Justificativa e Objetivos: apesar da importância dos acompanhantes/visitantes para pacientes hospitalizados em precauções específicas, nota-se que os riscos de exposição e disseminação de ...microrganismos nos serviços de saúde por essa população ainda são incipientes na literatura. Dessa forma, objetivou-se caracterizar as recomendações vigentes sobre precauções específicas para acompanhantes e visitantes de pacientes hospitalizados e analisar as barreiras para a sua implementação sob a ótica de prevencionistas de infecção. Métodos: estudo descritivo e exploratório, de abordagem quantitativa, com 89 prevencionistas de infecção, entre março e junho de 2020. Dados coletados por questionário eletrônico, com amostragem tipo “bola de neve” e analisados segundo frequência das respostas. Resultados: a higienização das mãos foi a recomendação mais indicada (>95,0%). Quanto às não conformidades, destacou-se permanecer no quarto sem paramentação (78,6%), frequentar outros quartos (53,9%) e manter portas abertas em precaução para aerossóis (51,7%). Referente às estratégias adotadas para a orientar os acompanhantes/visitantes, houve predomínio da orientação verbal individual (92,4%). A principal barreira citada foi a falta de política institucional (56,2%). Conclusão: não houve uniformidade nas recomendações, e não conformidades e barreiras foram elencadas. Destaca-se a importância de diretrizes de prevenção específicas para esse público e estratégias educativas efetivas para sua implementação.
Objetivo: validar cenários clínicos para o ensino baseado em simulação sobre prevenção e controle de infecções relacionadas à assistência à saúde. Métodos: estudo metodológico de elaboração, ...validação de conteúdo de dois cenários clínicos simulados e avaliação do design da simulação. Especialistas (n=10) analisaram abrangência, clareza e pertinência dos cenários, e 44 graduandos de enfermagem avaliaram o design, utilizando a Escala do Design da Simulação. Para análise utilizou-se procedimentos de estatística descritiva, Índice de Validade de Conteúdo e Razão de Validade de Conteúdo. Resultados: os itens do cenário apresentaram índice de validade de conteúdo ≥ 0,8 e razão de validade de conteúdo predominantemente ≥ 0,8. A escala apresentou média de 4,7±0,2, indicando adequação dos cenários pelos participantes da simulação. Conclusão: a validação permitiu alcance de adequada qualidade dos cenários propostos, os quais podem ser amplamente utilizados para o ensino de medidas de prevenção e controle de infecção.
Mutations in genes coding for proteasome subunits and/or proteasome assembly helpers typically cause recurring autoinflammation referred to as chronic atypical neutrophilic dermatosis with ...lipodystrophy and elevated temperatures (CANDLE) or proteasome-associated autoinflammatory syndrome (PRAAS). Patients with CANDLE/PRAAS present with mostly chronically elevated type I interferon scores that emerge as a consequence of increased proteotoxic stress by mechanisms that are not fully understood. Here, we report on five unrelated patients with CANDLE/PRAAS carrying novel inherited proteasome missense and/or nonsense variants. Four patients were compound heterozygous for novel pathogenic variants in the known CANDLE/PRAAS associated genes,
PSMB8
and
PSMB10
, whereas one patient showed additive loss-of-function mutations in
PSMB8
. Variants in two previously not associated proteasome genes,
PSMA5
and
PSMC5
, were found in a patient who also carried the
PSMB8
founder mutation, p.T75M. All newly identified mutations substantially impact the steady-state expression of the affected proteasome subunits and/or their incorporation into mature 26S proteasomes. Our observations expand the spectrum of PRAAS-associated genetic variants and improve a molecular diagnosis and genetic counseling of patients with sterile autoinflammation.
•Effective communication in transmission-based precautions can avoid adverse events.•Study showed that the effective communication is a concept not always understood.•Lessons learned allowed us to ...propose suggestions for future implementations.•When planning implementation, consider political-economic status of institution.•Identify whether intervention fits the organization's culture in terms of demands.
Patient engagement with transmission-based precautions can be an important strategy to prevent adverse events related to isolation. Most patient education is still highly prescriptive and is thus unlikely to help. Effective communication requires behavior change, leading to a meaningful dialog between the parties involved.
evaluate implementation process of a protocol for effective communication with patients in transmission-based precautions (Com-Efe).
Implementation research using qualitative methods in 4 sequential phases: (1) nonparticipant observation in inpatient wards; (2) design of the intervention for implementation; (3) adaptation of the Com-Efe through workshops with nurses; (4) final assessment of the implementation results through interviews with nurses. Study was performed in a public, secondary, teaching hospital. Consolidated Framework for Implementation Research was used as the reference for interview design and data analysis, aiming to identify barriers and enablers of the implementation process.
Main factors that could have facilitated adherence were beliefs and perceived advantages in using the Com-Efe by nurses. Main barriers that may have contributed to the failure were the unfavorable climate for implementation, insufficient individual and leadership commitment, and the lack of understanding of the concepts underpinning effective communication.
Despite using a systematic approach, the Com-Efe protocol was not fully implemented. The lessons learned in this study allowed us to propose suggestions for future protocol implementations in similar contexts.
Background
Infection prevention competencies are critical for successful job performance, career progression and robust performance of infection prevention and control programs.
Aim/objective
...Identify competency assessment tools available to infection preventionists and describe their characteristics, validation processes and reliability.
Methods
A scoping review was conducted on five databases and grey literature from 1999 to 2022. A descriptive synthesis approach was undertaken to analyse the data.
Finding/results
Seven tools that meet the inclusion criteria were identified. Of those, one tool was reviewed twice. All tools were developed in the United Kingdom, Canada, China and the United States, and were published between 2009 and 2022. All tools use a rating scale; and the most used method to assess competencies was self-assessment. Levels of competency were cited by five tools. Two tools provided information on validation methods and reliability tests for internal consistency.
Discussion
Few competency assessment tools are available in the literature, and there is a lack of information on their development process. A global effort to develop an assessment tool that allows comparison across countries and cultures can be a step forward to propel infection preventionists’ careers and enhance the efficacy of Infection Prevention and Control Programs.
RESUMO Objetivo: desenvolver e avaliar um curso online utilizando WebQuests sobre gerenciamento de antimicrobianos para graduandos em enfermagem, baseado em consenso internacional. Método: pesquisa ...metodológica para o desenvolvimento e a validação de estratégia educativa, e pesquisa quantitativa e descritiva, para se avaliar sua praticabilidade, realizada no período de março de 2021 a abril de 2022. Após o desenvolvimento, houve a validação de aparência e conteúdo do material por juízes, adotando-se o índice de validade de conteúdo superior a 0,80 para cada item. As quatro WebQuests validadas foram disponibilizadas em formato de curso no Portal de Cursos Abertos da Universidade Federal de São Carlos. Foi elaborado um instrumento em formato eletrônico para avaliar a praticabilidade da estratégia educativa segundo a visão de 73 graduandos em enfermagem. Os resultados foram armazenados em planilhas Excel e analisados por meio de estatística descritiva. Resultados: a estratégia educativa foi validada por 10 juízes especialistas, com índice de validade de conteúdo total maior de 0,90 para aparência e conteúdo. Quanto à praticabilidade, avaliada por 73 graduandos de enfermagem, foi considerada de fácil entendimento e realização, sendo que os participantes manifestaram interesse em utilizar este tipo de estratégia educativa. Conclusão: o curso desenvolvido, validado e avaliado é uma ferramenta útil e está disponível gratuitamente para contribuir com a formação de futuros enfermeiros na temática do gerenciamento de antimicrobianos.
ABSTRACT Objective: to develop and evaluate an online course using WebQuests on antimicrobial stewardship for nursing students, based on international consensus. Method: this is a methodological study to develop and validate an educational strategy, as well as quantitative and descriptive to evaluate its practicability. The study was conducted from March 2021 to April 2022. After development, there was validation of the appearance and content of the material by judges, adopting a content validity index greater than 0.80 for each item. The four validated WebQuests were made available in course format on the Open Courses Portal of the Federal University of São Carlos. An instrument was developed in electronic format to evaluate the practicality of the educational strategy according to the views of 73 nursing students. The results were stored in Excel spreadsheets and analyzed using descriptive statistics. Results: the educational strategy was validated by 10 expert judges, with a total content validity index greater than 0.90 for appearance and content. Its practicality was evaluated by 73 nursing students, and it was considered easy to understand and implement, with participants expressing interest in using this type of educational strategy. Conclusion: the developed, validated and evaluated course is a useful tool and is available free of charge to contribute to the training of future nurses on the topic of antimicrobial stewardship.
RESUMEN Objetivo: desarrollar y evaluar un curso en línea mediante WebQuests sobre manejo de antimicrobianos para estudiantes de enfermería, basado en consenso internacional. Método: investigación metodológica para el desarrollo y validación de una estrategia educativa, e investigación cuantitativa y descriptiva, para evaluar su viabilidad, realizada de marzo de 2021 a abril de 2022. Luego del desarrollo, se realizó la validación de la apariencia y contenido del material por parte de jueces, adoptando un índice de validez de contenido superior a 0,80 para cada ítem. Las cuatro WebQuests validadas estuvieron disponibles en formato curso en el Portal de Cursos Abiertos de la Universidad Federal de São Carlos. Se desarrolló un instrumento en formato electrónico para evaluar la practicidad de la estrategia educativa según la visión de 73 estudiantes de enfermería. Los resultados se almacenaron en hojas de cálculo de Excel y se analizaron mediante estadística descriptiva. Resultados: la estrategia educativa fue validada por 10 jueces expertos, con un índice de validez de contenido total mayor a 0,90 para apariencia y contenido. En cuanto a la practicidad, evaluada por 73 estudiantes de enfermería, se consideró de fácil comprensión y realización, manifestando los participantes interés en utilizar este tipo de estrategia educativa. Conclusión: el curso desarrollado, validado y evaluado es una herramienta útil y está disponible de forma gratuita para contribuir a la formación de futuros enfermeros en el tema de manejo antimicrobiano.
This study reports the development of conjugates based on quantum dots (QD)s and lectins from Schinus terebinthifolia leaves (SteLL) and Punica granatum sarcotesta (PgTeL). Cryptococcus neoformans ...cells were chosen to evaluate the efficiency of the conjugates. Lectins were conjugated to QDs via adsorption, and the optical parameters (emission and absorption) were monitored. Lectin stability in the conjugates towards denaturing agents was investigated via fluorometry. The conjugation was evaluated using fluorescence microplate (FMA) and hemagglutination (HA) assays. The labeling of the C. neoformans cell surface was quantified using flow cytometry and observed via fluorescence microscopy. The QDs-SteLL and QDs-PgTeL conjugates, obtained at pH 7.0 and 8.0, respectively, showed the maintenance of colloidal and optical properties. FMA confirmed the conjugation, and the HA assay indicated that the lectin carbohydrate-binding ability was preserved after conjugation. SteLL and PgTeL showed stability towards high urea concentrations and heating. Conjugates labeled over 90% of C. neoformans cells as observed via flow cytometry and confirmed through fluorescence microscopy. C. neoformans labeling by conjugates was inhibited by glycoproteins, suggesting specific interactions through the lectin carbohydrate-binding site. Thus, an effective protocol for the conjugation of SteLL or PgTeL with QDs was proposed, yielding new nanoprobes useful for glycobiological studies.
Reflect on the implications of COVID-19 for the nursing care of pediatric oncology patients.
Theoretical and reflective essay, based on recent scientific publications and expert recommendations on ...the care of pediatric patients under cancer treatment in the context of the current pandemic.
Reflected on the involvement of the pediatric population in general by COVID-19, the vulnerability of pediatric oncology patients to the complications of the disease and the likely challenges for their care. The pandemic demanded a rapid adaptation of health services in terms of patient care flow, care protocols, infection prevention measures, and redefinition of cancer therapy, with repercussions for professionals, patients, and their families.
It is not yet known how often or how severely children with cancer have been affected by COVID-19, but therapeutic and care adaptations for the maintenance of these patients' treatment in the pandemic context are noted.
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