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Objective Guidelines recommend that the cleaning area in a Central Sterile Supply Department (CSSD) maintain a negative pressure of the environmental air, but how much this system can impact the contamination of the air by bioaerosols in the area is not known. The objective of this study was to assess the impact of negative pressure on CSSD by evaluating the microbiological air quality of this sector. Methods Microbiological air samples were collected in two CSSD in the same hospital: one with and one without a negative air pressure system. Outdoor air samples were collected as a comparative control. Andersen six‐stage air sampler was used to obtain the microbiological air samples. Results The concentration of bioaerosols in the CSSD without negative pressure was 273.15 and 206.71 CFU/m3, while in the CSSD with negative pressure the concentration of bioaerosols was 116.96 CFU/m3 and 131.10 CFU/m3. The number of isolated colonies in the negative pressure CSSD was significantly lower (P = .01541). Conclusion The findings showed that the negative pressure system in the CSSD cleaning area contributed to the quantitative reduction in bioaerosols. However, the concentration of bioaerosols was lower than that established in the guideline for indoor air quality of many countries. Therefore, it cannot be concluded that CSSDs which do not have a negative pressure system in their cleaning area offer occupational risk.

A systematic review of seven studies on infections related to contaminated ultrasound probes showed that the infections were related to a failure in the decontamination process of ultrasound devices used on immature skin of neonates in an intensive care unit and transesophageal echocardiography probes. Six of the studies involved outbreaks in patients who underwent transesophageal echocardiography either during or after surgery or as a part of treatment for a nonsurgical cardiac condition. The evidence shows links between the infection outbreaks and environmental contamination, lack of standardized ultrasound probe disinfection processes, inadequate storage, and lack of monitoring of probe integrity. When personnel addressed the deficiencies (eg, improving the disinfection process, cleaning the probes immediately after use, inspecting the probes for defects), the infections ceased. Personnel involved with the reprocessing of ultrasound probes should clean, disinfect, inspect, and store ultrasound probes in a manner that maintains device integrity and prevents contamination.

This study aimed to compare the antimicrobial action of three soaps for hand hygiene (HH): 2.0% Tea Tree Oil (TTO); 0.5% triclosan; 2.0% chlorhexidine, and to explore the perception of healthcare professionals about TTO. Two-step study: a quantitative, to determine the logarithmic reduction of Escherichia coli K12 colony-forming units before and after HH of 15 volunteers and quali-quantitative, through interviews with 23 health professionals. All the three products demonstrated antimicrobial action (a log10 reduction factor of 4.18 for TTO, 4.31 for triclosan, 3.89 for chlorhexidine, and 3.17 for reference soap). Professionals remarked the pleasant aroma and non-dryness of skin when using soap containing TTO.

To determine if the standardized B&D type test for hospital steam sterilizer is correctly indicating cycle failures in slower come-up ramps cycles. Two commercially available B&D type test were challenged in a quality control sterilizer. A common failure was simulated in triplicate cycles, using a standardized cycle configuration, and then compared to triplicate cycles of a common cycle configuration. Tests procedures were conducted according to B&D manufacturer test standard and results were compared to standardized endpoint specifications. We found that B&D type tests are only capable of detecting the presence of non-condensable gases if the sterilization equipment is adjusted to meet all the cycle requirements of the test. False positive results were obtained with come-up ramp time of 3 min. Correct results were only obtained with come-up ramp of 1.7-1.9 min. Until the ISO 17665 and AAMI ST-79 standards are revised, equipment qualification experts should observe come-up time duration criterion for B&D type test cycles according to ISO 11140-4. Sterile Processing Department professionals must add the come-up ramp criterion to cycle evaluation before clearing the equipment for routine use. This will allow B&D correct performance, reducing the infection risk from unsterilized medical device.

Another study assessed whether HFNO or continuous positive airway pressure was associated with increased levels of viral RNA in air samples compared to standard oxygen therapy.9 Only 30% participants had at least 1 positive or suspected positive result and they showed that Ct values were much higher than a paired nasopharyngeal sample. [...]we did not sample surfaces as another surrogate of environmental spread, although fomites are likely not the main transmission route. [...]air samples were collected mainly from patients in the second week of disease and may have been less infective; nevertheless, this timing is representative of patients with the timing of respiratory failure onset and potential need for NIRS.

ABSTRACT Objective: To construct and validate an instrument to assess events related to maintaining the sterility of processed healthcare products. Methods: This methodological study developed the instrument through analysis by a panel of experts, focusing on the integrity of commonly used packaging: spunbond-meltblown-spunbond and medical-grade paper. The instrument was analyzed using the Content Validity Index and Content Validity Ratio (≥ 0.80) and modified Kappa (≥ 0.74). The instrument underwent pre-testing. Results: Six experienced professionals participated in the expert panel. After two rounds, the final version of the instrument contained five dimensions. In the pre-test, 30 nursing professionals participated, of whom 86.67% considered the instrument good, and 90% found it understandable. Conclusion: The construction and validation followed literature recommendations. The instrument is available, aiding in the safe use of processed healthcare products. RESUMEN Objetivo: Construir y validar instrumento para evaluar evento relacionado a manutención de la esterilidad de productos para salud procesados. Métodos: Estudio metodológico para desarrollar instrumento mediante análisis por comité de jueces. Considerado como aspecto rector la integridad de envases más utilizados en la práctica: de no tejido y de papel grado quírurgico. Realizado análisis por Índice de Validez de Contenido y Razón de Validez de Contenido ≥ 0,80 y Kappa modificado ≥ 0,74. Sometido el instrumento a pre-prueba. Resultados: Participaron del comité de jueces seis profesionales experientes en la temática. Trás dos rondas, fue constituída la versión final del instrumento, conteniendo cinco dimensiones. En la pre-prueba, participaron 30 profesionales de enfermería, en que 86,67% consideraron el instrumento bueno; y 90%, comprensible. Conclusion: La construcción y validación siguió las recomendaciones de la literatura. El instrumento está disponible para ser utilizado, auxiliando el uso seguro del producto para salud. RESUMO Objetivo: Construir e validar instrumento para avaliar evento relacionado à manutenção da esterilidade de produtos para saúde processados. Métodos: Estudo metodológico para desenvolver instrumento mediante análise por comitê de juízes. Considerou-se como aspecto norteador a integridade das embalagens mais utilizadas na prática: a de não tecido e a de papel grau cirúrgico. A análise foi realizada pelo Índice de Validade de Conteúdo, Razão de Validade de Conteúdo ≥ 0,80 e Kappa modificado ≥ 0,74. Submeteu-se o instrumento ao pré-teste. Resultados: Participaram do comitê de juízes seis profissionais experientes na temática. Após duas rodadas, chegou-se à versão final do instrumento, contendo cinco dimensões. No pré-teste, participaram 30 profissionais de enfermagem, dos quais 86,67% consideraram o instrumento bom; e 90%, compreensível. Conclusões: A construção e validação seguiu as recomendações da literatura. O instrumento está disponível para ser utilizado, auxiliando no uso seguro do produto para saúde.

Objective: to compare the efficacy of 80% (w/v) alcohol, rubbed for 30 and 60 seconds, in the manual processing of stainless-steel wash bowls, after cleaning with running water and neutral detergent. Method: experimental study conducted in a hospital in the state of São Paulo, Brazil, on 50 bowls randomly divided into two groups of 25 bowls each for interventions of 30 and 60 seconds of rubbing with 80% (w/v) alcohol. Results: based on the microbiological analyses collected, before and after the interventions for both groups, partial efficacy of the disinfectant was observed even when extending rubbing time. In both groups, there was a higher prevalence of survival of Pseudomonas aeruginosa, with 14 strains that were resistant to carbapenems, being, specifically, 11 to imipenem and three to meropenem. Conclusion: stainless-steel bed wash bowls decontaminated for reuse by 80% (w/v) alcohol, after cleaning with running water and neutral detergent, showed to be reservoirs of hospital pathogens. The use of bed wash bowls for patients with intact skin would not have worrying consequences, but considering those with non-intact skin and the contamination of professionals’ hands, the results in this study justify the search for other decontamination methods or the adoption of disposable bed baths. Objetivo: comparar a eficácia do álcool 80% (p/v), friccionado por 30 e 60 segundos, no processamento manual de bacias de banho em aço inoxidável, após limpeza com água corrente e detergente neutro. Método: estudo experimental realizado em hospital do estado de São Paulo, Brasil, com 50 bacias randomicamente distribuídas em dois grupos de 25, para as intervenções de 30 e 60 segundos de fricção com álcool 80% (p/v). Resultados: das análises microbiológicas coletadas, antes e após as intervenções para os dois grupos, verificou-se eficácia parcial do desinfetante, mesmo ampliando o tempo de fricção. Em ambos os grupos, observou-se maior prevalência de sobrevida de Pseudomonas aeruginosa, 14 cepas resistentes a carbapenens, especificamente, 11 ao imipenen e três ao meropenen. Conclusão: bacias de banho no leito em aço inoxidável, descontaminadas para reuso com álcool 80% (p/v), após limpeza com água corrente e detergente neutro, apresentam-se como reservatórios de patógenos hospitalares. O uso das bacias de banho no leito para pacientes com pele íntegra não teria consequências preocupantes, mas para aqueles com pele não íntegra e pensando na contaminação das mãos dos profissionais, os resultados dessa pesquisa justificam a busca de outros métodos de descontaminação ou a adoção de banho de leito descartável. Objetivo: comparar la eficacia del alcohol al 80% (p/v), frotado durante 30 y 60 segundos, en el proceso de descontaminación manual de palanganas de baño de acero inoxidable, después de lavarlas con agua corriente y detergente neutro. Método: estudio experimental realizado en un hospital del estado de São Paulo, Brasil, con 50 palanganas divididas aleatoriamente en dos grupos de 25, para intervenciones de 30 y 60 segundos de frotamiento con alcohol al 80% (p/v). Resultados: los análisis microbiológicos recolectados, antes y después de las intervenciones para ambos grupos, demostraron efectividad parcial del desinfectante, incluso cuando se extendió el tiempo de fricción. En ambos grupos, se observó una mayor prevalencia de supervivencia de Pseudomonas aeruginosa, 14 cepas resistentes a carbapenemas, específicamente 11 a imipenem y tres a meropenem. Conclusión: las palanganas de baño de cama de acero inoxidable, descontaminadas para su reutilización con alcohol al 80% (p/v), después del lavado con agua corriente y detergente neutro, actúan como reservorios de patógenos hospitalarios. El uso de las palanganas de baño de cama no tendría consecuencias preocupantes para pacientes con la piel íntegra, pero para aquellos cuya piel no conserva su integridad y pensando en la contaminación de las manos de los profesionales, los resultados de esta investigación justifican la búsqueda de otros métodos de descontaminación o la adopción del baño de cama desechable.

Cleaning cannulated medical devices can be challenging for perioperative and sterile processing department personnel. We performed a laboratory experimental study to evaluate differences in cleaning effectiveness using either a back-and-forth or helical spinning brushing motion and the effect of rinsing the bristles at each reintroduction of the brush in the lumen. We also tested the lumen cleanliness after high-pressure water cleansing without brushing. We inspected the devices to determine whether visible soil remained, and we measured the amount of residual organic matter using adenosine triphosphate testing to determine cleaning method effectiveness. The results showed that rinsing the brush during cleaning decreased the amount of organic material that remained in the lumen. A helical spinning motion with brush rinsing at each reintroduction of the brush may be more effective than back-and-forth brushing with rinsing, but additional testing with a larger sample size is required to determine whether this result is replicable.

Aerosolization may occur during reprocessing of medical devices. With the current coronavirus disease 2019 pandemic, it is important to understand the necessity of using respirators in the cleaning area of the sterile processing department. To evaluate the presence of severe acute respiratory syndrome coronavirus (SARS-CoV-2) in the air of the sterile processing department during the reprocessing of contaminated medical devices. Air and surface samples were collected from the sterile processing department of two teaching tertiary hospitals during the reprocessing of respiratory equipment used in patients diagnosed with coronavirus disease 2019 and from intensive care units during treatment of these patients. SARS-CoV-2 was detected only in 1 air sample before the beginning of decontamination process. Viable severe acute respiratory syndrome coronavirus 2 RNA was not detected in any sample collected from around symptomatic patients or in sterile processing department samples. The cleaning of respiratory equipment does not cause aerosolization of SARS-CoV-2. We believe that the use of medical masks is sufficient while reprocessing medical devices during the coronavirus disease 2019 pandemic.