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Reflexiones acerca del lavado de manos

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TLDR
A search in Latin American indexes with the words “hand washing” or “lavado de manos” yielded only four references, none devoted particularly to this issue as mentioned in this paper.
Abstract
SUMMARY Hand washing represents the easiest way to prevent nosocomial infection. Despite this fact, poor medical adherence to this practice has been the rule, never reaching more than 50 % of the evaluated personnel. It is mandatory to find ways to improve this inadequate health-personnel practice. In that sense, medical journals are the major channels to communicate and share experiences. A search in Latin American indexes with the words “hand washing” or “lavado de manos” yielded only four references, none devoted particularly to this issue. Many medical recommendations that come from the developed world are not applicable to our environment. However, hand-washing recommendations are among the few that are applicable worldwide. Hand-washing practice should be encouraged in all areas where patients are treated. RESUMEN El lavado de manos desempena un importante papel en la disminucion de las infecciones nosocomiales. Despues de revisar algunos indices se destaca la carencia de informacion en espanol sobre el tema, cuando que por su sencillez y aplicabilidad debiera ser motivo frecuente de publicacion para comunicar y compartir experiencias. En forma similar a lo encontrado en investigaciones internacionales, los escasos trabajos latinoamericanos al respecto demuestran que existe resistencia del personal de salud para llevar a cabo el lavado de manos, que debiera ser rutinario. Al evaluar esta practica, personal de salud de paises desarrollados no alcanzo 50 % de cumplimiento. En un servicio de urgencias del Sector Salud nacional, solo 12.1 % del personal de salud cumplio con ella. Por su facilidad, bajo costo y potencialidad para disminuir las infecciones nosocomiales, las recomendaciones acerca del lavado de manos formuladas en paises desarrollados son de las pocas practicas medicas que pueden ser emuladas en los paises en desarrollo.

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The role of understaffing in central venous catheter-associated bloodstream infections [see comments]

S. Fridkin, +1 more
Abstract: OBJECTIVE To determine risk factors for central venous catheter-associated bloodstream infections (CVC-BSI) during a protracted outbreak. DESIGN Case-control and cohort studies of surgical intensive care unit (SICU) patients. SETTING A university-affiliated Veterans Affairs medical center. PATIENTS Case-control study: all patients who developed a CVC-BSI during the outbreak period (January 1992 through September 1993) and randomly selected controls. Cohort study: all SICU patients during the study period (January 1991 through September 1993). MEASUREMENTS CVC-BSI or site infection rates, SICU patient clinical data, and average monthly SICU patient-to-nurse ratio. RESULTS When analyzed by hospital location and site, only CVC-BSI in the SICU had increased significantly in the outbreak period compared to the previous year (January 1991 through December 1991: pre-outbreak period). In SICU patients, CVC-BSI were associated with receipt of total parenteral nutrition [TPN]; odds ratio, 16; 95% confidence interval, 4 to 73). When we controlled for TPN use, CVC-BSI were associated with increasing severity of illness and days on assisted ventilation. SICU patients in the outbreak period had shorter SICU and hospital stays, were younger, and had similar mortality rates, but received more TPN compared with patients in the pre-outbreak period. Furthermore, the patient-to-nurse ratio significantly increased in the outbreak compared with the pre-outbreak period. When we controlled for TPN use, assisted ventilation, and the period of hospitalization, the patient-to-nurse ratio was an independent risk factor for CVC-BSI in SICU patients. CONCLUSIONS Nursing staff reductions below a critical level, during a period of increased TPN use, may have contributed to the increase in CVC-BSI in the SICU by making adequate catheter care difficult. During healthcare reforms and hospital downsizing, the effect of staffing reductions on patient outcome (i.e., nosocomial infection) needs to be critically assessed.
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PORTADORES ASINTOMÁTICOS DE Staphylococcus aureus EN TRABAJADORES DEL HOSPITAL REGIONAL DE ICA, PERÚ 2011

TL;DR: The prevalencia de portadores asintomaticos de Staphylococcus aureus in trabajadores del Hospital Regional de Ica, Colombia, was found to be 12,98% in total, 10,7% in manos and 5,3% in fosas nasales.
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TL;DR: Objective: to know patterns of antimicrobial resistance of bacterial isolates from tracheal aspirates in an Intensive Care Unit and to evaluate the cases of cases of resistance to antibiotics.

Calidad de la atención de enfermería en los servicios quirúrgicos del Hospital Clinicoquirúrgico Docente "Dr. Joaquín Castillo Duany" Quality of the nursing care in the surgical services of "Dr. Joaquín Castillo Duany" Teaching Clinical Surgical Hospital

TL;DR: An evaluative investigation of health systems and services was carried out in "Dr. Joaquin Castillo Duany" Teaching Clinical Surgical Hospital in Santiago de Cuba from January, 2011 to October, 2012, in order to evaluate the quality of nursing care in the surgical rooms of this institution, for which the patients admitted to these services during that period (97), and the nursing staff working at the moment of carrying out the study were considered as discussed by the authors.

Effectiveness of alcohol-based handrub vs handwashing with soap and water

TL;DR: The alcohol-based handrub was effective when calculated before and handrubbing when compared with the technique handwashing with soap and water, and the technique of handwashing was not effective.
References
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Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force.

TL;DR: The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis and provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health- Care settings.
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Guideline for Hand Hygiene in Health-Care Settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force.

TL;DR: The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health care settings.
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Improving compliance with hand hygiene in hospitals.

TL;DR: In this article, the authors present a framework that includes parameters to be considered for hand-hygiene promotion in hospitals based on epidemiologically driven evidence and review of the current knowledge.
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Comparative Efficacy of Alternative Hand-Washing Agents in Reducing Nosocomial Infections in Intensive Care Units

TL;DR: A prospective multiple-crossover trial involving 1894 adult patients in three intensive care units involving either chlorhexidine, a broad-spectrum antimicrobial agent, or 60 percent isopropyl alcohol with the optional use of a nonmedicated soap to prevent nosocomial infections.
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Hands as route of transmission for Klebsiella species.

Mark Casewell, +1 more
- 19 Nov 1977 - 
TL;DR: Handwashing with chlorhexidine hand cleanser reliably gave 98-100% reduction in hand counts, and the introduction of routine handwashing by staff before moving from one patient to the next was associated with a significant and sustained reduction in the number of patients colonised or infected with Klebsiellae.