Search

Background: Strategies to improve adherence to standard and transmission-based precautions are essential to reduce the risk of health care-associated infections. This study aims to evaluate the effectiveness of an educational strategy on precautions among nursing staff in primary health care settings., Methods: A randomized nonblinded controlled trial was conducted with 100 nursing staff working in 28 primary health care units. Groups were allocated randomly. The intervention group received a WebQuest educational strategy: a guided, creative method designed to engage participants in developing learning tasks, organized in 5 dimensions. The control group did not receive any training. Knowledge and self-reported adherence were assessed at 3 time points in the intervention group and at 2 time points in the control group. Data analyses were performed using Pearson's chi-square or Fisher's exact for categorical data, and Mann-Whitney and Repeated Measures analysis of variance for quantitative data., Results: A higher level of knowledge was identified in the postintervention for the dimensions of risk assessment, hand hygiene, and mask use and cough etiquette (all P values P < .05). The self-reported adherence increased in intervention (P = .008) and control groups (P = .005). The differences decreased after 6 months., Conclusions: The educational intervention increased the knowledge and self-reported adherence to standard and transmission-based precautions., (Copyright © 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

This study aimed to compare the antimicrobial action of three soaps for hand hygiene (HH): 2.0% Tea Tree Oil (TTO); 0.5% triclosan; 2.0% chlorhexidine, and to explore the perception of healthcare professionals about TTO. Two-step study: a quantitative, to determine the logarithmic reduction of Escherichia coli K12 colony-forming units before and after HH of 15 volunteers and quali-quantitative, through interviews with 23 health professionals. All the three products demonstrated antimicrobial action (a log 10 reduction factor of 4.18 for TTO, 4.31 for triclosan, 3.89 for chlorhexidine, and 3.17 for reference soap). Professionals remarked the pleasant aroma and non-dryness of skin when using soap containing TTO.

Background: Most bloodstream infections related to vascular catheters can be avoided if evidence-based practices are applied during insertion and maintenance. In practice, adherence by health care workers (HCWs) is unsatisfactory and is the main current challenge. The objective of this study is to investigate associations between adherence to infection control practices and performance in psychological tests., Methods: We conducted a prospective observational study in 4 intensive care units involving HCWs. Physicians were observed for adherence to hand hygiene (HH). Nurses were observed during central venous catheter dressing and handling. HCWs were then evaluated psychologically., Results: There were 7,572 observations of 248 HCWs. Adherence to different steps of central venous catheter manipulation ranged widely: from 13% for HH before procedure to 95% regarding the use of gloves. Adherence to HH ranged from 14% before to 99% after dressing. For physicians, HH ranged from 10% before touching patients to 98% after touching body fluids, and adherence was associated with age, self-esteem, and aggression. For nurses, adherence was positively associated with deference, and negatively associated with nurturance., Conclusions: Psychosocial variables affect the quality of care that HCWs provide. The next step would be to define what type of psychological interventions could be effective., (Copyright © 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Competing Interests: The authors declare they have no conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Objective: Healthcare-associated infections (HAI) are a serious patient safety problem. There are effective preventive practices, but little information on adherence in Brazilian hospitals. This study aims at assessing adherence to good HAI prevention practices., Methods: A cross-sectional observational study was conducted at 3 different types of hospitals (public-federal, public-state and private) in Rio Grande do Norte state, Brazil. A total of 19 structure and process indicators were measured based on 7 National Quality Forum Patient Safety Practices., Results: Overall adherence was low, but higher in the private hospital, followed by the public-federal and public-state institutions. There was adequate maintenance of central venous catheters and high vaccine coverage against the influenza virus among health professionals. However, hand hygiene adherence was low, and surgical antibiotic prophylaxis and prevention of multidrug-resistant bacteria transmission, urinary tract infection by urinary catheter and associated with mechanical ventilation were inadequate., Conclusions: Despite the availability of evidence-based recommendations, there is ample room for improvement in adherence to safe practices in the hospitals under study, contributing to the heightened risk of unnecessary harm to patients., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Minimal structure is required for effective prevention of health care-associated infection (HAI). The objective of this study was to evaluate the structure for prevention of HAI in a sample of Brazilian hospitals., Methods: This was a cross-sectional study from hospitals in 5 Brazilian regions (n = 153; total beds: 13,983) classified according to the number of beds; 11 university hospitals were used as reference for comparison. Trained nurses carried out the evaluation by using structured forms previously validated. The evaluation of conformity index (CI) included elements of structure of the Health Care-Associated Prevention and Control Committee (HAIPCC), hand hygiene, sterilization, and laboratory of microbiology., Results: The median CI for the HAIPCC varied from 0.55-0.94 among hospital categories. Hospitals with >200 beds had the worst ratio of beds to sinks (3.9; P < .001). Regarding alcoholic product for handrubbing, the worst ratio of beds to dispensers was found in hospitals with <50 beds (6.4) compared with reference hospitals (3.3; P < .001). The CI for sterilization services showed huge variation ranging from 0.0-1.00. Reference hospitals were more likely to have their own laboratory of microbiology than other hospitals., Conclusion: This study highlights the need for public health strategies aiming to improve the structure for HAI prevention in Brazilian hospitals., (Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Antimicrobial soaps containing chlorhexidine gluconate (CHG) are indicated for hand hygiene (HH) in specific situations. This study aimed to identify whether the continuous use of CHG for HH affects the reduction of healthcare-associated infections (HAI), the selection of microorganisms resistant to CHG, or hands skin damage. Systematic review was performed using the protocol of the Joanna Briggs Institute, including clinical trials and observational comparative studies. Search was conducted via PubMed, Medline, CINAHL, LILACS, Embase, Cochrane Library, Scopus, Web of Science, ProQuest, Google Scholar, and gray literature. To evaluate outcomes, 3 independent reviews were conducted: HAI rates, presence of resistance genes or higher minimum inhibitory or bactericidal concentration, and damage to skin integrity. Studies showed no significant difference in HAI rates when using CHG for HH. Among 13 studies, 10 suggested an association with use of and tolerance to CHG. The use of CHG was associated with skin reaction events. Strong evidence regarding the risks and benefits of CHG for HH is still lacking. Due to potential risk of selecting mutants carrying genes for cross-resistance to CHG and antibiotics, it is advisable to reserve the use of CHG for purposes other than HH. [ABSTRACT FROM AUTHOR]