Biossegurança em DST/AIDS: condicionantes da adesão do trabalhador de enfermagem às precauções

Effects of educational intervention on adherence to the technical recommendations for tracheobronchial aspiration in patients admitted to an intensive care unit

OBJECTIVE

To evaluate the effectiveness of an educational intervention on healthcare professionals' adherence to the technical recommendations for tracheobronchial aspiration in intensive care unit patients.

METHODS

A quasi-experimental study was performed to evaluate intensive care unit professionals' adherence to the tracheobronchial aspiration technical recommendations in intensive care unit patients both before and after a theoretical and practical educational intervention. Comparisons were performed using the chi-square test, and the significance level was set to p<0.05.

RESULTS

A total of 124 procedures, pre- and post-intervention, were observed. Increased adherence was observed in the following actions: the use of personal protective equipment (p=0.01); precaution when opening the catheter package (p<0.001); the use of a sterile glove on the dominant hand to remove the catheter (p=0.003); the contact of the sterile glove with the catheter only (p<0.001); the execution of circular movements during the catheter removal (p<0.001); wrapping the catheter in the sterile glove at the end of the procedure (p=0.003); the use of distilled water, opened at the start of the procedure, to wash the connection latex (p=0.002); the disposal of the leftover distilled water at the end of the procedure (p<0.001); and the performance of the aspiration technique procedures (p<0.001).

CONCLUSION

There was a low adherence by health professionals to the preventive measures against hospital infection, indicating the need to implement educational strategies. The educational intervention used was shown to be effective in increasing adherence to the technical recommendations for tracheobronchial aspiration.

[Care and specialized clinical follow-up of nursing professionals who have been victims of accidents with biological material]

This cross-sectional study aimed to evaluate the conduct of nursing professionals who had been victims of accidents with biological material in a teaching hospital in the interior of the state of São Paulo, Brazil, regarding their care and specialized clinical follow-up. The study population consisted of 1,215 nursing professionals, who were interviewed individually between 2010 and 2011. Of the 1,215 nursing professionals interviewed, 636 (52.3%) reported having experienced accidents with biological material; of this population, 182 (28.6%) didn't sought specialized care. The most frequent reason reported for not seeking care was believing that it was a low-risk accident. The reasons professionals do not seek care and do not complete treatment and the clinical follow-up can contribute to strategies to increase professionals' adherence to prophylaxis measures after occupational exposure to biological material.

Analysis of accidents with organic material in health workers

This retrospective and descriptive study with a quantitative design aimed to evaluate occupational accidents with exposure to biological material, as well as the profile of workers, based on reporting forms sent to the Regional Reference Center of Occupational Health in Florianópolis/SC. Data collection was carried out through a survey of 118 reporting forms in 2007. Data were analyzed electronically. The occurrence of accidents was predominantly among nursing technicians, women and the mean age was 34.5 years. 73% of accidents involved percutaneous exposure, 78% had blood and fluid with blood, 44.91% resulted from invasive procedures. It was concluded that strategies to prevent the occurrence of accidents with biological material should include joint activities between workers and service management and should be directed at improving work conditions and organization.

[Biosecurity and clinical care nursing: contributions for the promotion of worker's health]

Qualitative study that aimed at investigating concepts and practices of nursing technicians on biosecurity and its interface with biological hazards, with 20 workers developed a clinical care unit of a hospital in the interior of Rio Grande do Sul. Data were collected through interviews and systematic observation. Thematic analysis was the methodology used for data processing. The negligence of its employees on the use of individual protection equipment and work overload are risk factors for accidents with biological material. Suggested that partnerships between the actors involved in caring for the construction of healthy environments and accountability for negligence on biosecurity.

A estruturação do Programa de Capacitação Profissional de Biossegurança no contexto do Projeto de Modernização da Gestão Científica do Instituto Oswaldo Cruz

O presente artigo apresenta as etapas de estruturação do Programa de Capacitação Profissional de Biossegurança (PCPB), em consonância com o Projeto de Modernização da Gestão Científica do Instituto Oswaldo Cruz (IOC), detalhando o ciclo planejamento-desenvolvimento-avaliação, em especial do Curso de Biossegurança em Laboratório de Pesquisa Biomédica. Inicialmente, para o ciclo diagnóstico foram aplicados questionários aos interlocutores dos laboratórios do IOC, os quais revelaram interesse de participação no PCPB para ambas as categorias profissionais (níveis médio e superior), indicando como temáticas preferenciais biossegurança e boas práticas de laboratório. Na fase de planejamento foi definido que o PCPB seria subdivido em dois projetos (Boas Práticas de Laboratório de Saúde Pública para os profissionais de nível médio e Curso de Biossegurança para Laboratórios de Pesquisa Biomédica para profissionais de nível superior). A seguir, na fase de estruturação do curso, os módulos contemplados incluíram: introdutório; riscos químico, físico e biológico; gestão da qualidade e experimentação animal. Assim, no período 2006-2008, foram capacitados 315 profissionais e realizadas avaliações segundo o modelo de David Kirkpatrick. O primeiro nível, chamado de reação, foi aferido e demonstrou que 54,03% dos profissionais declararam que o curso foi excelente; 39,59% classificaram como bom e os demais 6,38% acharam que foi regular ou não opinaram. Para a avaliação do aprendizado foram realizados, a cada módulo, pré e pós-testes. Foi verificado que todos os módulos tiveram acréscimos nas médias do pós-teste em relação ao pré-teste. Os resultados obtidos apontaram estratégias a serem seguidas no aperfeiçoamento desse modelo de educação continuada em biossegurança.

[HIV and the nursing professional in the face of needlestick accidents]

The goal of this study was to identify the scientific production about work-related needlestick accidents among nursing professionals involving HIV-contaminated biological material, as well as to characterize the pre-existing factors to such accidents, such as procedures occurring after the exposure to potentially HIV-contaminated needlestick material. This is a literature review, whose bibliographic search for keywords was carried out within the LILACS databases from the year 2000 onward. This study confirms that pre-existing factors for the occurrence of work-related needlestick accidents are related to work conditions as much as to individual conditions. In face of these accidents, the nursing workers need to know the conducts concerning post-exposure to potentially HIV-contaminated needlestick material. We conclude that the adoption of standardized precautions when working in healthcare is a fundamental condition for worker safety, independently of their area of expertise, given the increasing number of HIV cases.

Enfermeiros com cargos de chefia e medidas preventivas à exposição ocupacional: facilidades e barreiras

Este estudo descritivo teve como objetivo avaliar as facilidades e barreiras enfrentadas por enfermeiros com cargo de chefia quanto às medidas preventivas à exposição ocupacional envolvendo material biológico, tendo como base o Modelo de Crenças em Saúde de Rosenstock. O estudo foi realizado com 87 enfermeiros de um hospital-escola do interior paulista em 2006. Os dados foram coletados através de um roteiro semi-estruturado, com questões abertas e fechadas e analisados pela técnica de Análise de Conteúdo. O equipamento de proteção individual foi citado como a maior facilidade para a prevenção de acidentes, porém a falta de adesão ao uso e o uso incorreto foram referidos como barreiras para a prevenção de acidentes e como os principais motivos para a ocorrência destes. É importante que estes enfermeiros estejam preparados para desenvolver estratégias individualizadas e motivadoras para adesão ao uso do equipamento de proteção individual em seus setores de trabalho.

[The teaching of biosafety in undergraduate nursing: a literature review]

It's a study that made a scientific production survey in nursing regarding to biosafety teaching aiming to investigate its context and discover the content of publishing on biosafety teaching in the nursing undergraduation. It was analyzed the journal articles found consulting LILACS, SciELO, MEDLINE, BDENF, DEDALUS and PERIENF databases, identifying 26 articles. The results found provided the creation and discussion of these categories: "Ideological and theoretical bases", "Historic approach of biosafety", "Occupational risks and AIDS" and "Biosafety education in graduation". It was concluded that the number of articles is small, mainly the ones focusing on biosafety teaching, but there was an evolution of this content in the last years.

Nurses' understanding of standard precautions at a public hospital in Goiania - GO, Brazil

Standard Precautions (SP) are effective strategies to prevent and control nosocomial infections. This study aimed to verify nurses' understanding about standard precaution measures. Data were collected through interviews, followed by content analysis in accordance with Bardin. Eighty-two nurses took part in this study, 75.6% of whom understand SP as protective measures: for professionals (11.0%); for both professionals and patients (52.4%); for patient care independently of the diagnosis (7.3%); for patients with diagnosed infection (9.8%). Other nurses indicated SP as human care (4.9%) and only as Individual Protection Equipment (IPE) (11.0%). Most participants' understanding points to favorable cognitive adaptation to the daily implementation of SP. However, reductionist and even mistaken perceptions about their range persist, which makes the social function of these measures vulnerable.