RESUMO
BACKGROUND: COVID-19 is caused by the SARS-CoV-2 virus, an emerging respiratory pathogen. The work environment represents a high-risk factor for health professionals. Given the scarcity of protective personal equipment due to global demand, decontamination and reuse studies should be carried out. Thus, the aim of this study was to evaluate the safety of a method of decontamination of N95/PFF2 respirators, especially regarding structural integrity. METHODS: N95/PFF2 respirators were subjected to hydrogen peroxide decontamination and analyzed using scanning electron microscopy and thermogravimetric analysis. Seven respirators of the same brand and lot were used, one being a control and the other six subjected to decontamination process. As for the sealing, a qualitative test was applied, in order to identify the changes in the structure that could damage the sealing of respirators. RESULTS: Indicated that the fiber morphology in all layers was not affected by the six decontamination cycles. Also, the thermal stability in the different layers was very similar. Fit testing showed that the respiradors submitted to all cycles of decontamination were approved. CONCLUSIONS: Thus, it is possible to conclude that the hydrogen peroxide decontamination method is effective, since it does not alter the physical properties of the respirators.
Assuntos
COVID-19 , Descontaminação , Reutilização de Equipamento , Humanos , SARS-CoV-2 , Ventiladores MecânicosRESUMO
BACKGROUND: Hand hygiene is considered the single most effective means of reducing healthcare-associated infections, but improving and sustaining hand hygiene compliance remains a great challenge. OBJECTIVES: To compare hand hygiene compliance before and after interventions to promote adherence in a paediatric intensive care unit (PICU) and to identify predictors of intention to perform the behaviour "hand hygiene during patient care in the PICU". METHODS: A before and after study was conducted in three phases. Based on the World Health Organization guideline for hand hygiene compliance monitoring, 1261 hand hygiene opportunities were directly observed during routine patient care by two observers simultaneously, in a nine-bed PICU in Brazil, before and after infrastructure and educational interventions. To identify predictors of healthcare professionals' intention to perform the behaviour hand hygiene during patient care, a data collection instrument was designed based on the Theory of Planned Behaviour. Statistical analyses were undertaken using Chi-square test or the Fisher's exact test and regression analysis. A significance level of 5% (p < 0.05) was applied to all analyses. RESULTS: The hand hygiene compliance rate increased significantly from 27.3% in the "pre-intervention phase" to 33.1% in "phase 1-post-intervention," to 37.0% in "phase 2-post-intervention" (p = .010). Perceived social pressure (p = .026) was a determinant factor of intention to perform the behaviour. CONCLUSIONS: Hand hygiene compliance raised significantly after infrastructure, educational, and performance feedback interventions. However, despite the significant effect of the implemented interventions, the overall hand hygiene compliance rate was low. Perceived social pressure characterised a determinant factor of intention to perform the behaviour "hand hygiene during patient care in the PICU", reinforcing the need for behaviour determinants analysis when designing promotional interventions.
Assuntos
Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes , Higiene das Mãos , Pessoal de Saúde , Controle de Infecções/métodos , Unidades de Terapia Intensiva Pediátrica , Adulto , Brasil , Cuidados Críticos , HumanosRESUMO
OBJECTIVES: To assess the practical application of the Pediatric Surgical Safety Checklist on the preoperative period and to verify family satisfaction regarding the use of the material. METHOD: Exploratory study that aimed to analyze the use of the checklist by children who underwent surgical interventions. The sample was constituted by 60 children (from preschoolers to teens) and 60 family members. The variables related to demographic characterization, filling out the checklist, and family satisfaction, being evaluated through inferential and descriptive statistical analysis. RESULTS: Most children (71.7%) were male, with a median age of 7.5 years. We identified the achievement of 65.3% of the checklist items, 30.0% were not filled due to non-performance of the team and 4.7% for children and family reasons. In the association analysis, we found that the removal of accessories item (p = 0.008) was the most checked by older children. Regarding satisfaction, the family members evaluated the material as great (63.3%) and good (36.7%) and believed that there was a reduction of the child's anxiety (83.3%). CONCLUSION: The use of the checklist in clinical practice can change health services regarding safety culture and promote customer satisfaction.
Assuntos
Lista de Checagem , Segurança do Paciente , Pediatria , Procedimentos Cirúrgicos Operatórios , Adolescente , Ansiedade/enfermagem , Criança , Pré-Escolar , Família , Feminino , Humanos , Masculino , Procedimentos Cirúrgicos Operatórios/psicologiaRESUMO
Objectives: to assess the practical application of the Pediatric Surgical Safety Checklist on the preoperative period and to verify family satisfaction regarding the use of the material. Method: exploratory study that aimed to analyze the use of the checklist by children who underwent surgical interventions. The sample was constituted by 60 children (from preschoolers to teens) and 60 family members. The variables related to demographic characterization, filling out the checklist, and family satisfaction, being evaluated through inferential and descriptive statistical analysis. Results: most children (71.7%) were male, with a median age of 7.5 years. We identified the achievement of 65.3% of the checklist items, 30.0% were not filled due to non-performance of the team and 4.7% for children and family reasons. In the association analysis, we found that the removal of accessories item (p = 0.008) was the most checked by older children. Regarding satisfaction, the family members evaluated the material as great (63.3%) and good (36.7%) and believed that there was a reduction of the child's anxiety (83.3%). Conclusion: the use of the checklist in clinical practice can change health services regarding safety culture and promote customer satisfaction.
Objetivos: avaliar a aplicação na prática do Checklist Pediátrico para Cirurgia Segura no período pré-operatório e verificar a satisfação da família quanto ao uso do material. Método: estudo exploratório, no qual se visou analisar o uso dochecklist por crianças que seriam submetidas a intervenções cirúrgicas, sendo a amostra constituída por 60 crianças pré-escolares a adolescentes e 60 familiares. As variáveis relacionaram-se à caracterização demográfica, preenchimento do checklist e satisfação dos familiares, sendo avaliadas por meio da análise estatística descritiva e inferencial. Resultados: a maioria (71,7%) das crianças era do sexo masculino, com mediana de idade de 7,5 anos. Identificou-se consecução do checklist em 65,3% dos itens, 30,0% não foram preenchidos devido à não execução da equipe e 4,7% por motivos das crianças e familiares. Na análise de associação, verificou-se que o item da retirada de adornos (p=0,008) foi mais checado por crianças com maior média de idade. Quanto à satisfação, os familiares avaliaram o material como ótimo (63,3%) e bom (36,7%) e acreditaram que houve redução de ansiedade na criança (83,3%). Conclusão: o uso do checklist na prática clínica pode colaborar para mudanças nos serviços de saúde com relação à cultura de segurança e promover satisfação dos clientes.
Objetivos : evaluar la aplicación en la práctica del ChecklistPediátrico para la Cirugía Segura en el periodo preoperatorio y verificar la satisfacción de la familia con respecto al uso del material. Método : estudio exploratorio, cuyo objetivo fue analizar el uso delchecklist por niños que serían sometidos a intervenciones quirúrgicas, siendo la muestra compuesta por 60 niños en edad preescolar a adolescentes y 60 familiares. Las variables se relacionaron con la caracterización demográfica, llenado del checklist y satisfacción de los familiares, siendo evaluadas por medio del análisis estadístico descriptivo e inferencial. Resultados : la mayoría (71,7%) de los niños eran varones, con una edad media de 7,5 años. Se identificó el cumplimiento del checklist en el 65,3% de los ítems, el 30,0% no ha sido rellenado debido a la falta de ejecución por parte del equipo y el 4,7% por causa de los niños y familiares. En el análisis de asociación, se constató que el ítem de retirada de joyas (p =0,008) fue el más marcado por los niños con una edad media más alta. En cuanto a la satisfacción, los familiares evaluaron el material como óptimo (63,3%) y bueno (36,7%) y acreditaron que hubo una reducción de la ansiedad en los niños (83,3%). Conclusión : el uso del checklist en la práctica clínica puede contribuir a cambios en los servicios de salud con respecto a la cultura de seguridad y promover la satisfacción de los clientes.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Pediatria , Procedimentos Cirúrgicos Operatórios , Lista de Checagem , Segurança do Paciente , Ansiedade/enfermagem , Procedimentos Cirúrgicos Operatórios/psicologia , FamíliaRESUMO
Vancomycin (VCM) is indicated in combat against Gram-positive infections, but it is not considered a first-choice drug because of its adverse effects. It is believed that oxidative stress is the primary mechanism of endothelial injury and the consequent VCM toxicity, which varies from phlebitis to nephrotoxicity. Moreover, dose recommendations, dilution, rates and types of infusion are still controversial. The aim of this study was to determine the effect of different VCM dilutions in endothelial, liver and kidney injuries by biochemical parameters and histopathological analysis. Wistar rats were randomly divided into six groups and subjected to femoral vein cannulation for drug administration. Control groups received 0.9 ml of saline and the others received VCM (10mg/Kg/day) at dilutions of 5.0 and 10.0 mg/mL for 3 and 7 days. Homocysteine, hs-CRP, AST, ALT, GGT, urea, creatinine, lycopene, alpha-tocopherol, beta-carotene and retinol were analyzed. Kidney, liver and cannulated femoral vein fragments were collected.This study showed alterations in ALT which featured hepatotoxicity. However, drug dilutions were not able to show changes in other biochemical parameters. In contrast, kidney and endothelium pathological changes were observed. More studies are needed to characterize VCM induced kidney and endothelium toxicity and biochemical markers able to show such morphological modifications.
Assuntos
Antibacterianos/toxicidade , Veia Femoral/efeitos dos fármacos , Rim/efeitos dos fármacos , Rim/patologia , Fígado/efeitos dos fármacos , Vancomicina/toxicidade , Animais , Relação Dose-Resposta a Droga , Veia Femoral/metabolismo , Veia Femoral/patologia , Rim/metabolismo , Fígado/metabolismo , Fígado/patologia , Masculino , Distribuição Aleatória , Ratos WistarRESUMO
AIMS: The aims were to compare characteristics of children with peripheral intravenous catheters who developed infiltration and those who did not and to identify risk factors for developing this complication. METHOD: A retrospective cohort study carried out at a university hospital, with 338 children with peripheral intravenous catheters. Variables related to the children and therapies were investigated. RESULTS: Researchers identified infiltration in 54 children (16%). Characteristics statistically different in those who developed infiltration were the following: intravenous therapy for more than 5 days, presence of predisposing factors to peripheral venipuncture failure, history of previous infiltration, catheter readjustment to vein insertion, use of infusion pump, intermittent administrations, and shorter dwell time. CONCLUSION: Only intravenous therapy variables showed a significant relation with the occurrence of infiltration and represented risk factors for its occurrence.
Assuntos
Cateterismo Periférico/efeitos adversos , Extravasamento de Materiais Terapêuticos e Diagnósticos/epidemiologia , Infusões Intravenosas/efeitos adversos , Adolescente , Braço , Brasil/epidemiologia , Cateterismo Periférico/enfermagem , Criança , Criança Hospitalizada , Pré-Escolar , Estudos de Coortes , Extravasamento de Materiais Terapêuticos e Diagnósticos/etiologia , Extravasamento de Materiais Terapêuticos e Diagnósticos/prevenção & controle , Feminino , Mãos , Humanos , Lactente , Recém-Nascido , Infusões Intravenosas/enfermagem , Masculino , Flebite/epidemiologia , Flebite/etiologia , Flebite/prevenção & controle , Estudos Retrospectivos , Fatores de RiscoRESUMO
BACKGROUND: Considering all sources of errors that may occur during healthcare, medication errors are the most common and also the most frequent cause of adverse events. OBJECTIVE: The objective of the study was to describe the medication errors reported in a pediatric intensive care unit for oncologic patients. METHODS: This is a descriptive and exploratory study. The errors were reported by the professionals involved in the medication system in a medication error report form developed for the study. RESULTS: The sample consisted of 110 medication errors reported on 71 forms. The omission error was the most common error type reported (22.7%), followed by administration error (18.2%). No harm to patients was reported in 83.1% of the notifications. CONCLUSION: The analysis of the110 medication errors provides evidence of the context of their occurrence and the need to implement measures that can prevent or intercept these errors. IMPLICATIONS FOR PRACTICE: In an institution without adverse events report and a formal system to patient safety analysis, the implementation of a local nonpunitive approach to medication errors notification represented an important tool to patient safety promotion.
Assuntos
Unidades de Terapia Intensiva Pediátrica , Erros de Medicação/estatística & dados numéricos , Neoplasias/tratamento farmacológico , Sistemas de Notificação de Reações Adversas a Medicamentos , Brasil , Criança , Cálculos da Dosagem de Medicamento , HumanosRESUMO
OBJETIVO: Verificar o potencial hidrogeniônico (pH) de soluções de cloridrato de dobutamina sob condições ambientais que mimetizam unidades de cuidados intensivos neonatais. MÉTODOS: Analisou-se pH do fármaco em solução glicosada 5 por cento ou NaCl 0,9 por cento segundo temperatura (22 e 37 °C), luz (escuro, lâmpadas fluorescentes ambiente e equipamento de fototerapia) e equipos (incolor e âmbar) em intervalos de tempo (0, 1, 24, 48, 72 e 96 horas). RESULTADOS: Evidenciaram-se valores próximos de pH do fármaco na apresentação comercial e diluído. Obteve-se média de pH de 3,45±0,19 a 22 °C e de 3,55±0,20 a 37 °C. A média de pH das soluções mantidas no escuro foi de 3,62±0,09, na luz ambiente, de 3,63±0,07, e sob fototerapia, de 3,31±0,16. Soluções em equipos incolores tiveram média menor (3,41±0,24) do que em âmbares (3,52±0,15). Obtiveram-se menores valores de pH nas soluções sob fototerapia em equipos incolores (3,17±0,03) do que em âmbares (3,55±0,03). CONCLUSÃO: Sob a luz da fototerapia houve maior variação do pH das soluções, e o emprego de equipos âmbares minimizou tal efeito.
OBJECTIVE: To verify the hydrogen-ion potential (pH) of dobutamine hydrochloride solutions under environmental conditions similar to those of neonatal intensive care units. METHODS: We analyzed the pH of the drug diluted in 5 percent dextrose in water or 0.9 percent NaCl under different conditions of temperature (22 and 37 °C) and light (dark, fluorescent light bulbs, and phototherapy equipment), using colorless and amber intravenous sets at time intervals of 0, 1, 24, 48, 72, and 96 hours. RESULTS: The pH values of the marketed form of the drug and the diluted drug were similar. The pH means were 3.45±0.19 at 22 °C and 3.55±0.20 at 37 °C. The average of the pH according to light conditions were as follows: in the dark = 3.62±0.09, under room light = 3.63±0.07, and exposed to phototherapy = 3.31±0.16. Solutions stored in colorless intravenous sets had a lower mean (3.41±0.24) than those kept in amber intravenous sets (3.52±0.15). We found lower pH values in the solutions exposed to phototherapy using colorless intravenous sets (3.17±0.03) than in those using amber intravenous sets (3.55±0.03). CONCLUSION: There was higher variation in the pH of the solutions exposed to phototherapy, and the use of amber intravenous sets reduced such effect.
Assuntos
Dobutamina/química , Meio Ambiente , Estabilidade de Medicamentos , Concentração de Íons de Hidrogênio , Unidades de Terapia Intensiva Neonatal , Laboratórios , Luz , Soluções , TemperaturaRESUMO
OBJECTIVE: To verify the hydrogen-ion potential (pH) of dobutamine hydrochloride solutions under environmental conditions similar to those of neonatal intensive care units. METHODS: We analyzed the pH of the drug diluted in 5% dextrose in water or 0.9% NaCl under different conditions of temperature (22 and 37 degrees C) and light (dark, fluorescent light bulbs, and phototherapy equipment), using colorless and amber intravenous sets at time intervals of 0, 1, 24, 48, 72, and 96 hours. RESULTS: The pH values of the marketed form of the drug and the diluted drug were similar. The pH means were 3.45+/-0.19 at 22 degrees C and 3.55+/-0.20 at 37 degrees C. The average of the pH according to light conditions were as follows: in the dark = 3.62+/-0.09, under room light = 3.63+/-0.07, and exposed to phototherapy = 3.31+/-0.16. Solutions stored in colorless intravenous sets had a lower mean (3.41+/-0.24) than those kept in amber intravenous sets (3.52+/-0.15). We found lower pH values in the solutions exposed to phototherapy using colorless intravenous sets (3.17+/-0.03) than in those using amber intravenous sets (3.55+/-0.03). CONCLUSION: There was higher variation in the pH of the solutions exposed to phototherapy, and the use of amber intravenous sets reduced such effect.