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Avalia??o e melhoria da ades?o ? higieniza??o das m?os em uma UTI neonatal orientada pela estrat?gia multimodalMedeiros, Aur?lia Cristina de 29 September 2016 (has links)
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Previous issue date: 2016-09-29 / Introdu??o: A higieniza??o das m?os ? uma a??o simples, mas que traz um benef?cio imensur?vel aos pacientes e profissionais de sa?de no controle de infec??o hospitalar e seguran?a do paciente.
Objetivo: Melhorar a ades?o dos profissionais ? pr?tica da higieniza??o das m?os, nos cinco momentos da assist?ncia orientados pela Estrat?gia Multimodal da Organiza??o Mundial de Sa?de. Metodologia: O desenho metodol?gico do estudo ? quase experimental do tipo antes e depois, realizado na UTI neonatal de uma Maternidade Escola no Rio Grande do Norte. Para calcular a melhoria entre as avalia??es realizou-se o c?lculo da estimativa pontual com um intervalo de confian?a (95%) do n?vel de cumprimento dos crit?rios das amostras selecionadas, calculado os valores das melhorias absoluta e relativa de cada um dos crit?rios, e para a significa??o estat?stica da melhoria detectada realizada um teste de hip?tese unilateral por meio do c?lculo do valor de Z, considerando como hip?tese nula a aus?ncia de melhoria, n?o considerando quando p ? valor fosse < a 0,05. Resultados: Na 1? avalia??o, (n=44 profissionais), 55% dos profissionais cumpriram crit?rios higiene das m?os, ao entrar na UTI Neo. Realizado mais quatro observa??es, tr?s com (n=179) oportunidades, para 96 a??es desenvolvidas, distribu?das nos meses de Outubro com 53 oportunidades (18% de a??es desenvolvidas), em Novembro 88 oportunidades (58% de a??es desenvolvidas) e em Dezembro 38 oportunidades (24% de a??es desenvolvidas). A quinta observa??o,(n=44 profissionais) 86% cumpriram crit?rio de HM ao entra na UTI Neo. Conclus?o: O estudo mostra que a ades?o ? higiene das m?os, ainda est? muito baixa, quando associada aos cinco momentos da assist?ncia, enquanto que em rela??o ao crit?rio de HM ao entrar na UTI, houve uma melhora significativa. Fazem-se necess?rias a??es de educa??o continuada e planejada. Deve-se trabalhar a cultura da higieniza??o das m?os nos cinco momentos da assist?ncia em busca da qualidade e seguran?a na assist?ncia ? sa?de, reduzindo n?o s? a infec??o hospitalar, mas tamb?m o ?ndice da morbimortalidade. / Introduction: hygiene of the hands is a simple action, but that brings immeasurable beneficial to patients and health professionals in hospital infection control and patient safety. Objective: The present study aims to improve the adhesion of the practice of professional hygiene of the hands, in five moments of the Multimodal Strategy assistance from the World Health Organization. Methodology: the methodology of the study design is almost like before and after trial, held in the NICU a maternity School in Rio Grande do Norte. To calculate the improvement between the evaluations there was the calculation of the point estimate with a confidence interval (95%) of the compliance level with the criteria of the selected samples, calculated the values of the absolute and relative improvements to each of the criteria, and the statistical significance of improving detected held a one-sided hypothesis test by means of calculating the value of Z considering how null hypothesis the lack of improvement, when p-value was the < 0.05. Results: The first evaluation (n = 44), 55% of professionals have met criteria for hand hygiene, on entering the ICU Neo. Held four more observations, three with (n = 179), opportunities for 96 actions developed, distributed in October with 53 opportunities (18% of developed actions) in November 88 chances (58% of actions) and in December 38 opportunities (24% of actions). The fifth observation (n = 44) 86% fulfilled criterion of Hand Hygiene to enter in ICU Neo and 14% did not meet. Conclusion: The study shows that the adherence to hand hygiene, still is too low, when linked to the five times of assistance, while in relation to the criterion of HH when entering in the ICU, there has been a significant improvement. Makes necessary continuing education and planned actions. It should Works with the culture of hygiene of hands in five moments of assistance in the pursuit of quality and safety in health care, reducing not only the hospital infection, but also the index of morbidity and mortality.
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A concep??o de ensino sob medida na obra hygiene mental e educa??o (1927), de Luiz Ant?nio dos Santos LimaSilva, Juliana da Rocha e 05 August 2013 (has links)
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Previous issue date: 2013-08-05 / This dissertation examines the concept of the personalized teaching proposed by the physician and educator from Rio Grande do Norte Luiz Antonio dos Santos Lima, in his doctoral thesis "Mental Hygiene and Education," published in 1927. To do so, we start from the assumption that this thinker appropriated part of the educational theory formulated by ?douard Clapar?de - specifically, in the case of the teaching concepts of the personalized teaching and comprehensive education designed by the Swiss intellectual - and, considering the Brazilian social reality of early twentieth century, reframed these concepts, adapting them to the country context. To implement the proposed idea, the bibliographical study was the option chosen, and so was done through a theoretical research which had as a reference authors whose studies referred to the Brazilian historical moment in the late nineteenth and early twentieth century, our examined time frame. As for the understanding and the methodological analysis of discourse, seen as socially constructed, the Foucault postulations were studied under an analytical approach, in which the disciplinary society is analyzed from the relations of power and knowledge that exist in it. The main source of this research was the work of "Mental Hygiene and Education," published as a requirement to the obtainment of Luiz Antonio s medical degree by the Rio de Janeiro Medicine School. Thus, it was found that the conception of personalized learning to the comprehensive education of students, as proposed in the doctoral thesis of Luiz Antonio dos Santos Lima, was related to abnormalities of mental character that children could present. School education was thought in a way by the potiguar thinker that it could be applied as deep as the moral, intellectual and behavioral deviations of the individual were, making use of hygiene practices of the minds through a normalizing process towards a civilized and developed future of the Brazilian nation which would manage, watch and fix the thoughts of the school students / Esta disserta??o examina a concep??o de ensino sob medida proposta pelo m?dico e educador potiguar Luiz Antonio dos Santos Lima, em sua tese de doutoramento Hygiene Mental e Educa??o , publicada no ano de 1927. Para tanto, partimos da hip?tese de que esse pensador apropriou-se de parte da teoria educacional formulada por ?douard Clapar?de especificamente, dos conceitos de ensino sob medida e educa??o completa pensados pelo su??o e, considerando a realidade social brasileira do in?cio do s?culo XX, ressignificou esses conceitos, adaptando-os ao contexto do pa?s. Para a execu??o do proposto, optou-se pelo estudo bibliogr?fico, no qual foi feito o aporte te?rico da investiga??o, tendo como refer?ncia os autores cujos estudos remetiam ao momento hist?rico brasileiro do final do s?culo XIX e in?cio do s?culo XX, nosso recorte temporal. Quanto ? compreens?o e tratamento metodol?gico do discurso, tido como socialmente constru?do, aderiu-se ao enfoque anal?tico das postula??es foucaultianas, nas quais a sociedade disciplinar ? analisada a partir das rela??es de poder e saber nela existente. A principal fonte de pesquisa foi a obra Hygiene Mental e Educa??o , publicada como requisito da Faculdade de Medicina do Rio de Janeiro para Luiz Antonio obter o diploma de m?dico. Desse modo, constatou-se que a concep??o de ensino sob medida para a educa??o completa dos escolares, proposta na tese de doutoramento de Luiz Antonio dos Santos Lima, estava relacionada ?s anormalidades de car?ter mental que as crian?as pudessem apresentar. O ensino escolar pensado pelo potiguar seria na medida dos desvios morais, intelectuais e comportamentais do indiv?duo e faria uso das pr?ticas de higieniza??o das mentes num processo normalizador que, voltado para o futuro civilizado e desenvolvido da na??o brasileira, controlaria, vigiaria e corrigiria os pensamentos dos escolares
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Fatores de influ?ncia na produ??o de leite bovino sobre os n?veis da contagem bacteriana total / Factors influencing the production of bovine milk on the levels of total bacterial countGuerra, Mirela Gurgel 07 February 2012 (has links)
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Previous issue date: 2012-02-07 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The objective of this study was to evaluate the influence of milking procedures on the levels of total bacterial count (TBC) in bovine milk. In the first study the influences of procedures for hygienic milking, cleaning of milking equipment and
milk cooling tanks on the TBC levels were evaluated. Four bulk samples of milk were collected from each tank in eight properties for TBC analysis, employing the flow cytometry method. A questionnaire was applied in each property to assess the current
situation of milking procedures on each production system that took part on this research, followed by training of employees in good agricultural practices in the production of milk and monitoring of the TBC measurements. The methodology for
analysis of longitudinal data was considered, focusing on random effects models. The results showed that the handling procedures for milking and the cleanliness of the cooling tank contributed to a further reduction in the levels of TBC raw milk cooling
tanks. The second study aimed to describe the percentage of the properties that comply with the Normative Instruction N? 51 (Brazil s IN 51) with regard to total bacterial count (TBC) in bovine milk. The study was conducted from January 2010 to July 2011. Milk samples were collected from the eight properties selected for TBC analysis by the flow cytometry method. Again, on each property a questionnaire was applied to assess
the current situation of milking procedures on each production system that took part on this research, followed by training of employees in good agricultural practices in the production of milk and monitoring of the TBC measurements. The methodology of
marginal models based on Generalized Estimate Equations (GEEs) was followed in the statistical analysis. The results showed that the handling procedures of the milking and the cleanliness of the cooling tanks contributed to a considerable percentage of the
properties that reached the limits of TBC established by IN 51 / Objetivou-se com este trabalho avaliar a influ?ncia dos procedimentos de ordenha sobre os n?veis da Contagem Bacteriana Total (CBT) no leite bovino. No primeiro estudo foram avaliados as influ?ncias dos procedimentos de ordenha higi?nica
e de limpeza dos equipamentos de ordenha e dos tanques de resfriamento do leite sobre os n?veis da CBT. Para tanto, foram coletadas quatro amostras de leite de cada tanque
de oito propriedades, para an?lise da CBT, pela metodologia de citometria de fluxo. Em cada propriedade aplicou-se um question?rio para avalia??o da atual situa??o dos
procedimentos de ordenha em cada sistema de produ??o participante da pesquisa, seguida da capacita??o e treinamento dos colaboradores em boas pr?ticas agropecu?rias
na produ??o de leite e uma fase de acompanhamento das medidas da CBT. Considerouse a metodologia para an?lise de dados longitudinais, com enfoque nos modelos de efeitos aleat?rios. Observou-se que os procedimentos adequados no manejo na ordenha e na limpeza do tanque de resfriamento contribu?ram para uma maior redu??o nos n?veis da CBT do leite cru de tanques de resfriamento. No segundo estudo, objetivou-se
descrever a propor??o de propriedades que atendem ? Instru??o Normativa n? 51 (IN 51) em rela??o ? Contagem Bacteriana Total (CBT) em leite bovino. O estudo foi realizado no per?odo de janeiro de 2010 a julho de 2011. Foram coletadas amostras de
leite de oito propriedades selecionadas, para an?lise da CBT pelo m?todo de citometria de fluxo. Em cada propriedade aplicou-se um question?rio para avalia??o da atual situa??o dos procedimentos de ordenha em cada sistema de produ??o participante da pesquisa, seguido da capacita??o e treinamento dos colaboradores em boas pr?ticas agropecu?rias na produ??o de leite e uma fase de acompanhamento das medidas da
CBT. Para an?lise estat?stica considerou-se a metodologia para modelos marginais baseada nas Equa??es de Estima??es Generalizadas (EEGs). Constatou-se que os procedimentos adequados no manejo da ordenha e na limpeza do tanque de resfriamento contribu?ram para que uma parcela consider?vel das propriedades atingisse os limites da CBT estabelecidos pela IN 51
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