OBJECTIVE: to assess the efficiency of cleaning/disinfection of surfaces of an Intensive Care Unit. METHOD: descriptive-exploratory study with quantitative approach conducted over the course of four weeks. Visual inspection, bioluminescence adenosine triphosphate and microbiological indicators were used to indicate cleanliness/disinfection. Five surfaces (bed rails, bedside tables, infusion pumps, nurses' counter, and medical prescription table) were assessed before and after the use of rubbing alcohol at 70% (w/v), totaling 160 samples for each method. Non-parametric tests were used considering statistically significant differences at p<0.05. RESULTS: after the cleaning/disinfection process, 87.5, 79.4 and 87.5% of the surfaces were considered clean using the visual inspection, bioluminescence adenosine triphosphate and microbiological analyses, respectively. A statistically significant decrease was observed in the disapproval rates after the cleaning process considering the three assessment methods; the visual inspection was the least reliable. CONCLUSION: the cleaning/disinfection method was efficient in reducing microbial load and organic matter of surfaces, however, these findings require further study to clarify aspects related to the efficiency of friction, its frequency, and whether or not there is association with other inputs to achieve improved results of the cleaning/disinfection process.

Background Cleaning and disinfection processes must be improved so that there is a reduction in environmental contamination of frequent-contact surfaces. The objective of this study was to evaluate cleaning and disinfection of surfaces at a specialized healthcare unit after an intervention program. Methods Exploratory, longitudinal, and correlational study carried out in a medium-complexity clinic. Two hundred and forty samples from five surfaces were collected during three phases: diagnosis; implementation of an intervention program; and evaluation of immediate and long-term effects. In total, 720 evaluations were made, performed through three monitoring methods: visual inspection; adenosine triphosphate bioluminescence assay (ATP); and aerobic colony count (ACC). The Wilcoxon, Mann-Whitney, and Fisher’s Exact tests were run to analyze data statistically. Results Cleaning and disinfection of surfaces were not being performed properly in most cases. Failure rates of surfaces reached 37.5 and 100% when the ATP and ACC procedures were used, respectively. However, after an intervention program, an improvement occurred. Success rates increased by 43.96% (ATP) and 12.46% (ACC) in phase I, by 70.6% (ATP) and 82.3% (ACC) immediately after interventions, and by 76.52% (ATP) and 85.76% (ACC) two months after the changes, showing that the program was effective. Conclusion The present study reveals that implementing intervention actions with a cleaning and healthcare team brings benefits to prevent the spread of pathogenic agents through frequently touched hospital surfaces.

RESUMO Objetivo: avaliar o efeito de intervenções educativasna limpeza e desinfecção de superfícies em uma unidade básica de saúde. Métodos: trata-se de um estudo prospectivo, analítico com abordagem quantitativa. O estudo foi realizado em uma unidade básica de saúde, onde atuam duas equipes da Estratégia de Saúde da Família. Optou-se por avaliar a limpeza e desinfecção das superfícies: carrinho de curativo, balcão da recepção, mesa ginecológica, maca do paciente e mesa de consulta de enfermagem, utilizando-se dos métodos de monitoramento: avaliação visual, contagem de unidades formadoras de colônias e mensuração de adenosina trifosfato. Utilizaram-se, para a análise estatística, o teste de postos de Wilcoxon e o teste de Mann-Whitney, considerou-se nível de significância de 5% ou (p<0,05). Resultados: obteve-se um total de 720 avaliações realizadas ao término de todas as fases. Observou-se na fase I uma taxa de reprovação de 57,5%, 20,0% e 90,0%; após a intervenção educativa, os quantitativos de reprovação em curto prazo diminuíram para 0,0%, 2,5,0% e 50,0% (dados da fase III) e, em longo prazo, para 5,0%, 0,0% e 65% (dados da fase IV) para os métodos visual, adenosina trifosfato e cultura, respectivamente. A inspeção visual foi o método que apresentou maior frequência de superfícies reprovadas nas fases I e IV. Conclusão: houve redução da carga microbiana e valores das leituras de adenosina trifosfato; embora essa redução não tenha sido estatisticamente significativa em todas as superfícies. Constatou-se que a intervenção educativa foi eficiente.

RESUMO ABSTRACTObjective: to analyze the relationship with health professionals working in the treatment of tuberculosis in centralized and decentralized health services, from the patients' perspective. Method: evaluative study, in which we interviewed 89 patients using the Primary Care Assessment Tool, validated in Brazil and adapted for assistance in TB. The data satisfied our assumptions of independence, homoscedasticity and normality and were subjected to variance analysis; the others, to the Kruskal-Wallis test. Results: most participants (46, that is 51.7%) were between 30 to 49 years old and 53 had incomplete primary education (59.6%). The nurse was the professional most required by users (46, that is, 53.1%); As for the indicator time for the user to ask questions and concerns, it was evaluated as regular in the centralized (mean 3.84, SD: 1.61) and decentralized (mean 3.80, SD: 1.73) services. Conclusion: it is necessary to improve the relationship between professionals and patients. Descriptors: Tuberculosis; Health services research; Professional-patient relationship; Nursing. RESUMENObjetivo: analizar, desde la perspectiva de los usuarios, el vínculo con los profesionales de la salud que trabajan en el tratamiento de la tuberculosis en servicios centralizados y descentralizados de salud. Método: estudio evaluativo, que entrevistó a 89 pacientes utilizando Primary Care Assessment Tool, validado y adaptado para la asistencia en la tuberculosis. Los datos que satisficieron las hipótesis de independencia, homocedasticidad y normalidad se sometieron a análisis de varianza; los otros a la prueba de Kruskal-Wallis. Resultados: la mayoría de los participantes (46, equivalentes al 51,7%) tenía entre 30 y 49 años y 53 con educación primaria incompleta (59,6%). El enfermero es el profesional más buscado por los usuarios (46 o sea 53,1%); En cuanto al indicador tiempo para que el usuario se saque dudas y preocupaciones, se obtuvo la evaluación de regular en los servicios centralizados (media de 3,84, desvío estándar: 1.61) y descentralizados (media de 3,80, desvío estándar: 1.73). Conclusión: hay necesidad de ampliar el vínculo entre los profesionales y los pacientes. Descriptores: Tuberculosis; Investigación en servicios de salud; Relaciones profesional-paciente; Enfermería.

Objective: To evaluate the correlation between microbiological culture, ATP tests by bioluminescence and visual inspection for monitoring the surface cleaning and disinfection in an emergency room. Methods: This is a prospective, analytical study with a quantitative approach. Data analysis was guided by the following tests: Spearman’s correlation, Fisher ‘s exact test and receiver operating characteristic (ROC) curve. Results: There was a correlation between ATP quantification methods and microbial count for the women’s bathroom door handle (ρ = 0.526; p= 0.008). In this study, considering the ROC curve, the ATP value below 20 RLU is suggested to classify surfaces as approved in the emergency room. Conclusion: Using different methods of monitoring the cleaning and disinfection process is essential, considering that each method has a different purpose.