ofreciendo apoyo a esta práctica. Método: fue realizado la formación de un Comité Multiprofesional para elaborar los procedimientos, después la validación, y finalmente, ejecutado la implementación de los procedimientos en las unidades de cuidados intensivos. Resultados:se observó una disminución en las infecciones de los pacientes después de la aplicación de medidas preventivas, con la optimización de la calidad y la seguridad. Consideraciones finales: el apoyo directivo, la disponibilidad de recursos y la participación colectiva de los enfermeros gestores fueron esenciales para el éxito del desarrollo de los bundles.