The University Hospital of Liège has 955 beds in 8 intensive care units, 15 medical wards, 10 surgical wards and 1 paediatric ward. Approximately 36,000 patients are admitted each year, giving a total of 265,000 patient-days hospitalization. Extended-spectrum beta-lactamase-producing Enterobacteriaceae (E-ESBL) constitute, along with methicillin-resistant Staphylococcus aureus (MRSA), the main multi-resistant bacteria recovered in our hospital. The aims of the present study were to: - evaluate the epidemiology of E-ESBL - evaluate the impact of an infection control programme to reduce the spread of E-ESBL in the University Hospital of Liège. In order to do this, several studies were carried out between 2001 and 2007: 1. Determination of the high risk units in the CHU (2001) The high risk units were determined by comparing the incidence rates of each type of unit. Two types of high risk unit were identified in this way: the Intensive Care Units (ICUs) and the Onco-Haematology Unit. 2. Epidemiology of E-ESBL in the Onco-Haematology unit (2002-2003 and 2005-2006) Digestive tract colonization by E-ESBL was found to be relatively high (7.3%) and this explains the high incidence of E-ESBL in Onco-Haematology in comparison with the rest of the hospital. However, the clinical gravity associated with exposure to the risk factor (digestive tract colonization by E-ESBL) was found to be relatively weak. 3. Importance of digestive tract colonization by E-ESBL in General ICUs (2002-2003) Digestive tract colonization by E-ESBL was found to be relatively common (8.8%) and faecal carriage of E-ESBL was found to be a good marker for infection with E-ESBL at another body site. Even though the number of infected patients was found to be low, the risk of infection due to E-ESBL was multiplied by 14.7 in a group of digestive carriers of E-ESBL with regard to a group of non carriers. Our data also showed that Enterobacter aerogenes is the most frequent species producing extended-spectrum beta-lactamase (ESBL) and that TEM-24 is the most prevalent ESBL produced by E-ESBL species in our ICUs. No CTX-M-type genes were identified. With regard to antibiotic susceptibility, meropenem and cefepime appeared to be the most active agents against the majority of isolates. 4. Impact of an infection control programme to reduce the spread of E-ESBL (2006-2007) A surveillance programme was carried out to evaluate the implementation of infection control procedures including surveillance of ESBL-producing strains, utilization of computer alerts for E-ESBL positive patients and the application of contact precautions for colonized or infected patients. Infection control compliance observations were performed by trained referring nurses. During the 2 years of application, one or more E-ESBL were identified in 500 patients. A total of 2268 internal messages regarding the identification of E-ESBL were sent within the hospital, among which 91.84 % were received (at least 1 for every patient). An alert was associated with 406 patients, who were always hospitalized as the identification of the E-ESBL by the laboratory was obtained. A total of 257 registration forms were filled in by the referring nurses, resulting in a survey compliance of 63%. This survey showed that door signs identifying positive patients, hydro-alcoholic solution and gloves were present in 90% of the cases, but that gowns were only present in 59%. The overall incidence of nosocomial acquisition of E-ESBL between 2006 and 2007 was 0.92/1000 patient-days, more or less the same as in 2002. In relation to this research, several questions remain: - Even though the rates of digestive tract colonization with E-ESBL in the 2 types of high risk unit were found to be more or less the same (7.3 and 8.8%), the impact on infections due to E-ESBL was very different. - Are the infections due either to E-ESBL endogenous infections (owing notably to the use of broad spectrum antibiotics) or to secondary infections (resulting from cross-transmission) or to both? The implementation of an infection control programme to limit the spread of E-ESBL has been based on the limitation of the cross-transmission of these micro-organisms. An enhanced barrier precautions policy has been in place in our institution for 2 years, and we have seen no erosion in compliance. We should not however lose sight of the fact that, whatever the institutional policy for the management of multi-resistant bacteria, the correct application of standard precautions for all patients is the first measure to limit the cross-transmission of all micro-organisms.

The purpose of the study The purpose of this research project was to develop and test an educational program for preparing Taiwanese nursing students for clinical practice. Study background The SARS outbreak revealed that health care professionals were ill-prepared for coping with the disease epidemic in terms of the rapid transmission of the infection, the high mortality and morbidity rate among health care workers, and the significant impacts on the public and health care personnel. Frontline nurses were the group at highest risk of becoming infected, as they are the health care personally that provide direct health care to infected patients. However, to date the ability of Taiwanese frontline nurses to respond to such a disease epidemic has not been examined. Study design This research project incorporated a three phase design, presented in the form of two separate studies. A small qualitative exploratory study was undertaken to validate the assumptions emerging from international literature regarding the preparedness nurses in managing an infection outbreak. The information gained was used to construct an infection control education program (Study I). A quasi-experimental design, using pre- and post-tests and experimental and control groups was then used to test the effectiveness of the education intervention (Study II). Participants A purposive sampling technique was used in the qualitative exploratory study, whereby six Taiwanese nurses who had provided direct nursing care to patients with SARS were interviewed. A convenience sampling approach was utilised in the quantitative study, which aimed to test the effectiveness of educational intervention. This, second study, had 175 participants in total, 80 in the experimental group and 95 in the control group. All participants were enrolled in the first semester of their fourth year in a five-year nursing program in two selected junior nursing colleges. The education intervention The purpose-designed standard and additional precautions (SnAP) program was the intervention. The experimental group received a SnAP program which consisted of 16 hours of classes over 16 weeks. The control group received a conventional education program. Data collection and instrument Data were collected at three time points during the study (baseline, four months, six month) using validated instrument. The reliability and validity of the instrument was established in a pilot study with a Taiwanese population prior to the present study. Data analysis t-tests and chi-square analyses were performed to assess any differences across demographic variables and baseline outcome variables between the experimental and control groups. Two-way repeated measures ANOVAs were used to examine the scores of the intervention and control groups across three time points. Results The data revealed that, at six months following the education program, there was a statistically significant improvement in the knowledge (F [2,180] =13.53, p=0.001) and confidence (F [2,94] =4.88, p= 0.01) of infection precautions in the intervention group compared to the control group. Also, the means of knowledge and confidence in intervention group showed a consistently increased across three time points; whereas, the mean of confidence relating infection control management in the control group resulted a drop at time 3. Although the application skills relating to infection control procedures did not show a statistically significant change during this period (F [2, 174] = 2.54, p=0.081), there were minor improvements in these scores at the six-month follow-up assessment. Conclusion The SnAP program had a positive impact on Taiwanese nursing students' readiness for clinical placement and potential outbreak of disease epidemics. Participation increased their knowledge about infection control precautions, their ability to properly use these specific precautions, and their confidence in solving infection-related issues in clinical practice.

International Telemetering Conference Proceedings / October 25-28, 1999 / Riviera Hotel and Convention Center, Las Vegas, Nevada / This paper describes the current internationally recognized atomic time scales of International Atomic Time (TAI), Coordinated Universal Time (UTC), and Global Positioning System (GPS) Time as well as solar based Universal Time. The concept of Leap Seconds and the differences between the time scales are discussed. A brief history of the international agreements that created organizations responsible for maintaining these time scales is provided. A brief review of the GPS 1999 (Week Number Roll Over) WNRO with its potential GPS user problems is provided. Prudent personal precautions are proposed for the Year 2000 (Y2K) Rollover.

As Precauções-Padrão (PP) são consideradas como as principais medidas de prevenção à exposição com material biológico potencialmente contaminado e a adesão as PP contribui significativamente para reduzir esses riscos. Este estudo teve como objetivo descrever e comparar os escores de adesão às PP de profissionais de enfermagem que atuavam nas unidades de internação de um hospital universitário. Trata-se de um estudo transversal, comparativo e quantitativo, realizado em um hospital de ensino do interior do estado de São Paulo, Brasil. A amostra de 290 sujeitos foi calculada e sorteada segundo um plano amostral estratificado (alfa =0,01; número de preditores = 3, sendo, tempo de exercício na profissão, carga horária semanal, categoria profissional, effect size = 0,08, poder 0,99). Critérios de inclusão: exercer no mínimo seis meses de trabalho na função de enfermeiro, técnico ou auxiliar de enfermagem na instituição; estar lotado na unidade selecionada para a realização do estudo; prestar assistência direta aos doentes. Critérios de exclusão: exercer exclusivamente atividades administrativas; estar em férias, licença-saúde ou afastamento. Utilizou-se um formulário contendo variáveis demográficas e a escala psicométrica de adesão às PP, desenvolvido por Gershon et al. (1995), traduzida e validada por Brevidelli e Cianciarullo (2009), no total de 13 ítens, cujas opções variam segundo uma escala Likert de cinco pontos. A coleta de dados foi realizada entre 01 de setembro de 2009 a 31 de março de 2010 e os profissionais abordados e entrevistados em seu próprio turno de trabalho. A análise dos dados foi efetuada por meio do software Social Package for Social Science (SPSS), versão 15.0. Participaram do estudo 256 profissionais de enfermagem, sendo 178 (69,5%) auxiliares de enfermagem, 27 (10,5%) técnicos e 51 (19,9%) enfermeiros. A confiabilidade da escala de adesão às PP, cujo resultado de 0,70, foi considerado satisfatório. Os resultados apontaram que 152 (59,4%) profissionais apresentaram escores médios altos para a adesão às PP, igual ou acima de 4,5; 98 (38,3%) escores intermediários, entre 3,5 a 4,49 e 06 (2,3%) baixos, ou seja, menores que 3,5. Verificou-se que 50 (19,5%) informaram ter menos de 05 anos na profissão, 83 (32,4%) entre 05 e 10 anos e a maioria, 123 (48,0%), mais que 10 anos na profissão. A análise dos escores de adesão às PP e tempo na profissão mostrou fraca correlação (r=0,629; p=0,395). A análise dos escores de adesão às PP dos profissionais de saúde segundo a carga horária semanal também apontou que houve fraca correlação (r = - 0,070; p = 0,266). Entre profissionais expostos ou não a material biológico não houve diferenças nos escores de adesão às PP. Os resultados apontaram alta e intermediária adesão às PP dos profissionais de enfermagem, entretanto, não houve diferenças estatisticamente significativas entre os escores segundo a categoria profissional, tempo na profissão, carga horária semanal ou setores de trabalho ou exposição prévia ao material biológico. / The Standard Precautions (SP) are considered as key measures for preventing exposure to potentially contaminated biological material adhesion to the PP and contributes significantly to reducing these risks. This study aimed to describe and compare the scores of adherence to the SP of nurses who worked in inpatient units of a university hospital. This is a cross-sectional, comparative and quantitative, carried out in a teaching hospital in the state of São Paulo, Brazil. The sample of 290 subjects was calculated and drawn in a plane stratified sample (alpha = 0.01, 3 = number of predictors, being, exercise time in the profession, weekly workload, professional category, effect size = 0.08; power 0.99). Inclusion criteria: exercise at least six months working in the role of nurse, technician or nursing assistant in the institution was packed in the unit selected for the study, provide direct care to patients. Exclusion criteria: exercise exclusive administrative activities; be on vacation, sick leave or removal. We used a form containing demographic and psychometric scale for adherence to the SP, developed by Gershon et al. (1995), translated and validated by Brevidelli and Cianciarullo (2009), totaling 13 items, whose options vary according to a five-point Likert scale. Data collection was conducted between September 1, 2009 to 31 March 2010 and discussed the pros and interviewed in their own shift. Data analysis was performed using the software Social Package for Social Sciences (SPSS) version 15.0. The study included 256 nurses, of which 178 (69.5%) nursing assistants, 27 (10.5%) technicians and 51 (19.9%) nurses. The reability scale adhesion to SP, which results of 0.70, was considered satisfactory. The results showed that 152 (59,4%) professionals had higher mean scores for adherence to SP equal to or above 4.5, 98 (38.3%) scores intermediate between 3.5 and 4.49 and 06 (2 3%) low , less than 3.5. It was found that 50 (19.5%) reported having less than 05 years in the profession, 83 (32.4%) between 05 and 10 years and the majority, 123 (48.0%), more than 10 years in the profession. The mean score for adherence to SP and length of service showed a weak correlation (r=0,629; p=0,395). Analysis of the scores of compliance with standard precautions for health professionals according to weekly working hours also pointed out that there was a weak correlation (r = - 0,070; p = 0,266). Among workers exposed to biological material or not there were differences in scores for adhesion to SP. The results showed high, intermediate, and high adhesion to SP nursing professionals, however, no significant statistically differences between scores by professional category, length of service, weekly or sectors of work or exhibition prior to the biological material.

Introdução: A propagação das infecções em serviços de saúde pode ocorrer devido ao não cumprimento das precauções padrão e precauções específicas por parte dos profissionais da assistência a saúde, indivíduos e visitantes. Estudos demonstraram baixa adesão às medidas de precaução pelos profissionais da assistência a saúde, o que pode ter relação com os aspectos do comportamento humano, como a falsa percepção de um risco invisível e a subestimação do compromisso individual nas taxas de infecções relacionadas à assistência a saúde. Com relação aos indivíduos e familiares a orientação inadequada, que se restringe apenas em dizer o que deve ou não ser feito pelo familiar e indivíduo, não esclarece o objetivo principal das precauções, fazendo com que a adesão aos procedimentos não ocorra ou ocorra de maneira inadequada. A partir da década de 1980, teóricos em saúde coletiva propuseram o conceito de vulnerabilidade para ser utilizado como quadro de referência para apoiar o manejo de agravos em saúde. No presente estudo, o conceito de vulnerabilidade foi utilizado como referencial teórico para a abordagem dos aspectos que envolvem o conhecimento e engajamento do indivíduo nas situações que requerem precauções específicas. Objetivo: elaborar e validar com especialistas um roteiro de orientação escrito sobre precauções específicas para indivíduos adultos, tendo como quadro de referência o conceito de vulnerabilidade. Métodos: trata-se de um estudo do tipo metodológico. O estudo foi aplicado em três fases sequenciais: a coleta de dados por meio de aplicação de um questionário dirigido aos indivíduos, a elaboração do roteiro de orientação aos profissionais de saúde e a validação desse material. O estudo foi desenvolvido em dois hospitais, sendo um deles universitário público de nível assistencial secundário e o outro um hospital geral privado com atendimento a convênios de saúde. Participaram do estudo indivíduos adultos que se encontravam em situação de precauções específicas para a transmissão de doenças durante a internação, no período do estudo. Foram convidados a participar como juízes na validação profissionais de saúde com conhecimento reconhecido na área de prevenção de transmissão de doenças ou na temática de vulnerabilidade. O Índice Validade de Conteúdo (IVC) de 0,75 foi utilizado como critério para validação dos tópicos desenvolvidos no instrumento de orientação. Resultados: foram entrevistados 39 indivíduos, em média sete dias após a instituição das precauções específicas. A maior parte estava em precaução para contato. Menos da metade sabia que necessitava de algum cuidado específico; dentre estes, menos da metade sabia como se transmitia seu agravo. O roteiro educacional foi desenvolvido de modo a proporcionar maior conhecimento nos aspectos usualmente negligenciados pelos profissionais e estimular o cuidado centrado na individualidade. Todos os itens tiveram um índice de validade de conteúdo acima de 75%. Conclusão: o roteiro educacional apresenta potencial para instrumentalizar os profissionais da assistência à saúde para a elaboração de ações educativas para indivíduos adultos em precauções específicas. Espera-se que este roteiro possa ser aplicado rotineiramente pelos profissionais nos serviços de saúde, visando a minimizar os efeitos indesejados decorrentes das situações de precauções específicas para transmissão de doenças. / Introduction: The spread of infections in health services may occur due to health care professionals, patients and visitors noncompliance with standard precautions and specific precautions. Studies have shown low adherence from health care professionals to precautionary measures, which may be related to aspects of human behavior, such as false perception of an invisible risk and underestimation of the individual commitment in reference to infections rates related to health care. With regard to patients and families, inadequate guidance - which is limited only to saying what the family member and patient should or should not do - does not clarify the main purpose of the precautions, hindering adherence to precautions or making them occur inappropriately. From the 1980s on, public health theorists proposed the concept of vulnerability to be used as a framework to support health hazard management. In this study, the concept of vulnerability will be used as a theoretical framework to address the aspects concerning the patients knowledge and engagement in situations that require specific precautions. Purpose: to develop and validate with experts a guidance reference in writing on specific precautions for adult patients, using the concept of vulnerability as a referential framework. Method: this is a methodological study design, which will be implemented in three sequential phases: data collection by means of a survey to patients, development of a guidance instrument and validation of this material. The study will be developed in two hospitals, one of them, a state university hospital of secondary care level and the other, a private general hospital covering health insurance plans. Patients participating in the study were adults under specific precautions concerning transmission of diseases during hospitalization at the time of the study. Health professionals with recognized expertise in diseases transmission prevention or on the topic of vulnerability were invited to participate as judges for validation. The Content Validity Index (CVI) of 0.75 was used as a criterion for validation of the topics developed in the guidance tool. Results: Thirty-nine patients were interviewed, on average seven days after the imposition of specific precautions. Most were under contact precautions. Less than half knew they needed some special care; among these, less than half knew how their hazard was transmitted. The educational guide was developed to provide more knowledge on the aspects usually neglected by professionals and to foster care centered on the patient\'s individuality. All items had a content validity index above 75%. Conclusion: the educational guide has the potential to enable health care professionals for the development of educational activities for adults under specific precautions. This guide is expected to be applied routinely by professionals in health services, in order to minimize the undesirable effects of the cases of specific precautions to disease transmission.

Introdução: Staphylococcus aureus é um importante patógeno responsável por diversas infecções no ambiente hospitalar com elevada morbi-mortalidade. Os profissionais de saúde, sobretudo os de enfermagem, apresentam elevado risco de colonização por meio do contato direto com indivíduos suscetíveis ou pelo contato com fômites em suas atividades laborais. Com isso, esses profissionais podem disseminar esses microrganismos tanto no ambiente hospitalar como na comunidade. Objetivo: Avaliar a colonização por Staphylococcus aureus em profissionais de enfermagem e a adesão às precauções-padrão. Metodologia: Trata-se de um estudo transversal realizado em clínica médica e em unidades especializadas em prestação de cuidados a pessoas com HIV/aids de um hospital escola do município de Ribeirão Preto. A população foi composta por 100 profissionais de enfermagem que prestam cuidados direto aos pacientes dessas unidades. Foram coletadas amostras de saliva, de secreção nasal e um swab do telefone celular dos profissionais. A coleta ocorreu no período de abril de 2014 a fevereiro de 2015, em três momentos, nos meses zero, quatro e oito. A obtenção dos dados demográficos, profissionais e individuais foi feita por meio de um questionário estruturado. Para avaliar a adesão dos profissionais às precauções-padrão, foram aplicadas dez escalas psicométricas do tipo Likert, já traduzidas e validadas para o português. As amostras coletadas foram encaminhadas e processadas pelo Laboratório de Microbiologia e Sorologia do referido hospital. Resultados: Dos 100 profissionais de enfermagem, 43,0% estavam colonizados por Staphylococcus aureus nas amostras de saliva e/ou de secreção nasal; 36,0% eram Staphylococcus aureus sensível à oxacilina e 7,0% resistente à oxacilina. A prevalência foi de 32,0% na secreção nasal, 1,0%, na saliva e 11,0%, nas amostras de saliva e de secreção nasal. Observou-se que 93,0% dos Staphylococcus aureus apresentaram resistência à penicilina, 43,0%, à eritromicina e 39,5%, à clindamicina. Nenhuma das amostras coletadas da base do telefone celular dos profissionais apresentou Staphylococcus aureus. Os profissionais apresentaram escores médios altos para a Escala de Adesão às Precauções-padrão e Escala de Personalidade de Risco. Não houve diferença significante ao comparar a média dos escores das escalas entre o grupo de colonizados e não colonizados. Armazenamento da escova dental em compartimento fechado/protegido (RP=2,07; IC95%=1,07-3,80) foi um fator de risco para a colonização. Enquanto que, o conhecimento sobre as PP (RP=0,53; IC95%=0,44-0,64) e participação em treinamento sobre as PP (RP=0,52; IC95%=0,43-0,64) apresentaram-se como um fator de proteção para a não colonização. Conclusão: A cavidade nasal foi um importante sítio de colonização quando comparada à cavidade oral, sendo um sítio relevante e indicado para a coleta em estudos que investigam a prevalência de colonização por Staphylococcus aureus. O conhecimento sobre precauções-padrão e a participação em treinamentos foram fatores associados à proteção para a não colonização. No entanto, um dos fatores determinantes para a adesão às precauções-padrão é a percepção de suscetibilidade do profissional de adquirir e disseminar esses microrganismos / Introduction: Staphylococcus aureus is an important pathogen responsible for several infections in hospitals with high morbidity and mortality rates. Health professionals, especially nurses, are at increased risk of colonization through direct contact with susceptible individuals or by contact with fomites in their work activities. As a consequence, these professionals can disseminate these microorganisms both in the hospital and in the community. Objective: To assess colonization by Staphylococcus aureus in nursing professionals and the adherence to standard precautions. Methods: This cross-sectional study was carried out in an outpatient clinic and in specialized units that provide care to people with HIV/Aids, in a teaching hospital of Ribeirão Preto. The population consisted of 100 nursing professionals who provide direct care to patients of these units. Samples of saliva, nasal secretions and a swab from the mobile phone of professionals were collected. The collection took place from April 2014 to February 2015 on three occasions, in months zero, four and eight. A structured questionnaire was used to obtain demographic, occupational and personal data. To assess the adherence of professionals to standard precautions, ten Likert-type psychometric scales, translated and validated for Portuguese, were applied. The collected samples were forwarded to and processed by the Microbiology and Serology Laboratory of the hospital. Results: Of the 100 nursing professionals, 43% were colonized with Staphylococcus aureus in saliva samples and/or nasal secretions; 36% were oxacillin-sensitive Staphylococcus aureus and 7.0% oxacillin-resistant. The prevalence was 32% in nasal secretion, 1% in saliva and 11% in saliva samples and nasal discharge. It was observed that 93% of Staphylococcus aureus were penicillin-resistant strains, 43% resistant to erythromycin and 39.5% to clindamycin. None of the samples collected from the base of the mobile phone of the professionals presented Staphylococcus aureus. Professionals had high mean scores for the Compliance with Standard Precautions Scale and the Risk Personality Scale. There was no significant difference when comparing the average scores of scales between the colonized and non-colonized groups. Storing the toothbrush in a closed/protected space (PR=2.07; CI95%=1.07-3.80) was a risk factor for colonization. Knowledge of the SP (PR=0.53, CI95%=0.44-0.64) and participation in training on SP (PR=0.52, CI95%=0.43-0.64) were a protective factor for non- colonization. Conclusion: The nasal cavity was an important colonization site compared to the oral cavity, the nasal site is relevant and recommended for collection in studies investigating the prevalence of colonization for Staphylococcus aureus. Knowledge of the standard precautions and participation in training on standard precautions were protective factors for non-colonization. However, one of the determining factors for adherence to standard precautions is the perceived susceptibility of professional to acquire and disseminate these microorganisms

Introdução: Staphylococcus aureus é um importante patógeno responsável por diversas infecções no ambiente hospitalar com elevada morbi-mortalidade. Os profissionais de saúde, sobretudo os de enfermagem, apresentam elevado risco de colonização por meio do contato direto com indivíduos suscetíveis ou pelo contato com fômites em suas atividades laborais. Com isso, esses profissionais podem disseminar esses microrganismos tanto no ambiente hospitalar como na comunidade. Objetivo: Avaliar a colonização por Staphylococcus aureus em profissionais de enfermagem e a adesão às precauções-padrão. Metodologia: Trata-se de um estudo transversal realizado em clínica médica e em unidades especializadas em prestação de cuidados a pessoas com HIV/aids de um hospital escola do município de Ribeirão Preto. A população foi composta por 100 profissionais de enfermagem que prestam cuidados direto aos pacientes dessas unidades. Foram coletadas amostras de saliva, de secreção nasal e um swab do telefone celular dos profissionais. A coleta ocorreu no período de abril de 2014 a fevereiro de 2015, em três momentos, nos meses zero, quatro e oito. A obtenção dos dados demográficos, profissionais e individuais foi feita por meio de um questionário estruturado. Para avaliar a adesão dos profissionais às precauções-padrão, foram aplicadas dez escalas psicométricas do tipo Likert, já traduzidas e validadas para o português. As amostras coletadas foram encaminhadas e processadas pelo Laboratório de Microbiologia e Sorologia do referido hospital. Resultados: Dos 100 profissionais de enfermagem, 43,0% estavam colonizados por Staphylococcus aureus nas amostras de saliva e/ou de secreção nasal; 36,0% eram Staphylococcus aureus sensível à oxacilina e 7,0% resistente à oxacilina. A prevalência foi de 32,0% na secreção nasal, 1,0%, na saliva e 11,0%, nas amostras de saliva e de secreção nasal. Observou-se que 93,0% dos Staphylococcus aureus apresentaram resistência à penicilina, 43,0%, à eritromicina e 39,5%, à clindamicina. Nenhuma das amostras coletadas da base do telefone celular dos profissionais apresentou Staphylococcus aureus. Os profissionais apresentaram escores médios altos para a Escala de Adesão às Precauções-padrão e Escala de Personalidade de Risco. Não houve diferença significante ao comparar a média dos escores das escalas entre o grupo de colonizados e não colonizados. Armazenamento da escova dental em compartimento fechado/protegido (RP=2,07; IC95%=1,07-3,80) foi um fator de risco para a colonização. Enquanto que, o conhecimento sobre as PP (RP=0,53; IC95%=0,44-0,64) e participação em treinamento sobre as PP (RP=0,52; IC95%=0,43-0,64) apresentaram-se como um fator de proteção para a não colonização. Conclusão: A cavidade nasal foi um importante sítio de colonização quando comparada à cavidade oral, sendo um sítio relevante e indicado para a coleta em estudos que investigam a prevalência de colonização por Staphylococcus aureus. O conhecimento sobre precauções-padrão e a participação em treinamentos foram fatores associados à proteção para a não colonização. No entanto, um dos fatores determinantes para a adesão às precauções-padrão é a percepção de suscetibilidade do profissional de adquirir e disseminar esses microrganismos / Introduction: Staphylococcus aureus is an important pathogen responsible for several infections in hospitals with high morbidity and mortality rates. Health professionals, especially nurses, are at increased risk of colonization through direct contact with susceptible individuals or by contact with fomites in their work activities. As a consequence, these professionals can disseminate these microorganisms both in the hospital and in the community. Objective: To assess colonization by Staphylococcus aureus in nursing professionals and the adherence to standard precautions. Methods: This cross-sectional study was carried out in an outpatient clinic and in specialized units that provide care to people with HIV/Aids, in a teaching hospital of Ribeirão Preto. The population consisted of 100 nursing professionals who provide direct care to patients of these units. Samples of saliva, nasal secretions and a swab from the mobile phone of professionals were collected. The collection took place from April 2014 to February 2015 on three occasions, in months zero, four and eight. A structured questionnaire was used to obtain demographic, occupational and personal data. To assess the adherence of professionals to standard precautions, ten Likert-type psychometric scales, translated and validated for Portuguese, were applied. The collected samples were forwarded to and processed by the Microbiology and Serology Laboratory of the hospital. Results: Of the 100 nursing professionals, 43% were colonized with Staphylococcus aureus in saliva samples and/or nasal secretions; 36% were oxacillin-sensitive Staphylococcus aureus and 7.0% oxacillin-resistant. The prevalence was 32% in nasal secretion, 1% in saliva and 11% in saliva samples and nasal discharge. It was observed that 93% of Staphylococcus aureus were penicillin-resistant strains, 43% resistant to erythromycin and 39.5% to clindamycin. None of the samples collected from the base of the mobile phone of the professionals presented Staphylococcus aureus. Professionals had high mean scores for the Compliance with Standard Precautions Scale and the Risk Personality Scale. There was no significant difference when comparing the average scores of scales between the colonized and non-colonized groups. Storing the toothbrush in a closed/protected space (PR=2.07; CI95%=1.07-3.80) was a risk factor for colonization. Knowledge of the SP (PR=0.53, CI95%=0.44-0.64) and participation in training on SP (PR=0.52, CI95%=0.43-0.64) were a protective factor for non- colonization. Conclusion: The nasal cavity was an important colonization site compared to the oral cavity, the nasal site is relevant and recommended for collection in studies investigating the prevalence of colonization for Staphylococcus aureus. Knowledge of the standard precautions and participation in training on standard precautions were protective factors for non-colonization. However, one of the determining factors for adherence to standard precautions is the perceived susceptibility of professional to acquire and disseminate these microorganisms

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style="font-size: 12pt / line-height: 115% / font-family: &quot / Times New Roman&quot / ,&quot / serif&quot / ">This study has reveled the levels of knowledge and compliance towards Universal Precautions and examined the factors that are influential in having a positive and negative effect on their adoption by healthcare practitioners in practice. Despite acceptable knowledge regarding the potential for infection and mechanisms to prevent these infections, this study has found out that health care workers are not as compliant with universal precautions as they need to be. The findings that compliance correlated directly with knowledge, with in-service training and with availability of protective equipment, provide important indications for future interventions. Therefore a regular on job refreshing training program on Universal Precautions, a written guideline and reminder poster on Universal Precautions and personal protective equipment need to be made available for all health care providers in every department of the hospital for better compliance. <span style="">&nbsp / </span><span style="">&nbsp / </span><span style="">&nbsp / </span><o:p></o:p></span></p> <p>&nbsp / </p>

<p>Background: Health care workers, more specifically, nursing students are at increased risk of occupational injury and exposure to blood borne pathogens. Compliance with universal precautions (UP) will minimise risk or transmission of HIV and HBV (Hepatitis B virus) according to the Department of Health of South Africa. Aim: The aim of this study was to investigate the knowledge and practice of universal precautions amongst nursing students and their fear of occupational exposure to blood borne pathogens. Rationale: The rationale for the study was to investigate what the students&rsquo / knowledge and practice of UP were, to see if this could be a possible contributing factor to occupational exposure. Research design: The study was a quantitative, cross sectional survey using a questionnaire that included one open ended question. Participants: The participants for the study were the undergraduate nursing students in year levels two to four (n = 253) who and were selected by means of stratified random sampling. Procedures: A questionnaire was administered to the participants by the researcher. Analysis of the data collected was done through statistical package for social sciences (SPSS 16.0) and content analysis. Results: The researcher established that there is indeed a lack of knowledge regarding UP and that the students&rsquo / self reported practice of UP is poor. No statistically significant correlation between knowledge and practice of UP were found. There is underreporting of occupational exposures to staff at the School of Nursing. The majority of students reported a moderate to severe fear for occupational exposures and contributing factors raised by them are reality in the clinical facilities.</p>

Syftet med denna litteraturstudie var att beskriva sjuksköterskestuderandes kunskaper om och följsamhet till basala hygienrutiner. Vidare var syftet att beskriva faktorer som bidrar till sjuksköterskestuderandes följsamhet respektive oföljsamhet avseende basala hygienrutiner. Metoden var en deskriptiv litteraturstudie. Artikelsökningen har skett via databaserna Medline via Pubmed och Cinahl, sökning har även skett manuellt. Huvudresultatet visade att sjuksköterskestudenter har generellt goda teoretiska kunskaper om vårdhygien och basala hygienrutiner. Dock finns faktorer som minskar följsamheten till vårdhygien och basala hygienrutiner. Sjusköterskestudenterna har få positiva förebilder som utför korrekta basala hygienrutiner. Hög arbetsbelastning och stress minskar utförandet av basala hygienrutiner. Ytterligare faktorer som bidrar till minskad följsamhet var studenternas vilja att bli accepterade som en i vårdlaget och rädslan att relationen mellan student och handledare försämras. Goda förebilder för sjuksköterskestudenterna kan öka följsamheten till basala hygienrutiner, samt lärarledda målinriktade utbildningar inom vårdhygien och basala hygienrutiner. Slutsatsen av studien är att sjuksköterskestudenter har generellt goda teoretiska kunskaper om vårdhygien och basala hygienrutiner, dock att följsamheten till detta inte alltid följs på grund av olika faktorer. Samt att det behövs mer utbildning om basala hygienrutiner för sjuksköterskestudenter. / The aim of this literature review was to describe nursing students’ knowledge about standard precautions and infection control. Furthermore the aim was to describe contributing factors to nursing student’s compliance and noncompliance to standard precautions and infection control. The chosen method for this study was a descriptive review. Scientific articles were searched in the databases Pubmed and Cinahl. Manual search was also conducted.  The main results of the study showed that nursing students generally have good theoretical knowledge about standard precautions and infection control. There are however factors that reduce the compliance to standard precautions and infection control. Nursing students have few positive role models that perform correct standard precautions. Heavy workload and stress reduce the performance of standard precautions. Additional factors that reduce the compliance are the students’ intentions to become accepted as members of the nursing team, and the fear of the relationship between the student and the mentor would deteriorate. Good role models and teacher-led targeted education interventions for the students can increase the compliance to standard precautions. The conclusion of this study is that nursing students’ generally have good theoretical knowledge about standard precautions and infection control, there are however factors that reduce the compliance. More educations about hygiene are necessary for nursing students.