Bakgrund: Sjuksköterskor vårdar patienter med hepatit B, hepatit C och HIV dagligen. Risken att utsättas för smitta kan skapa oro och rädsla vilket kan påverka sjuksköterskor att ge en god vård på lika villkor. Erfarenhet av att vårda patienter med blodsmitta är därför viktig för professionens utveckling inom ämnet. Syftet: Syftet är att belysa sjuksköterskors erfarenheter av att vårda patienter med blodsmitta. Metod: En litteraturöversikt med kvantitativa samt kvalitativa artiklar har genomförts. Resultat: I resultatet framkom fyra teman. Sjuksköterskans kunskap och okunskap, Resursbrist påverkar omvårdnaden, Risker skapar rädsla och oro samt förhållningssätt och helhetssyn. Konklusion: Sjuksköterskor i utvecklingsländer löper högre risk att utsättas för smitta och har sämre möjligheter att kunna leva upp till professionen eftersom ekonomiska samt materiella resurser saknas. Det krävs kunskap och resurser för att möjliggöra en god vård. / Background: Nurses care for patients with hepatitis B, hepatitis C and HIV daily. The risk of being exposed to infection can create anxiety and fear, which can influence nurses to provide good care on equal terms. Experience in caring for patients with blood contamination is therefore important for the professional development of the subject. Purpose: The purpose is to elucidate nurses' experiences of caring for patients with blood contamination. Method: A literature review with quantitative and qualitative articles was carried out. Result: Four themes emerged in the result. Nurse's knowledge and ignorance, Lack of resources affects nursing, Risks create fear and worry as well as approach and holistic view. Conclusion: Nurses in developing countries are at higher risk of being exposed to infection and have less opportunity to live up to the profession because financial and material resources are lacking. Knowledge and resources are required to enable good care.

Submitted by Ana Lúcia Torres (bfmhuap@gmail.com) on 2017-09-29T15:37:00Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) DISSERTAÇAO LUCIANO MEIRELES.pdf: 1043230 bytes, checksum: 20c7f97cfba9488935ee9dcde38c164c (MD5) / Approved for entry into archive by Ana Lúcia Torres (bfmhuap@gmail.com) on 2017-09-29T15:37:08Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) DISSERTAÇAO LUCIANO MEIRELES.pdf: 1043230 bytes, checksum: 20c7f97cfba9488935ee9dcde38c164c (MD5) / Made available in DSpace on 2017-09-29T15:37:08Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) DISSERTAÇAO LUCIANO MEIRELES.pdf: 1043230 bytes, checksum: 20c7f97cfba9488935ee9dcde38c164c (MD5) Previous issue date: 2013 / Instituto Nacional do Câncer / As infecções de corrente sanguínea (ICS) são complicações frequentes em pacientes com câncer. O objetivo deste estudo foi descrever as características epidemiológicas, clínicas e microbiológicas das ICS em pacientes com câncer ginecológico. Método: uma série de 311 episódios de ICS com comprovação microbiológica (ICS-CM) detectadas em 288 pacientes com câncer ginecológico assistidas no Hospital do Câncer II de janeiro/2002 a dezembro/2009. Para análise das variáveis categóricas, foram utilizados o teste do qui-quadrado ou o teste exato de Fisher e, para as variáveis contínuas, os testes t de Student, Mann-Whitney ou de regressão linear com cálculo do coeficiente de correlação (R2). P-valores ≤ 0,05 foram considerados estatisticamente significativos. Resultados: 205 (66%) episódios foram hospitalares; 85 (27%) comunitários, 13 (4%) relacionados à assistência à saúde e 8 (2,57%) corresponderam a neutropenia febril. As ICS secundárias foram mais frequentes (148; 47,58%) do que as primárias (141; 45,34%); dentre as secundárias, grande parte deveu-se a infecções urinárias (79; 53,4%). Dentre os 336 microrganismos isolados, os mais frequentes foram Escherichia coli (70; 20,83%), Staphylococcus aureus (66; 19,64%), staphylococcus coagulase negativo (SCN; 37; 11,01%), Klebsiella pneumoniae (33; 9,82%) e Pseudomonas aeruginosa (26; 7,74%). A prevalência global de microrganismos multirresistentes (MMR) foi 17,56% (59 MMR em 336 amostras): 11 (3,27%) amostras de S. aureus resistentes à oxacilina (MRSA), 14 (4,2%) amostras de gramnegativos entéricos resistentes às cefalosporinas de 3ª/4ª geração, 29 (8,63%) amostras de gramnegativos não fermentadores (GNNF) resistentes às cefalosporinas de 3ª/4ª geração, 5 (1,5%) amostras de GNNF resistentes aos carbapenemas. Em 224 (72%) episódios, o escore de Pitt foi ≥2. A mortalidade bruta foi 39,86% (114) com 57,89% (66) dos óbitos relacionados às ICS. Conclusão: as ICS são eventos associados a elevada mortalidade. Estes dados sugerem que as infecções urinárias, de evolução geralmente benigna na população geral, devem ser nas pacientes com câncer ginecológico, objeto de uma abordagem preventiva, diagnóstica e terapêutica mais cuidadosa. Estudos futuros, que avaliem os fatores determinantes para o óbito serão fundamentais para um melhor entendimento do prognóstico dessas pacientes / Bloodstream infections (BSI) are frequent complications in patients with cancer. The goal of this study was to describe the epidemiological, clinical and microbiological characteristics of these infections in patients with gynecological cancer. Method: a case-series of 311 episodes of laboratory-confirmed BSI detected in 288 patients with gynecological cancer assisted at Hospital do Cancer II from January 2002 to December 2009. Chi-squared test or Fisher's exact test were used for analysis of categorical variables and Student's t test, Mann-Whitney or linear regression with correlation coefficients (R2) were used with continuous variables. P-values ≤0.05 were considered statistically significant. Results: 205 (66%) BSI episodes were hospital-acquired; 85 (27%) community acquired; 13 (4%) healthcare-associated and 8 (2.57%) related to febrile neutropenia episodes. Secondary BSI episodes were more frequent (148; 47.58%) than primary cases (141; 45.34%); among the secondary BSI, many resulted from urinary tract infections (79; 53.4%). The most frequent agents among 336 microorganisms detected were Escherichia coli (70, 20.83%), Staphylococcus aureus (66, 19.64%), coagulase-negative Staphylococcus (CoNS; 37, 11.01%), Klebsiella pneumoniae (33, 9.82%) and Pseudomonas aeruginosa (26, 7.74%). The overall prevalence of multidrug resistant (MDR) agents were 17.56% (59 MDR in 336 isolates): 11 (3.27%) methicillin resistant S. aureus (MRSA) isolates, 14 (4.2%) enteric gram-negative isolates resistant to 3rd/4th generation cephalosporins, 29 (8.63%) non-fermentative gramnegative isolates resistant to 3rd/4th generation cephalosporins, 5 (1.5%) non-fermentative gramnegative isolates resistant to carbapenems. In 224 (72%) episodes had Pitt score ≥2. The crude mortality rate was 39.86% (114) with 57.89% (66) deaths were related to BSI. Conclusion: BSI are severe events associated with high mortality. These data suggest that urinary tract infection, mostly a nonthreatening illness in the general population, must have a special preventive, diagnostic and therapeutic approach in patients with gynecological cancer. Further studies assessing the factors predisposing to death will be necessary to a better understand of the prognosis in this population.

Sjuksköterskor har flera arbetsuppgifter som innebär en möjlig kontakt med patienters blod och risk för en blodsmitta. Enligt föreskrifter från Arbetsstyrelsen ska handskar användas av vårdpersonal för att förebygga smitta. Trots dessa föreskrifter varierar användningen av handskar bland sjuksköterskor. Syftet med denna studie var att undersöka sjuksköterskors attityder till att använda handskar i vården där risk för blodsmitta kan förekomma. En empirisk studie med kvalitativ ansats genomfördes. Datainsamlingen skedde med hjälp av sju enskilda intervjuer med legitimerade sjuksköterskor. Analysmetod som användes var inspirerad av innehållsanalys. Genom analys identifierades fyra kategorier: Intryck av bakomliggande omständigheter, Intryck av medvetenhet, Intryck av förförståelse samt Intryck av trygghet. Kategorierna bildade tillsammans huvudkategorin Influenser till attityder. Resultatet visade att sjuksköterskors attityder till att använda handskar är något som utvecklas med tiden och påverkas av åtskilliga faktorer. / Nurses’ have several worktasks that put them in contact with patient’s blood and a possible risk of infection. According to guidelines from the Occupation committee, health care personnel should use gloves to prevent spreading infection. Despite the guidelines, nurses’ use of gloves varies. The aim of this study was to investigate nurses’ attitudes to using gloves where there is a risk of blood infection. An empirical study with a qualitative approach was conducted; collection of data was done by interviews with seven registered nurses. The method for analyzing was inspired by content analysis. Through analyzing, four categories where identified: Impression of causes from before, Impressions of awareness, Impressions of judgments and Impressions of safety. These categories all formed one main category: Influences for attitudes. The results showed that nurse’s attitudes to using gloves are something that develop over time and are influenced by many factors.