Oral hygiene prior to cardiac surgery to prevent infections: Randomized clinical trial

CONTEXT

It is not clear if an oral hygiene protocol to control biofilm applied before cardiac surgery can reduce infection rates.

OBJECTIVE

We aim to verify the effectiveness of an oral hygiene protocol in reducing postoperative infections when compared to usual practices, in patients admitted to a cardiology unit, prior to cardiac surgery.

DESIGN, SETTING AND PARTICIPANTS

Randomized, blind, controlled clinical trial, with 107 participants who expected to undergo cardiac surgery, randomized into two groups: Experimental Group (EG) standardized oral hygiene protocol (54) and Control Group (CG), usual practices performed in patients admitted (53).

INTERVENTION

a standardized oral hygiene protocol, 1 day before surgery: professional prophylaxis with a portable ultrasound device, tooth brushing and flossing plus a 0.12% chlorhexidine gluconate solution (0.12% CHX) mouth rinsing. When applicable, removable prostheses cleaning.

PRIMARY OUTCOME

the presence of infection.

RESULTS

The occurrence of postoperative infection was higher in CG = 7 (13.2%) than in EG = 5 (9.3%); but no statistical difference was found between protocols (p = 0.518). The length of stayed from surgery to discharge presented a statistical difference (p = 0.047; RR = 4.9; CI = 1.01-24.33); the percentage of postoperative infection was almost five times higher in those participants who stayed 11 or more days.

CONCLUSION

The standardized oral hygiene protocol with mechanical and chemical cleaning, 1 day before cardiac surgery, was not more effective than the usual practices performed regarding the reduction of postoperative infections. Other interventions regarding oral hygiene procedures before cardiac surgery must be studied to contribute to the reduction of adverse post-surgical events.

CLINICAL TRIAL REGISTRATION

Site Ensaclinicos.gov.br number U1111-1214-2862.

DESCRIPTORS

Healthcare Associated Infections, Cardiovascular Diseases, Periodontal Diseases, Dental Biofilm, Cardiovascular Surgery.

Management Actions for Prevention and Control of Healthcare-associated Infections: A Grounded Theory approach

AIM

To understand the management actions for prevention and control of healthcare-associated infections performed by health professionals.

BACKGROUND

Prevention of nosocomial infections has evidence-based practice at its essence, but not all institutions are successful in implementing prevention methodology.

METHODS

Qualitative research with Grounded Theory methodological framework. The research was carried out in two southern Brazilian hospitals. Data collected was employed through open interviews with twenty-one health professionals and managers. This process occurred concurrently with the data analysis, through constant comparative analysis.

RESULTS

The understanding of the co-responsibility of managerial actions emerged as a central phenomenon of the theoretical model. Management actions for the prevention and control of healthcare-associated infections are a collective phenomenon, in which co-responsibility sustains the effectiveness of the offered assistance. The behaviors of health teams in the face of structural and human weaknesses influence the construction of a supportive relationship in the effectiveness of patient safety actions.

CONCLUSIONS

The sharing of responsibilities between professionals, and the actions of prevention and control of healthcare-associated infections arising from this conduct, positively influence the promotion of safer and improved quality care.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers should consider applying the tools to prevent and control HAIs and generate in-depth discussion to promote institution's cultural changes.

Empatía en el proceso de cuidado en enfermería bajo la óptica de la teoría del reconocimiento: síntesis reflexiva

  Introducción: La integración humanística-científica entre conocimiento científico y prácticas en salud tienen por objeto promover el cuidado dentro de la perspectiva constructiva del proceso de ayuda mutua y de confianza enfocada en la efectividad del cuidado. La esencia del cuidado en Enfermería se fundamenta en las relaciones de confianza y el vínculo entre enfermero y persona cuidada, dentro de esta lógica surge la empatía como el lazo que une las relaciones recíprocas de cuidado. Materiales y Métodos: Se trata de un estudio reflexivo cuyo objetivo era discutir sobre el cuidado realizado por profesionales de enfermería a través de la empatía a la luz de la Teoría del Reconocimiento. Resultados: El cruce de los datos se hizo a través de un eje filosófico central y dos categorías caracterizadoras: empatía en la contemporaneidad y la enfermería como ciencia del cuidado, buscando captar la esencia del reconocimiento en este proceso dialógico y recíproco. Discusión: En la literatura, la empatía, comprendida en el proceso de cuidado en enfermería, aparece como una construcción procesal y relacional entre el profesional y la persona, buscando establecer interdependencias con confianza mutua y recíproca. El reconocimiento del otro a través de la empatía es necesario para construir una relación de afecto y estima, con miras a tener relaciones de confianza y reciprocidad. Conclusiones: La empatía se construye en el cuidado de enfermería a través de la valorización íntima e individual de los involucrados, por medio del respeto, dignidad, civismo, compasión y superación de las diferencias. Como citar este articulo: Zuchetto M, Engel F, Medeiros L, Hammerschmidt K, Schoeller S. Empatia no processo de cuidado em enfermagem sob a ótica da teoria do reonhecimento: síntese reflexiva. Rev Cuid. 2019; 10(3): e624. http://dx.doi.org/10.15649/cuidarte.v10i3.624