OBJECTIVE: to assess the efficiency of cleaning/disinfection of surfaces of an Intensive Care Unit.METHOD: descriptive-exploratory study with quantitative approach conducted over the course of four weeks. Visual inspection, bioluminescence adenosine triphosphate and microbiological indicators were used to indicate cleanliness/disinfection. Five surfaces (bed rails, bedside tables, infusion pumps, nurses' counter, and medical prescription table) were assessed before and after the use of rubbing alcohol at 70% (w/v), totaling 160 samples for each method. Non-parametric tests were used considering statistically significant differences at p<0.05.RESULTS: after the cleaning/disinfection process, 87.5, 79.4 and 87.5% of the surfaces were considered clean using the visual inspection, bioluminescence adenosine triphosphate and microbiological analyses, respectively. A statistically significant decrease was observed in the disapproval rates after the cleaning process considering the three assessment methods; the visual inspection was the least reliable.CONCLUSION: the cleaning/disinfection method was efficient in reducing microbial load and organic matter of surfaces, however, these findings require further study to clarify aspects related to the efficiency of friction, its frequency, and whether or not there is association with other inputs to achieve improved results of the cleaning/disinfection process.

Os objetivos deste estudo foram caracterizar a produção científica nacional da utilização tópica de ácidos graxos no tratamento de feridas e descrever os efeitos da sua ação nesse processo. Trata-se de uma revisão integrativa da literatura indexada nas bases de dados LILACS e BEDEnf. A coleta de dados ocorreu no mês de dezembro de 2010, com descritores de assuntos controlados e sem delimitação de período de busca. A amostra constitui-se de 09 artigos, sendo, a maioria conduzida em modelos animais e utilizando diferentes composições de ácidos graxos. Diante da escassez de estudos clínicos randomizados controlados em humanos e as limitações desta revisão, não se pôde generalizar, na prática clínica, que os ácidos graxos essenciais influenciam o processo de cicatrização positivamente ou possuem ação antimicrobiana. Assim, há necessidade de realização de pesquisas com maior rigor metodológico comparando as diferentes fórmulas disponíveis contendo ácidos graxos e sua influência no processo cicatricial.

Laboratory analysis of organisms in water include arduous methods, such as the multiple tube and membrane filter. The ATP bioluminescence system, proposes a new way of measuring cellular material in water by measuring adenosine triphosphate (ATP) levels, which are expressed in relative light units (RLU). The ATP bioluminescence assay has been increasingly used to assess the microbiological safety of the hospital environment. However, there are few studies investigating the use of this methodology to evaluate the microbiological quality of water. The objective of the present study was to verify whether ATP, as measured by the 3 M™ Clean-Trace Water™ ATP test, can be used as an alternative tool for presumptive testing for the presence of microorganisms in hospital water. Water samples (N = 88) were collected from faucets (74) and water purifiers (14) in a university hospital. The sample were filtered by the membrane filter technique (100 mL for bacterial analysis and 100 mL for fungal analysis) and then submitted to ATP bioluminescence assay to the determine quantity of RLU in each sample. In order to compare RLU and the presence of microorganisms, a receiver operating characteristic (ROC) curve was used to calculate sensitivity and specificity (levels higher than 90% were considered significant). In addition, control tests were conducted to compare RLU to the quantities of bacterial and fungal organisms added to distilled water (ANOVA and Tukey’s tests; p ≤ 0.05). This inoculum was compared to RLU emission, and the data were analyzed by calculating the Pearson’s correlation coefficient, with a 95% confidence interval. In the present study, 94.3% of the water samples presented bacterial growth. Of these, 15.6% showed heterotrophic bacteria above recommended levels and fungal contamination was detected in 55.6% of samples. Sensitivity and specificity of the samples were not significant (< 90%), and the correlation between ATP and the presence of these microorganisms in the samples (hospital water) was not significant, whereas, in distilled water, the results revealed a significant difference (p < 0.0001). These results demonstrated that the ATP test cannot be used as an alternative tool for presumptive assessment of the presence of microorganisms in water.

Background: Failures in the processes of cleaning and disinfecting health service surfaces may result in the spread and transfer of pathogens that are often associated with healthcare-related infections and outbreaks. Aims: To assess the effectiveness of environmental surface cleaning and disinfection in a hospital clinic. Method: The study was conducted in a nursing ward with 45 beds. A total of 80 samples from five high-touch surfaces were evaluated before and after cleaning and disinfection, using the following methods: visual inspection, adenosine triphosphate bioluminescence assay, aerobic colony count, Staphylococcus aureus colony count, and evaluation of resistance to methicillin. The data analysis used nonparametric comparative and correlative tests to observe any differences in the pre- and post- cleaning and disinfection results for the surfaces assessed. Results: Effective cleaning and disinfection had a significant effect on only two surfaces when measured for the presence of adenosine triphosphate, the inner bathroom door handle (p=0.007) and the toilet bowl (p=0.01). When evaluated for Staphylococcus aureus colony count, the toilet flush handle also demonstrated a significant effect (p=0.04). Conclusion: The effectiveness of cleaning and disinfection of the surfaces tested was not satisfactory. An educational intervention is recommended for the cleaning and disinfection staff and the nursing team at the healthcare facility. Relevance to Clinical Practice: The data in the study revealed that daily hospital cleaning and disinfection in the sampled sites are not sufficient in medical and surgical wards. Hospital cleanliness must be reevaluated from the point of view of materials, such as an adequate supply of clean cloths, in addition to establishing more precise cleanliness protocols and accurate monitoring systems.

Objective: To evaluate nurses' knowledge about the definitions of Sepsis-3 and updates to the Surviving Sepsis Campaign. Methods: This descriptive study was carried out from July to August 2018, with 30 nurses from four wards of a large university hospital. For data collection, we created, structured, and validated a questionnaire composed of socio-demographic/occupational data and knowledge test. Results: Only 16.6% of the professionals received in-service training on the subject. There was no implementation of sepsis protocols in the institution, although 96.6% of the participants considered their implementation necessary. Professionals aged ≥35 years old had a higher level of knowledge about the new definition of sepsis (p=0.042). The knowledge about volume resuscitation (p=0.001) and use of vasopressors (p=0.025) was greater in those with ≥10.5 years of experience in the profession. Nurses from the clinical units presented a higher level of knowledge about the organic dysfunctions caused by sepsis (p=0.025). Conclusion and implications for the practice: Nurses do not have satisfactory knowledge for the proper identification, treatment, and clinical management of sepsis. There is a need for greater professional, institutional, and political incentives to implement a permanent education and the sepsis protocol.

Objective: to assess the correlation among the ATP-bioluminescence assay, visual inspection and microbiological culture in monitoring the efficiency of cleaning and disinfection (C&D) of high-touch clinical surfaces (HTCS) in a walk-in emergency care unit. Method: a prospective and comparative study was carried out from March to June 2015, in which five HTCS were sampled before and after C&D by means of the three methods. The HTCS were considered dirty when dust, waste, humidity and stains were detected in visual inspection; when ≥2.5 colony forming units per cm2 were found in culture; when ≥5 relative light units per cm2 were found at the ATP-bioluminescence assay. Results: 720 analyses were performed, 240 per method. The overall rates of clean surfaces per visual inspection, culture and ATP-bioluminescence assay were 8.3%, 20.8% and 44.2% before C&D, and 92.5%, 50% and 84.2% after C&D, respectively (p<0.001). There were only occasional statistically significant relationships between methods. Conclusion: the methods did not present a good correlation, neither quantitative nor qualitatively.