There is an increase in HIV/AIDS and other blood borne diseases. Health care workers are often exposed to blood and body fluids and thus prone to blood borne infections. Preventative measures can be taken to prevent health workers from contracting these diseases. However, health care workers need to stringently apply these measures. Universal precautions against blood borne infections include diligent hygiene practices, such as hand washing and drying, appropriate handling and disposal of sharp objects, prevention of needle stick or sharp injuries, appropriate handling of patient care equipment and soiled linen, environmental cleaning and spills management, appropriate handling of waste as well as protective clothing such as gloves, gowns, aprons, masks and protective eyewear. This study is aimed at investigating compliance with universal precautions in operating theatres in Northern KwaZulu–Natal as well as perceptions of registered nurses working in these operating theatres regarding factors influencing compliance in order to contribute to measures to limit the risk of infection to patients and health care workers. A sequential explanatory design, mixed–method (quantitative and qualitative) was used to explore the use of universal precautions in operating theatres in the Northern Kwa–Zulu Natal. In the first phase, the sample consisted of practices in operating theatres of six hospitals and one regional hospital in area 3 of Kwa–Zulu Natal. The adapted structured checklist based on an established document developed by the MASA Committee for Science and Education (1995) was pilot tested. The collected data was statistically analysed and interpreted with the help of a statistician using SPSS. The results of Phase 1 were used as a base for the Phase 2 questions. Three focus group interviews were conducted with professional nurses who were observed during Phase 1 at the selected hospitals. Findings from quantitative data show that although health care workers take precautions to prevent infections, they do not attain full compliance to universal precautions. The qualitative data indicated that the reasons for non–compliance amongst others were the lack of knowledge of universal precautions, communication factors, resources, including maintenance of equipment, lack of supplies and shortage of human resources and attitudes of health care workers. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.

There is an increase in HIV/AIDS and other blood borne diseases. Health care workers are often exposed to blood and body fluids and thus prone to blood borne infections. Preventative measures can be taken to prevent health workers from contracting these diseases. However, health care workers need to stringently apply these measures. Universal precautions against blood borne infections include diligent hygiene practices, such as hand washing and drying, appropriate handling and disposal of sharp objects, prevention of needle stick or sharp injuries, appropriate handling of patient care equipment and soiled linen, environmental cleaning and spills management, appropriate handling of waste as well as protective clothing such as gloves, gowns, aprons, masks and protective eyewear. This study is aimed at investigating compliance with universal precautions in operating theatres in Northern KwaZulu–Natal as well as perceptions of registered nurses working in these operating theatres regarding factors influencing compliance in order to contribute to measures to limit the risk of infection to patients and health care workers. A sequential explanatory design, mixed–method (quantitative and qualitative) was used to explore the use of universal precautions in operating theatres in the Northern Kwa–Zulu Natal. In the first phase, the sample consisted of practices in operating theatres of six hospitals and one regional hospital in area 3 of Kwa–Zulu Natal. The adapted structured checklist based on an established document developed by the MASA Committee for Science and Education (1995) was pilot tested. The collected data was statistically analysed and interpreted with the help of a statistician using SPSS. The results of Phase 1 were used as a base for the Phase 2 questions. Three focus group interviews were conducted with professional nurses who were observed during Phase 1 at the selected hospitals. Findings from quantitative data show that although health care workers take precautions to prevent infections, they do not attain full compliance to universal precautions. The qualitative data indicated that the reasons for non–compliance amongst others were the lack of knowledge of universal precautions, communication factors, resources, including maintenance of equipment, lack of supplies and shortage of human resources and attitudes of health care workers. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.

Objectives: To develop and validate a survey that can be used to measure key infection prevention and control (IP&C) structures and processes in LTC facilities. Methods: This study was designed using a three-phase methodology. In Phase I, six structural and process composite indices were developed based on the 2004 PHAC recommendations for IP&C in LTC and other literature. During the second phase of the study, a group of 7 experts in LTC IP&C used the Delphi methodology to validate and further develop the survey based on group consensus. Five Safety Principles published by the Institute of Medicine were also provided to the experts so they could be used to complement and further develop the concepts covered by the survey. The Delphi phase began in April and ended in October 2007; 114 worksheets were sent to experts to support the consensus-reaching process. Once the validity of a survey draft had been established based on expert-group consensus, it was pilot-tested in Phase III using 20 randomly selected LTC facilities in Fraser Health. Findings: The three-phase methodology used in this study was very useful and innovative way to further develop and validate the literature-based survey developed in Phase I for IP&C in long term care. In addition, by merging two bodies of knowledge and thought into the process, concepts and components that are not explicitly described in IP&C literature yet were felt to be key in program success, were incorporated into the measurement tool. Using Delphi, the experts expressed a need for IP&C professionals working in LTC to increase their knowledge, understanding and use of safety theory and strategies. They also felt that interdisciplinary work, the development of a culture of safety, and the development clear and simple IP&C systems are key ways in which infections can be prevented and outbreaks quickly controlled. In Phase III, the pilot-study analysis demonstrated the utility, validity and reliability of the survey. In addition, the analysis showed that there is a tendency for facilities to have lower levels of components within the Leadership Index and the ICP Index.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Dissertation (Ph.D.)--University of South Florida, 2009. / Title from PDF of title page. Document formatted into pages; contains 295 pages. Includes vita. Includes bibliographical references.

Submitted by NATÁLIA GROSSI VISONÁ null (natty_visona@hotmail.com) on 2018-04-04T01:15:21Z No. of bitstreams: 1 Dissetação Natália Grossi Visona Baruffi - repositorio.pdf: 882820 bytes, checksum: f8d4a34d565ca478f7d76d96ea3b1826 (MD5) / Approved for entry into archive by ROSANGELA APARECIDA LOBO null (rosangelalobo@btu.unesp.br) on 2018-04-06T12:01:58Z (GMT) No. of bitstreams: 1 baruffi_ngv_me_bot.pdf: 882820 bytes, checksum: f8d4a34d565ca478f7d76d96ea3b1826 (MD5) / Made available in DSpace on 2018-04-06T12:01:59Z (GMT). No. of bitstreams: 1 baruffi_ngv_me_bot.pdf: 882820 bytes, checksum: f8d4a34d565ca478f7d76d96ea3b1826 (MD5) Previous issue date: 2018-02-19 / Estudo retrospectivo e documental cujo objetivo foi analisar a efetividade do protocolo bundles como ferramenta para prevenção de Infecções Relacionadas à Assistência a Saúde (IRAS) de indivíduos internados em Unidade de Terapia Intensiva de Queimaduras (UTIQ) de um hospital terciário do interior paulista. Inicialmente, efetuou-se o levantamento de dados dos prontuários de todos os indivíduos que apresentaram IRAS internados na UTIQ de janeiro de 2008 a dezembro de 2016 e coletadas informações referentes aos que apresentaram infecções abordadas no protocolo bundles, compreendidos como as pneumonias associadas à ventilação mecânica (PAV), Infecção de corrente sanguínea (ICS) por uso de cateter venoso central e infecção do trato urinário (ITU) por uso de sonda vesical de demora, dividida em dois momentos: M1 (2008 a 2010) e M2 (2011 a 2016) pré e pós implantação do protocolo respectivamente. Dos 612 indivíduos admitidos na UTIQ nos dois momentos, 58,4% são do sexo masculino, a média de idade da população do estudo foi de 44,1 ± 15,3 anos. Em relação à área queimada, a média calculada em porcentagem foi de 33 +/- 18,5%, e o grau de queimadura predominante foram os de 2º e 3º graus (61,1%), tendo o fogo como agente causal com maior ocorrência (76,5%). O microrganismo com maior percentual de notificações 91 (36,7%) foi o Acinetobacter baumanii, também relacionados com os casos de PAV e ICS, enquanto que a Candida albicans (8,5%) aparece como o microrganismo mais frequente nos casos de ITU, 267 indivíduos (43,6%) apresentaram IRAS, sendo 49 (55,8%) resultantes de infecções por dispositivos invasivos de longa permanência, 179 (29,2%) evoluíram a óbito, sendo 74 dos óbitos (41,3%) relacionados/causados por infecções. Comparando os dois momentos, não foi observada associação significativa entre os indivíduos que apresentaram infecção hospitalar, o número total de infecções por dispositivos invasivos e os óbitos relacionados/causados por infecções. A incidência de IRAS, não diminuiu após o uso do protocolo, entretanto ao analisar separadamente os tipos de infecção, evidenciou-se que o uso dos bundles mostrou-se efetivo para prevenção de PAV e ICS em queimados. / A retrospective and documentary study aimed at analyzing the effectiveness of the Bundles protocol as a tool for the prevention of Health Care Related Infections (IRAS) of individuals hospitalized in an Intensive Care Unit of Burns (UTIQ) of a tertiary hospital in the countryside of São Paulo State. Initially, data were collected from the medical records of all individuals who presented IRAS hospitalized at the ICUQ from January 2008 to December 2016 and it has been collected the information referring to those who presented Bundle-related infections, known as pneumonias associated with mechanical ventilation (PAV), bloodstream infection (ICS) by the use of the central venous catheter and urinary tract infection (UTI) by use of the bladder catheter, divided into two moments: M1 (2008 to 2010) and M2 (2011 to 2016), before and after the implantation of the protocol, respectively. From the 612 individuals admitted in the ICUQ at both moments, 58.4% were males, the mean age of the study population was 44.1 ± 15.3 years old. In relation to the burned area, the mean calculated in percentage was 33 +/- 18.5% and the predominant degree of burn was those of 2º and 3º degrees (61.1%), with fire being the causal agent with the highest occurrence (76.5%). The microorganism with the highest percentage of reports 91 (36,7%) was Acinetobacter baumanii, it also related to cases of PAV and ICS, while Candida albicans (8.5%) appears as the most frequent microorganism in cases of UTI. 267 individuals (43.6%) presented IRAS, of which 49 (55.8%) resulted from invasive device infections. Regarding deaths during the same period, 179 individuals (29.2%) of the total hospitalizations died, of which 74 death (41.3%), was related/caused by infections. Comparing the two moments, no significant association was observed among the individuals who presented hospital infection, the total number of infections by invasive devices and deaths related/caused by infections, that is, the incidence of IRAS, did not decrease after the use of the protocol, but when analyzing the types of infection separately, it was evidenced that the use of Bundles was effective for the prevention of PAV and ICS in burns.

Flood events have caused detrimental impacts to humans' lives and anthropogenic climate change is anticipated to exacerbate the impact. It has been recognized that a long-term planning through risk-based optimization of flood defence will lead to a cost-effective solution for managing flood risk, but the prevailing assumption of stationarity may lead to an erroneous solution. In attempt to investigate the potential impact of the uncertain underlying statistical characteristics of extreme flow series to flood protection decisions, this research explores risk-based flood protection decisions in the context of climatic variability and change. In particular, the implications of persistence series and nonstationarity were investigated through hypothetical and real case studies. Monte Carlo simulation approach was adopted to capture the uncertainty due to the natural variability. For persistence model, AR(1) was integrated with the GEV model to simulate extreme flow series with persistence. To test the effects of nonstationary, GEV models with a linear location parameter and time as covariate were adopted. Rational decision makers' behaviours were simulated through a designed decision analysis framework. One of the main findings from the research is that the traditional stationary assumption should remain the basic assumption due to insignificant difference of the decisions' economic performance. However, exploration of the nonstationarity assumption enabled identification of options that are robust to climate uncertainties. It is also found that optimized protection of combined measures of flood defence and property-level protection may provide a cost-effective solution for local flood protection. Overall, the simulation and case studies enlighten practitioners and decision makers with new evidence, and may guide to practical enhancement of long term flood risk management decision making.

Orientador: Silvia Maria Caldeira / Resumo: Estudo retrospectivo e documental cujo objetivo foi analisar a efetividade do protocolo bundles como ferramenta para prevenção de Infecções Relacionadas à Assistência a Saúde (IRAS) de indivíduos internados em Unidade de Terapia Intensiva de Queimaduras (UTIQ) de um hospital terciário do interior paulista. Inicialmente, efetuou-se o levantamento de dados dos prontuários de todos os indivíduos que apresentaram IRAS internados na UTIQ de janeiro de 2008 a dezembro de 2016 e coletadas informações referentes aos que apresentaram infecções abordadas no protocolo bundles, compreendidos como as pneumonias associadas à ventilação mecânica (PAV), Infecção de corrente sanguínea (ICS) por uso de cateter venoso central e infecção do trato urinário (ITU) por uso de sonda vesical de demora, dividida em dois momentos: M1 (2008 a 2010) e M2 (2011 a 2016) pré e pós implantação do protocolo respectivamente. Dos 612 indivíduos admitidos na UTIQ nos dois momentos, 58,4% são do sexo masculino, a média de idade da população do estudo foi de 44,1 ± 15,3 anos. Em relação à área queimada, a média calculada em porcentagem foi de 33 +/- 18,5%, e o grau de queimadura predominante foram os de 2º e 3º graus (61,1%), tendo o fogo como agente causal com maior ocorrência (76,5%). O microrganismo com maior percentual de notificações 91 (36,7%) foi o Acinetobacter baumanii, também relacionados com os casos de PAV e ICS, enquanto que a Candida albicans (8,5%) aparece como o microrganismo mais frequente nos caso... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: A retrospective and documentary study aimed at analyzing the effectiveness of the Bundles protocol as a tool for the prevention of Health Care Related Infections (IRAS) of individuals hospitalized in an Intensive Care Unit of Burns (UTIQ) of a tertiary hospital in the countryside of São Paulo State. Initially, data were collected from the medical records of all individuals who presented IRAS hospitalized at the ICUQ from January 2008 to December 2016 and it has been collected the information referring to those who presented Bundle-related infections, known as pneumonias associated with mechanical ventilation (PAV), bloodstream infection (ICS) by the use of the central venous catheter and urinary tract infection (UTI) by use of the bladder catheter, divided into two moments: M1 (2008 to 2010) and M2 (2011 to 2016), before and after the implantation of the protocol, respectively. From the 612 individuals admitted in the ICUQ at both moments, 58.4% were males, the mean age of the study population was 44.1 ± 15.3 years old. In relation to the burned area, the mean calculated in percentage was 33 +/- 18.5% and the predominant degree of burn was those of 2º and 3º degrees (61.1%), with fire being the causal agent with the highest occurrence (76.5%). The microorganism with the highest percentage of reports 91 (36,7%) was Acinetobacter baumanii, it also related to cases of PAV and ICS, while Candida albicans (8.5%) appears as the most frequent microorganism in cases of UTI. 267 indiv... (Complete abstract click electronic access below) / Mestre

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Hansen s disease is a milenar, contagious disease, with a high frequency of for disability, which is still considered an important public health problem in Brazil. It occurs mainly among adults and, when the occurrence is among under the age of 15 years it represents recent transmission and occult endemia. The objective of this study is to describe the epidemiological and clinical profile of new cases of leprosy among 15 year-old minors notified at the SESAU-AL during the period of 1990-2007. This is a descriptive and sectional study; he data were collected using notification files of the new cases of leprosy under 15 year-old minors during 1990-2007, contained in SINAN s database. The same method was used to collect data of general detection of leprosy, in the same period, to analyze the proportion of leprosy s 15 year-old minor patients. The results of this study indicate that 8.9% of the new cases of leprosy recorded in Alagoas during 1990-2007, occurred among 15 year-old minors. The epidemiological indicator reveals high endemia in this State and hiperendemicity in some municipal districts. Operationally, the discovery of these cases was predominantly by passive demand, the medical examination of the household contacts was also regularly realized. The physical incapacity degree at diagnosis was mostly zero (69.6%) and 3.8% of case present physical incapacity degree was grade II. The occurrence of leprosy cases in this age group represents an epidemiological indicator of great importance, suggesting the need for reassessment of ongoing actions to control the disease. / A hanseníase é doença milenar, infectocontagiosa, com alto poder incapacitante, que ainda continua sendo grave problema de Saúde Pública no Brasil. Acomete principalmente a população adulta e, quando ocorre em menores de 15 anos, indica transmissão recente e endemia oculta. O objetivo deste estudo é descrever o perfil epidemiológico e clínico da ocorrência de casos novos de hanseníase em menores de 15 anos notificados à SESAU-AL. Estudo descritivo e transversal; os dados foram coletados por meio das fichas de notificação de casos novos de hanseníase em menores de 15 anos durante o período de 1990-2007, contidas no banco de dados do SINAN. Da mesma forma foram coletados dados quanto à detecção geral da hanseníase nesse período, para se observar a proporção de pacientes de hanseníase na faixa etária referida. Os resultados mostram que 8,9% dos casos novos detectados de hanseníase em Alagoas, no período de 1990-2007, são em menores de 15 anos. Os indicadores epidemiológicos apontam alta endemia no estado e em alguns municípios com hiperendemicidade. Operacionalmente, observa-se que as descobertas dos casos foi predominantemente de demanda passiva, o exame de comunicantes intradomiciliares foi realizado regularmente (58,4%). O grau de incapacidade física no diagnóstico foi, na maioria, igual a zero, representando 69,60% e 3,8% dos casos apresentaram grau de incapacidade física igual a II, nessa faixa etária. A ocorrência de casos de hanseníase, nessa faixa etária, representa um indicador epidemiológico de grande relevância, sugerindo a necessidade de reavaliação das ações em curso para o controle da doença.