em Enfermagem. Professora Adjunta da FEN/UFG. 3 Enfermeira. Mestre em Enfermagem. Professora Assistente da FEN/ UFG. RESUMO:Trata-se de um artigo de atualização tendo como objetivo destacar aspectos conceituais sobre a infecção hospitalar de interesse para o cuidado de enfermagem, evidenciando os fundamentos que norteiam a compreensão deste fenômeno de indiscutível importância epidemiológica para a assistência à saúde. O tema é trabalhado no sentido de evidenciar a responsabilidade em controlar a infecção como sendo papel inerente aos profissionais da equipe de saúde. Destaca-se a formação profissional voltada para uma cultura prevencionista como condição necessária para se concretizar um programa de controle e prevenção de infecção, descrevendo-se uma experiência local sobre a importância das atividades desenvolvidas pelo núcleo de pesquisa na área, como instrumento que interfere, positivamente, nos resultados das ações dos enfermeiros. Evidencia-se o importante papel do enfermeiro no desenvolvimento das ações de prevenção e controle de infecção e a educação continuada como estratégia de implementação de medidas eficazes na busca da qualidade do cuidado.ABSTRACT: Nursing practices and procedures play an indispensable role in the prevention of hospital infection. This review discusses the unquestionable importance of proper nursing practices related to the control of infection. The establishment of a culture based on prevention is a requirement for any infection control program. This paper also explains activities conducted by our research group that identified procedures that affirm the role of nursing practices in the prevention and control of infection. It is clear that continuing education represents the main strategy to implement effective measures for providing quality health care. RESUMEN:Las prácticas de la enfermería y los procedimientos juegan un papel indispensable en la prevención de infección del hospital. Este artículo tiene como objetivo destacar los aspectos conceptuales respecto a la infección hospitalaria de grande interés para el cuidado de la enfermería, así como, la importancia epidemiológica para la salud. Resalta la formación profesional volcada para una cultura basado en la prevención como requisito para cualquier programa de control de la infección. Explica las actividades dirigidas por el grupo de investigación en esta área, también identificó procedimientos que afirman el papel de la enfermera en las prácticas de la prevención y el control de la infección. La inplementación de la educación continuada representa la principal estrategia para desarrollar las medidas eficaces en la búsqueda de un cuidado con calidad a la clientela.Endereço: Milca Severino Pereira Rua 1024 Q-64, n° 366 Apto 1701 Residencial Frei Galvão.

This study aimed to analyze the management of waste generated by home care. Data were collected through observation of care provided by professionals and users and/or caregivers. Data were recorded on a checklist developed according to the recommendations of RDC 306. The following wastes were generated: syringes (38.1%), needles (36.5%), adhesive plasters (31.7%), gauze (31.7%) and lancets (28.5%). The residues of group A were not segregated in all opportunities and group E were segregated 100% and 10.5% by professionals and users, respectively. It is concluded that, given the inadequacies found, wide collective discussion is required for the proposal of public policies that address the specific waste management of home health services, aiming to provide safety to workers, community and the environment.

Significance and Impact of the Study: Contamination of healthcare facilities surfaces has been shown to play a major role in transmission of pathogens. The findings of this study show that dry surface biofilms are widespread and can incorporate pathogens and multidrug-resistant organisms (MROs). Biofilms on highly touched surfaces pose a risk to patients, as dry surface biofilms persist for long period and microorganisms within biofilm have been shown to be transmitted. This study also provides a better understanding of microbial populations in hospital environments, reinforcing that pathogens and MROs are found incorporated into biofilm, which impacts the difficulty in cleaning/disinfection. AbstractThe aim of this study was to determine the epidemiology (location, microbial load, microbiome, presence/absence of biofilm and pathogens, including ESKAPE-Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species, and antimicrobial susceptibility profiles) of the bacterial contamination on intensive care units (ICUs) surfaces. Fifty-seven high-touched surfaces were collected from adult, paediatric and neonatal ICUs from two large public Brazilian hospitals from central and north regions. Samples (c. 4 cm 2 ) were subjected to culture (qualitative), qPCR targeting 16s rRNA gene (microbial load-bacteria per cm 2 ), 16s rRNA amplicon sequencing (microbiome analysis) and scanning electron (SEM) or confocal laser scanning microscopy (CLSM) (biofilm presence). Multidrug resistant organisms (MROs) were detected using specific chromogenic agar. The average bacterial load was 1Á32 9 10 4 bacteria per cm 2 , container for newborn feeding bottles, stretcher mattress, humidicrib mattress filling and computer keyboards presented the higher bioburden. However, only 45Á6% (26/57) were culture-positive, including 4/26 with MROs. ESKAPE organisms were detected in 51Á8% of the samples subjected to next-generation sequencing. Viability staining and CLSM demonstrated live bacteria on 76Á7% of culture-negative samples. Biofilm was present on all surfaces subjected to microscopy (n = 56), demonstrating that current cleaning practices are suboptimal and reinforcing that MROs are incorporated into hospital surfaces biofilm.

Objective: to analyze waste management in urgency and emergency non-hospital health care service units. Method: Epidemiological cross-sectional study undertaken at three NonHospital Emergency Units. The data were collected using systematic observation, registered daily in a spreadsheet and checklist, and analyzed through descriptive statistics. Results: the generation of waste varied from 0.087 to 0.138 kg per patient per day. Waste management showed inadequacies in all stages, especially in the separation stage. Infectious waste was found together with common waste, preventing recycling, and piercing and cutting objects were mixed with waste from different groups, increasing the risk of occupational accidents. Conclusion: the study reveals the lack of an institutional waste management policy, as demonstrated by the failure of operational stages, involving problems related to management, physical structure, material and human resources at the units. This is relevant for health care units, considering the quality of patient care and its interface with sustainability. Manejo de residuos en las unidades no hospitalarias de urgencia y emergenciaObjetivo: analizar la gestión de los residuos en unidades hospitalarias de emergencias y urgencias. Método: estudio epidemiológico. Los datos fueron recolectados por observación sistemática, registrados diariamente en una hoja de cálculo y check list y analizados mediante estadística descriptiva. Resultados: la generación de residuos varió desde 0,087 hasta 0,138 kg / usuario / día. La gestión de los residuos mostró deficiencias en todas las etapas, especialmente en la segregación. Fueron encontrados residuos infecciosos añadidos a los comunes, invalidando el reciclaje, así como materiales punzantes y cortantes mezclados con los diferentes grupos, amentando el riesgo de accidentes de trabajo. Conclusión: el estudio revela la ausencia de una política institucional para la gestión de los residuos, como lo demuestran las fallas en las medidas operacionales, que implican problemas de gestión, estructura física, recursos materiales y humanos de las unidades. Muestra relevancia para los servicios de salud en lo que se refiere a la calidad del servicio para el usuario y su interfaz con la sostenibilidad.

A qualitative study conducted in a teaching hospital with 15 nursing professionals. Attempted to analyze the reasons, attitudes and beliefs of nursing staff regarding adherence to personal protective equipment. Data were collected through focus groups, analyzed by the method of interpretation of meanings, considering Rosenstock’s model of health beliefs as a reference framework. Data revealed two themes: Occupational safety and Interpersonal Relationship. We identified several barriers that interfere in matters of safety and personal protective equipment, such as communication, work overload, physical structure, accessibility of protective equipment and organizational and management aspects. Adherence to personal protective equipment is determined by the context experienced in the workplace, as well as by individual values and beliefs, but the decision to use the personal protective equipment is individual.

doi: 10.5216/ree.v12i3.10555O serviço de atendimento pré-hospitalar (APH) desempenha importante papel na saúde pública, uma vez que as doenças cardiovasculares e os eventos relacionados às causas externas como situações emergenciais são observadas cada vez mais na população em geral. A reunião de informações históricas permite ao leitor se inteirar rapidamente de como ocorreu a criação e estruturação dos serviços de atendimento pré-hospitalar. Os objetivos foram descrever os aspectos históricos da estruturação do serviço de atendimento pré-hospitalar e sua implantação e evolução no estado de Goiás. Trata-se de uma atualização que procura resgatar dados históricos relacionados ao APH em Goiás. Observa-se que, no Brasil, a formação das equipes de profissionais e a forma da abordagem no atendimento às vítimas foram baseadas nos modelos americano e francês de APH. São políticas públicas de saúde ligadas à atenção às urgências ainda novas e caminham para o aprimoramento. Como profissionais da área da saúde e/ou do APH, somos co-responsáveis pelo alcance do objetivo primordial que é a excelência no atendimento. Descritores: Busca e resgate; Serviços médicos de emergência; Assistência pré-hospitalar.

A large number of users are serviced in primary health care units in Brazil, both in health facilities and in households. These services generate waste that must be managed safely, but there is no legislation that regulates this type of waste management in Brazil. The objective of this study was to analyse the production and management of waste in primary health care. A direct observation was performed of the stages in the handling and weighing of waste generated in primary health care units in the municipality of Goiânia (Brazil). The units generated infectious, chemical, and common waste, as well as sharp objects. The generation of waste ranged between 0.027 and 0.075 kg user-day. The generated waste was classified mostly as common and recyclable. Flaws were observed in the management of all types of waste. The critical point is segregation. Only 34.1% of the waste disposed of as infectious actually belonged to this group, the rest was ordinary waste. Flaws at this stage increase the volume of infectious waste, the occupational and environmental risks, and associated costs. Intervention to change this reality is needed and it requires the careful preparation of a waste management plan, corroborating structural changes to the implementation of this plan, and professional training and public policies to guide waste management in primary care, especially those generated in households.

This qualitative research aims at identifying the perception of health care workers of different categories from a specialized institution in emergency health service in the city of Goiânia regarding the context involving biohazard accidents. Firstly, 382 workers were given a questionnaire in order to identify those who had experienced an accident, 39 of which also took part in an interview addressing the general aspects of the accidents. Among the main accident causes to be highlighted are: unattention, non-adherence to preventive measures, patient's severity and hurry. Among the experienced feelings the main ones are: inconfidence, fear of contamination, rage, and even calmness. Half reported no consequence resulted from the accident. Data points to the need of self-worth concerning the worker's health and also of programs aiming at occupational safety enhancement.