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[PMID]:29278907
[Au] Autor:Chojecka A; Tarka P; Kierzkowska A; Nitsch-Osuch A; Kanecki K
[Ad] Endereço:National Institute of Public Health ­ National Institute of Hygiene, Department of Bacteriology, Warsaw, Poland
[Ti] Título:Neutralization efficiency of alcohol based products used for rapid hand disinfection
[So] Source:Rocz Panstw Zakl Hig;68(4):389-394, 2017.
[Is] ISSN:0035-7715
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:Background: Alcohols are the most commonly used active substances in preparations for quick hand disinfection. They should be bactericidal in very short contact time. PN-EN 13727 + A2: 2015-12 standard, for testing hygienic and surgical handrub disinfection preparations, provides mandatory test conditions of disinfectants in contact times with the range of 30 s to 60 s (hygienic handrub disinfection) and 60 s to 5 min (surgical handrub disinfection). A short contact times for hand hygiene products require a short time of neutralization process. For contact times less than or equal to 10 minutes, the estimated neutralization time is 10 s ± 1 s. Neutralization is a process that abolishes the action of disinfectants. Correct application of this process allows for proper use of disinfectants in practice and its biocidal effect. Objectives. Verification of the effectiveness of 10-second neutralization time of alcohol based preparations for hygienic handrub disinfection Materials and Method: Neutralization of two products with different ethanol content (89% and 70%) for hygienic handrub disinfection according to PN-EN 13727 + A2: 2015-12 was investigated. The effectiveness of the neutralizer was assessed by determining toxicity of neutralizer, activity of residual effects of the tested products and their derivatives produced during neutralization (10 s) for test organisms (Staphylococcus aureus ATCC 6538; Pseudomonas aeruginosa ATCC 15442; Enterococcus hirae ATCC 10541; Escherichia coli K12 NCTC 10538) Results: The 10-second neutralization time was sufficient to eliminate the residual activity of products for hygienic handrub disinfection with differentiated ethanol concentration. The neutralizer used did not show toxicity to bacteria and did not produce toxic products with tested preparations after neutralization Conclusions: Conclusions. The use of 10-second neutralization time allows in a precise way designate the contact times for hygienic handrub disinfection products
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Bactérias/efeitos dos fármacos
Etanol/farmacologia
Desinfecção das Mãos
Higiene das Mãos/métodos
Higienizadores de Mão/farmacologia
[Mh] Termos MeSH secundário: Bactérias/crescimento & desenvolvimento
Contagem de Colônia Microbiana
Desinfecção/métodos
Seres Humanos
Testes de Neutralização/métodos
Polônia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Hand Sanitizers); 3K9958V90M (Ethanol)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE


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[PMID]:29280808
[Au] Autor:Rosenberg K
[Ti] Título:Improved Patient Hand Hygiene Reduces C. Difficile Infections in Hospitals.
[So] Source:Am J Nurs;118(1):56, 2018 01.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Clostridium difficile
Higiene das Mãos
[Mh] Termos MeSH secundário: Infecções por Clostridium
Infecção Hospitalar
Fidelidade a Diretrizes
Desinfecção das Mãos
Hospitais
Seres Humanos
Controle de Infecções
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000529717.00967.ff


  3 / 770 MEDLINE  
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[PMID]:29240382
[Au] Autor:Raymond L; Regional Wounds Victoria (RWV) collaborative
[Ti] Título:IMPORTANCE OF PREVENTATIVE HAND HYGIENE PRACTICES IN COMMUNITY NURSING. WOUND MANAGEMENT.
[So] Source:Aust Nurs Midwifery J;24(2):32, 2016 08.
[Is] ISSN:2202-7114
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Hand hygiene, when undertaken correctly, is the most effective preventative measure in reducing the spread of microorganisms that cause healthcare associated infections (WHO, 2009; NICE, 2012).
[Mh] Termos MeSH primário: Enfermagem em Saúde Comunitária
Higiene das Mãos/normas
Ferimentos e Lesões/enfermagem
[Mh] Termos MeSH secundário: Seres Humanos
Organização Mundial da Saúde
[Pt] Tipo de publicação:RESEARCH SUPPORT, NON-U.S. GOV'T; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


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[PMID]:29215224
[Au] Autor:Gregory A
[Ti] Título:Magnified Bacteria Powerful Motivator for Hand Hygiene Compliance.
[So] Source:ED Manag;28(8):94-5, 2016 Aug.
[Is] ISSN:1044-9167
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Infection prevention specialists at Henry Ford Hospital in Detroit have found that showing healthcare workers magnified pictures of bacteria found ontheir hands and in their surrounding units can be a powerful motivator for improved hand hygiene compliance. When tested in four units during a one-month period, the intervention boosted hand hygiene compliance by an average of 24%. Investigators note that to be successful, the intervention must be paired with an effective compliance monitoring program. For the study, investigators visited each unit twice per week, during which they would swab various items as well as employees' hands using and adenosine triphosphate (ATP) meter, a hand-held device that measures living organisms. During each unit visit, infection prevention specialists would show unit personnel pictures from a compilation of 12 magnified images of bacteria that had been lifted from the unit. This was to demonstrate what the bacteria would look like under a microscope. The unsavory pictures produced immediate increases in had hygiene compliance, and prompted healthcare workers to see who could produce the best ATP meter readings on subsequent infection prevention specialist visits.
[Mh] Termos MeSH primário: Bactérias/isolamento & purificação
Infecção Hospitalar/prevenção & controle
Higiene das Mãos
Mãos/microbiologia
Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle
Motivação
Recursos Humanos em Hospital
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Fidelidade a Diretrizes
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Michigan
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE


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[PMID]:28456322
[Au] Autor:Boyce JM
[Ad] Endereço:J.M. Boyce Consulting, LLC, Middletown, CT. Electronic address: jmboyce69@gmail.com.
[Ti] Título:Electronic monitoring in combination with direct observation as a means to significantly improve hand hygiene compliance.
[So] Source:Am J Infect Control;45(5):528-535, 2017 May 01.
[Is] ISSN:1527-3296
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Monitoring hand hygiene compliance among health care personnel (HCP) is an essential element of hand hygiene promotion programs. Observation by trained auditors is considered the gold standard method for establishing hand hygiene compliance rates. Advantages of observational surveys include the unique ability to establish compliance with all of the World Health Organization "My 5 Moments for Hand Hygiene" initiative Moments and to provide just-in-time coaching. Disadvantages include the resources required for observational surveys, insufficient sample sizes, and nonstandardized methods of conducting observations. Electronic and camera-based systems can monitor hand hygiene performance on all work shifts without a Hawthorne effect and provide significantly more data regarding hand hygiene performance. Disadvantages include the cost of installation, variable accuracy in estimating compliance rates, issues related to acceptance by HCP, insufficient data regarding their cost-effectiveness and influence on health care-related infection rates, and the ability of most systems to monitor only surrogates for Moments 1, 4, and 5. Increasing evidence suggests that monitoring only Moments 1, 4, and 5 provides reasonable estimates of compliance with all 5 Moments. With continued improvement of electronic monitoring systems, combining electronic monitoring with observational methods may provide the best information as part of a multimodal strategy to improve and sustain hand hygiene compliance rates among HCP.
[Mh] Termos MeSH primário: Terapia Comportamental/métodos
Desinfecção/métodos
Desinfecção/utilização
Fidelidade a Diretrizes
Higiene das Mãos/métodos
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


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[PMID]:27776819
[Au] Autor:Kwok YLA; Juergens CP; McLaws ML
[Ad] Endereço:School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Sydney, NSW, Australia.
[Ti] Título:Automated hand hygiene auditing with and without an intervention.
[So] Source:Am J Infect Control;44(12):1475-1480, 2016 Dec 01.
[Is] ISSN:1527-3296
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Daily feedback from continuous automated auditing with a peer reminder intervention was used to improve compliance. Compliance rates from covert and overt automated auditing phases with and without intervention were compared with human mandatory audits. METHODS: An automated system was installed to covertly detect hand hygiene events with each depression of the alcohol-based handrub dispenser for 5 months. The overt phase included key clinicians trained to share daily rates with clinicians, set compliance goals, and nudge each other to comply for 6 months. During a further 6 months, the intervention continued without being refreshed. Hand Hygiene Australia (HHA) human audits were performed quarterly during the intervention in accordance with the World Health Organization guidelines. Percentage point (PP) differences between compliance rates were used to determine change. RESULTS: HHA rates for June 2014 were 85% and 87% on the medical and surgical wards, respectively. These rates were 55 PPs and 38 PPs higher than covert automation rates for June 2014 on the medical and surgical ward at 30% and 49%, respectively. During the intervention phase, average compliance did not change on the medical ward from their covert rate, whereas the surgical ward improved compared with the covert phase by 11 PPs to 60%. On average, compliance during the intervention without being refreshed did not change on the medical ward, whereas the average rate on the surgical ward declined by 9 PPs. CONCLUSIONS: Automation provided a unique opportunity to respond to daily rates, but compliance will return to preintervention levels once active intervention ceases or human auditors leave the ward, unless clinicians are committed to change.
[Mh] Termos MeSH primário: Automação
Fidelidade a Diretrizes/utilização
Higiene das Mãos/métodos
Pesquisa sobre Serviços de Saúde/métodos
Auditoria Administrativa/métodos
[Mh] Termos MeSH secundário: Austrália
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


  7 / 770 MEDLINE  
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[PMID]:28462740
[Au] Autor:Jadraque PP; Carter KC
[Ad] Endereço:Department of Epidemiology,Hospital General de La Palma,Breña Alta, Canarias 38710,Spain.
[Ti] Título:What happened at Vienna's Allgemeines Krankenhaus after Semmelweis's contract as Assistant in the First Maternity Division was terminated?
[So] Source:Epidemiol Infect;145(10):2144-2151, 2017 07.
[Is] ISSN:1469-4409
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Ignác Fülöp Semmelweis is famous for dramatically reducing puerperal mortality while he was an Assistant in Vienna's largest hospital, the Allgemeines Krankenhaus; he did this, mainly, by requiring medical personnel to disinfect their hands by washing in a chlorine solution. But Semmelweis was soon removed from his post as assistant. The conventional view, which is suggested by Semmelweis's own account, is that his contemporaries were skeptical of his results, that he was marginalized and that once he was no longer directly responsible for caring for maternity patients, puerperal mortality returned to its former high levels. In fact, the situation appears to have been quite different. In this paper, we calculate and discuss the number of deaths at the Allgemeines maternity clinic after Semmelweis was removed from his position. As we will see, his successors maintained a relatively low mortality rate roughly consistent with the rate Semmelweis himself achieved. This suggests that the chlorine washings were probably still used conscientiously after he left and that the opposition he encountered had other sources than doubts about the effectiveness of the chlorine washings.
[Mh] Termos MeSH primário: Cloro/uso terapêutico
Higiene das Mãos/história
Maternidades/história
[Mh] Termos MeSH secundário: Áustria
Cloro/história
História do Século XIX
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE
[Ps] Nome de pessoa como assunto:Semmelweis IF
[Nm] Nome de substância:
4R7X1O2820 (Chlorine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171125
[Lr] Data última revisão:
171125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1017/S0950268817000875


  8 / 770 MEDLINE  
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[PMID]:28857850
[Au] Autor:Lydon S; Power M; McSharry J; Byrne M; Madden C; Squires JE; O'Connor P
[Ad] Endereço:1Department of General Practice, School of Medicine, National University of Ireland Galway, Galway, Ireland. 2Beaumont Hospital, Dublin, Ireland. 3Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland. 4School of Nursing, University of Ottawa, Ottawa, ON, Canada. 5The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
[Ti] Título:Interventions to Improve Hand Hygiene Compliance in the ICU: A Systematic Review.
[So] Source:Crit Care Med;45(11):e1165-e1172, 2017 Nov.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described. DATA SOURCES: Systematic searches were conducted in November 2016 using five electronic databases: Medline, CINAHL, PsycInfo, Embase, and Web of Science. Additionally, the reference lists of included studies and existing review papers were screened. STUDY SELECTION: English language, peer-reviewed studies that evaluated an intervention to improve hand hygiene in an adult ICU setting, and reported hand hygiene compliance rates collected via observation, were included. DATA EXTRACTION: Data were extracted on the setting, participant characteristics, experimental design, hand hygiene measurement, intervention characteristics, and outcomes. Interventional components were categorized using the Behavior Change Wheel. Methodological quality was examined using the Downs and Black Checklist. DATA SYNTHESIS: Thirty-eight studies were included. The methodological quality of studies was poor, with studies scoring a mean of 8.6 of 24 (SD= 2.7). Over 90% of studies implemented a bundled intervention. The most frequently employed interventional strategies were education (78.9%), enablement (71.1%), training (68.4%), environmental restructuring (65.8%), and persuasion (65.8%). Intervention outcomes were variable, with a mean relative percentage change of 94.7% (SD= 195.7; range, 4.3-1155.4%) from pre to post intervention. CONCLUSIONS: This review demonstrates that best practice for improving hand hygiene in ICUs remains unestablished. Future research employing rigorous experimental designs, careful statistical analysis, and clearly described interventions is important.
[Mh] Termos MeSH primário: Higiene das Mãos/estatística & dados numéricos
Pessoal de Saúde/educação
Unidades de Terapia Intensiva/estatística & dados numéricos
[Mh] Termos MeSH secundário: Planejamento Ambiental
Seres Humanos
Capacitação em Serviço
Motivação
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002691


  9 / 770 MEDLINE  
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[PMID]:28774285
[Au] Autor:Lofgren ET
[Ad] Endereço:Paul G. Allen School for Global Animal Health, Washington State University, 240 SE Ott Road, Room 311, Pullman, WA, 99164-7090, USA. Eric.Lofgren@wsu.edu.
[Ti] Título:Estimating the impact post randomization changes in staff behavior in infection prevention trials: a mathematical modeling approach.
[So] Source:BMC Infect Dis;17(1):539, 2017 Aug 03.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Randomized controlled trials (RCTs) of behavior-based interventions are particularly vulnerable to post-randomization changes between study arms. We assess the impact of such a change in a large, multicenter study of universal contact precautions to prevent infection transmission in intensive care units. METHODS: We construct a stochastic mathematical model of methicillin-resistant Staphylococcus aureus (MRSA) acquisition in a simulated 18-bed intensive care unit (ICU). Using parameters from a recent study of contact precautions that reported a post-randomization change in contact rates, with fewer visits observed in the treatment arm, we explore the impact of several possible interpretations of this change on MRSA acquisition rates. RESULTS: Scenarios where contact precautions resulted in less patient visitation resulted in a mean decrease in MRSA acquisition rate of 37%, accounting for much of the effect reported in the trial. CONCLUSIONS: Behavior changes that impact the contact rate have the potential to drastically alter the results of RCTs in infection control settings. Careful monitoring for these changes, and an assessment of which changes will likely have the greatest impact on the study before the study begins are both recommended.
[Mh] Termos MeSH primário: Modelos Teóricos
Infecções Estafilocócicas/prevenção & controle
[Mh] Termos MeSH secundário: Infecção Hospitalar/prevenção & controle
Higiene das Mãos
Seres Humanos
Controle de Infecções/métodos
Unidades de Terapia Intensiva
Staphylococcus aureus Resistente à Meticilina/patogenicidade
Distribuição Aleatória
Ensaios Clínicos Controlados Aleatórios como Assunto
Infecções Estafilocócicas/transmissão
Precauções Universais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170805
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2632-1


  10 / 770 MEDLINE  
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[PMID]:28767690
[Au] Autor:Su KC; Kou YR; Lin FC; Wu CH; Feng JY; Huang SF; Shiung TF; Chung KC; Tung YH; Yang KY; Chang SC
[Ad] Endereço:Department of Chest Medicine, Taipei Veterans General Hospital, Taipei City, Taiwan, ROC.
[Ti] Título:A simplified prevention bundle with dual hand hygiene audit reduces early-onset ventilator-associated pneumonia in cardiovascular surgery units: An interrupted time-series analysis.
[So] Source:PLoS One;12(8):e0182252, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To investigate the effect of a simplified prevention bundle with alcohol-based, dual hand hygiene (HH) audit on the incidence of early-onset ventilation-associated pneumonia (VAP). METHODS: This 3-year, quasi-experimental study with interrupted time-series analysis was conducted in two cardiovascular surgery intensive care units in a medical center. Unaware external HH audit (eHH) performed by non-unit-based observers was a routine task before and after bundle implementation. Based on the realistic ICU settings, we implemented a 3-component bundle, which included: a compulsory education program, a knowing internal HH audit (iHH) performed by unit-based observers, and a standardized oral care (OC) protocol with 0.1% chlorhexidine gluconate. The study periods comprised 4 phases: 12-month pre-implementation phase 1 (eHH+/education-/iHH-/OC-), 3-month run-in phase 2 (eHH+/education+/iHH+/OC+), 15-month implementation phase 3 (eHH+/education+/iHH+/OC+), and 6-month post-implementation phase 4 (eHH+/education-/iHH+/OC-). RESULTS: A total of 2553 ventilator-days were observed. VAP incidences (events/1000 ventilator days) in phase 1-4 were 39.1, 40.5, 15.9, and 20.4, respectively. VAP was significantly reduced by 59% in phase 3 (vs. phase 1, incidence rate ratio [IRR] 0.41, P = 0.002), but rebounded in phase 4. Moreover, VAP incidence was inversely correlated to compliance of OC (r2 = 0.531, P = 0.001) and eHH (r2 = 0.878, P < 0.001), but not applied for iHH, despite iHH compliance was higher than eHH compliance during phase 2 to 4. Compared to eHH, iHH provided more efficient and faster improvements for standard HH practice. The minimal compliances required for significant VAP reduction were 85% and 75% for OC and eHH (both P < 0.05, IRR 0.28 and 0.42, respectively). CONCLUSIONS: This simplified prevention bundle effectively reduces early-onset VAP incidence. An unaware HH compliance correlates with VAP incidence. A knowing HH audit provides better improvement in HH practice. Accordingly, we suggest dual HH audit and consistent bundle performance does matter in quality-of-care VAP prevention.
[Mh] Termos MeSH primário: Controle de Infecções/métodos
Unidades de Terapia Intensiva/normas
Pneumonia Associada à Ventilação Mecânica/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Higiene das Mãos/métodos
Seres Humanos
Incidência
Análise de Séries Temporais Interrompida
Masculino
Meia-Idade
Pneumonia Associada à Ventilação Mecânica/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182252



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