Bakgrund: Utövande av handhygienrutiner är en av de viktigaste åtgärderna inom vården för att förhindra vårdrelaterade infektioner. Årligen orsakar vårdrelaterade infektioner stort lidande för patienter och kan leda till bestående skador och döden. All personal inom hälso- och sjukvården är enligt lag ålagda att följa de regler kring basala hygienrutiner som fastställts av Socialstyrelsen. Syfte: Syftet med litteraturstudien var att belysa vad som främjar eller hindrar vårdpersonalens följsamhet till handhygienrutiner inom hälso- och sjukvården, samt äldrevården. Metod: Inklusionskriterierna för litteraturstudien var all vårdpersonal och studenter på sjukhus och äldreboenden. Nio artiklar valdes för att belysa vårdpersonalens upplevelser, perspektiv och erfarenheter. Artiklarna skulle vara skrivna på engelska och peer reviewed samt etiskt granskade. I litteraturstudien har de nio kvalitativa artiklarna kvalitetsbedömts efter SBU:s modell. Artikelsökningarna har gjorts på databaserna: Cinahl, Scopus och PubMed. Exklusionkriterierna var all personal inom tandvården. Analysmetoden innebar att texten kondenserades ned utan att innehållet förlorades. Tio underkategorier framkom i analysen som sedan delades in i två huvudkategorier. Resultat: Resultatet visar att organisatoriska och individuella faktorer har betydelse för utövandet av god handhygien. Information och utbildning höjde följsamheten tillfälligt. Att ha bra förebilder inom yrkesområdet sågs som viktigt och höjde vårdpersonalens benägenhet till att utföra hygienrutiner. Slutsats: Denna litteraturstudie visar att utförande av handhygien är beroende både av organisatoriska- och individuella faktorer. Det finns många metoder för att öka följsamheten, men författarna har inte funnit någon metod som gör att bra rutiner bibehålls. Orsaker som nämnts är bland annat tidsbrist och attityd till att utföra handhygienrutiner.

Bakgrund: Vårdrelaterade infektioner är vanligt förekommande över hela världen.Det innebär en hög kostnad, ökat lidande och medför fler vårddygn för patienten.God handhygien är den viktigaste påverkbara faktorn för att minska vårdrelateradeinfektioner. Det är sjuksköterskans ansvar att säkerställa rutiner för en godhandhygien. Syfte: Syftet är att beskriva vårdpersonalens följsamhet till riktlinjer för handhygien. Metod: En litteraturstudie där datainsamlingen valdes att göra från 10 olikakvantitativa studier. Genom analysen gjordes en sammanställning av de resultat somsvarade på vårt syfte och frågeställningar. Resultat: Resultatet redovisas i tre stapeldiagram med tillhörande text. Förstarubriken är följsamhet till riktlinjer för handhygien medel %. De två andradiagrammen är följsamhet till riktlinjer för handhygien före och efter patientkontaktsamt sjuksköterskor och läkares följsamhet till riktlinjer för handhygien. Huvudfynden i litteraturstudien visade att följsamhet till handhygien varierar i allastudier och att det är statistiskt säkerställt att fler vårdpersonal utför handhygienefter patientkontakt än före samt att fler sjuksköterskor än läkare följde riktlinjer förhandhygien. Konklusion: Det finns brister i följsamhet till handhygien. Kunskapen omsmittspridning och handhygien mellan olika arbetsmoment i den patientnära vårdenär otillräcklig. Ytterligare forskning behövs och alla länder måste sträva efter sammamål.

Background: Basic hygiene is an important measure to prevent healthcare associated infections, save patients’ lives, and reduce economic costs for health care. Healthcare associated infections are a threat to patient safety. In community care persons who are the care takers are a risk group and nurses must make sure that basic hygiene procedures are followed. Method: Literature studies with descriptive design, article search in databases Cinahl and PubMed. The results found are based on twelve chosen articles. Aim: To describe factors related to adherence to basic hygiene and how nurses in community care can help to improve compliance with these procedures. Results: In the nursing staff and leadership in health care interest in and the understanding of basic hygiene is described as being of most importance. Lack of knowledge of the meaning of patient care cleanliness, negative attitudes and non-existing availability of necessary tools and heavy workload had a negative impact. Intensified education and making sure that equipment is available as well as the application of standardized methods, were found to be prerequisite for adherence to basic hygiene routines. Conclusion: Nurses can contribute to improved adherence to basic hygiene routines by promoting education, positive attitudes, a positive adaption of the physical environment, strategic structuring of the workload, and standardized methods, applying basic hygiene routines, being part of and promoting increased interaction in nursing care. Suggestions for future studies is to implement web-based courses, updating courses and training in basic hygiene routines in the workplace. That may increase knowledge, understanding and awareness of the application of basic hygiene routines hence leading to improved nursing care and enhancing patient safety.

<p>Background Nightingale attention that hygiene was an important task to prevent health- related infection. Today there are guidelines how hand hygiene should be followed, to prevent health- related infection. Good knowledge and education in hand hygiene and its consequences if it’s not followed is of great importance. Hand hygiene should be performed before and after the clean and the unclean work with patients and materials. Health- related infection is an infection which can affect both employees and patients as a result of care, regardless of care service. Good compliance is when hand hygiene is carried out at an appropriate time, but several studies show that this is not followed. Aim The aim with the study was to describe nurse’s knowledge and compliance to hand hygiene. Method A literature review was used to analyze scientific articles related to the topic. Results The result showed that knowledge and education was an important factor to retain compliance to hand hygiene. Hand hygiene was performed as a routine, but this could be lacking when nurses where interrupted in their working moment. Another reason why hand hygiene was not performed was that some nurses experienced skin irritation as a result. Nurses used soap and water instead of hand disinfection. Compliance was better after than before patient contact. Conclusion The authors have noted that after the hygiene education increases compliance to hand hygiene. Regular education is seen as an important part to create and maintain procedures for hand hygiene.</p>

Background Nightingale attention that hygiene was an important task to prevent health- related infection. Today there are guidelines how hand hygiene should be followed, to prevent health- related infection. Good knowledge and education in hand hygiene and its consequences if it’s not followed is of great importance. Hand hygiene should be performed before and after the clean and the unclean work with patients and materials. Health- related infection is an infection which can affect both employees and patients as a result of care, regardless of care service. Good compliance is when hand hygiene is carried out at an appropriate time, but several studies show that this is not followed. Aim The aim with the study was to describe nurse’s knowledge and compliance to hand hygiene. Method A literature review was used to analyze scientific articles related to the topic. Results The result showed that knowledge and education was an important factor to retain compliance to hand hygiene. Hand hygiene was performed as a routine, but this could be lacking when nurses where interrupted in their working moment. Another reason why hand hygiene was not performed was that some nurses experienced skin irritation as a result. Nurses used soap and water instead of hand disinfection. Compliance was better after than before patient contact. Conclusion The authors have noted that after the hygiene education increases compliance to hand hygiene. Regular education is seen as an important part to create and maintain procedures for hand hygiene.

Methicillin Resistant Staphylococcus aureus (MRSA) is the most commonly isolated multi-drug resistant organism in the hospital setting. MRSA can result in death among people who have no identified risk factors for infection. One-third of MRSA infections are cross-transmitted as Healthcare-Associated Infections (HAIs). It is well known that the single most effective means for decreasing the risk of HAIs is hand hygiene (HH), yet poor performance among registered nurses persists. The theoretical framework used to guide the study was the Health Belief Model (HBM). The purposes of the study were to: explore the RNs’ self-reported HH performance rate; explore the RNs’ knowledge related to MRSA; identify relationships between MRSA knowledge and HBM constructs; explore the RNs’ barriers to HH performance; identify relationships between barriers and self-reported HH performance; explore relationships among HH behaviors and constructs in the HBM; explore predictors of ‘overall HH’ performance; and identify if certain demographic characteristics are related to MRSA knowledge, self-reported HH, and HBM constructs. A cross sectional descriptive study was conducted with a sample of RNs who were randomly selected. The questionnaire mailing, which included the survey, consent, and the return-stamped envelope were distributed to 684 RNs. Completed surveys (n=120) from RNs who met the sample inclusion criteria were returned within four weeks. Self-reported HH were highest during times of increased perceived susceptibility for infection. In addition, nurses were more likely to overcome barriers to HH during ‘moments’ associated with the highest perceived susceptibility. Although MRSA knowledge did not correlate with ‘overall HH’ performance, there was a significant relationship identified with self-efficacy (r=.27, p<.01), which may influence HH behaviors. The most commonly identified barriers to HH performance were system factors (e.g. ‘a high workload’). Self-efficacy and barriers represented 26% of the variability in the regression model when applying significant correlations among HBM constructs and ‘overall HH.’ The phenomenon of the RN’s HH decision making is not completely understood. More research is needed to explain predictors for HH among registered nurses. This understanding will allow researchers to plan interventions aimed at increasing knowledge and understanding about perceived susceptibility, which may in turn improve self-efficacy behaviors for HH, which could decrease HAI rates. / text

Background: Surgical site infections are commonly occuring within healthcare, especially in Africa. Good hygiene is the most effective way in which to reduce and prevent infection, compliance however is often low or insufficient. Aim: The Aim of the study was to observe intraoperative compliance to basic hand hygiene in the operating theatre, the secondary aim was to investigate the surgical teams views on patient safety by using a survey on patient safety culture. Method: The design is a quantitative observational study. Through participant observation information was gathered on compliance to basic intraoperative hygiene routines in operating theatres in Mozambique. Operating personnel were then asked to complete a survey on patient safety culture. Result: None of the work elements were performed in complete compliance to WHO’s guidelines at all times. The operating theatre personnel’s views on Patient Safety Culture showed the highest percentage of positive responses was the dimensions “Teamwork Within Hospital Units” and “Organisational Learning- Continous improvement”. The dimensions with the least positive response was “Nonpunitive Response To Error” and “Staffing”. When comparing compliance to basic hygiene and the results of the patient safety culture survey a medium relation was found, where the staff who gave the most positive response to the survey also complied better to the WHO’s hygiene guidelines. Conclusions: Compliance to basic hygiene during the intraoperative phase in the operating theatre in Mozambique, Maputo was often insufficient. There was a medium strong relation between the staffs views on patient safety and their compliance to basic hygiene. This implies that working with the staff’s attitudes concerning patient safety could improve hygiene compliance resulting in reduced number of surgical site infections.

Syftet med föreliggande studie var att redogöra för hälso- och sjukvårdspersonalens följsamhet till hygienföreskrifter avseende handhygien och de faktorer som påverkar detta. Metod: Artiklar söktes via CINAHL, Pubmed och Scopus. Sökord som användes i olika kombinationer var: hand hygiene, adherence, hygiene guidelines, health care workers, compliance, hand disinfection, infection control, nursing, nurse och hand cleansing. Tretton vetenskapliga artiklar erhölls. Vidare gjordes en manuell sökning ifrån inkluderade artiklars referenslistor och genererade två artiklar som ingick i resultatet. Resultat: Resultatet visade att hälso- och sjukvårdspersonalens följsamhet till hygienföreskrifter avseende handhygien var låg. Vidare framkom av resultatet att det fanns sju kategorier av faktorer som påverkade följsamheten till hygienföreskrifterna. Dessa var: utbildning och kunskap, arbetsbelastning och tidsbrist, tillgänglighet, hudproblem och handskar. Slutsats: Följsamheten till hygienföreskrifter avseende handhygien är låg. Kontinuerlig utbildning i kombination med ökad tillgänglighet och minskad arbetsbelastning är de viktigaste förutsättningarna för att öka följsamheten till hygienföreskrifter gällande handhygien.

The theme of my thesis Diseases of the vulva, I chose based on several years of his interest in gynecology and themes associated with that field. Although the vulva is a place that gynecologist for examination by viewing easy accessibility as one of the first, there is no diagnosis of disease in this area does not simple and requires interdisciplinary cooperation. vulva is not only the gateway to the internal genitals, but also a place where meet medical fields, especially gynecology, dermatology and pathology. View of dermatology and gynecology at some disease of the vulva was often different, as well as evaluation severity of disease classification and therapy. Simply words, the gynecologist is usually devoted to lesions that were considered to be precancerous or malignant nature attention to his dermatologist benign dermatózám. The these uncertainties, there were problems, how to evaluate some of the lesions in wider scale. Fortunately there was a unification of terminology when International Society for the Study of vulvar disease (ISSVD - International Society for the Study of vulvar Disease) uniform classification system published by some of the termsgoverning 1) . Interdisciplinary collaboration, a unified classification and availability "Evidence-based" information is, in my opinion, step in the...

Magister Curationis - MCur / Studies have shown that no great emphasis has been put on hand washing practices in psychiatric health facilities, despite the fact that nosocomial infection outbreaks have been reported for decades. Most studies have focused on hand washing practices among general health personnel; however, little is known about hand washing practices among nurses working at psychiatric hospitals.