Collecting uncontaminated urine specimens from infants is difficult. Commonly, an adhesive urinecollecting bag is used, which is uncomfortable. This study determined bacterial contamination rates using three methods of urine collection sequentially on the same infant (without known urinary tract infection)-clean-catch, cotton wool (sanitary) pad and urine bag. The study was undertaken in children under 3 years of age in the Institute of Maternal and Child Health of Pernambuco (IMIP), Recife, Brazil. Urine samples were analysed using phase contrast microscopy and routine culture. Culture of bacteria at any level was interpreted as a contaminated urine specimen. Cultures with > 10(5) colony-forming units/ml of one species by all three collection methods were regarded as true urinary tract infection and these children were excluded. Altogether, 534 urine samples from 191 patients were analysed. Median age was 2 months (1 day-36 months) and 124 (65%) were boys. Twelve children (6.3%) were considered to have true urinary tract infection, three were indeterminate and in 16 one or more samples were missing and all were excluded from analysis. There were more missing samples using the clean-catch method (12%) than when using the bag (4%) or pad (4%). Seventy-six of 160 (47.5%) children had evidence of bacterial contamination. Clean-catch specimens showed the least contamination (14.7%) and rates were similar between pads (29%) and bags (26.6%) (kappa = 0.40). Urine contamination rates were similar for sanitary pads and urine bags and significantly higher than for clean-catch (p<0.01). However, pads were a simple, non-invasive and comfortable alternative to bags.

doi: 10.5216/ree.v12i4.6585 A organização de serviços de urgência/emergência propicia elementos para assistência qualificada integral e contínua aos usuários. Trata-se de revisão integrativa de literatura com objetivo de sintetizar produção científica latino americana sobre organização dos serviços de urgência/emergência hospitalar no período de 1988 a março de 2010. Os dados foram coletados em base eletrônica (LILACS) e registrados em instrumento específico. A amostra totalizou 41 publicações. Os artigos foram agrupados por similaridade de conteúdo: aspectos estruturais do sistema de saúde, 12 artigos (29,3%), aspectos estruturais hospitalares, 10 artigos (24,4%) e qualidade da assistência, 19 artigos (46,3%). O crescimento do número de acidentes,  violência urbana e  insuficiente estruturação da rede de serviços de saúde são fatores que têm contribuído decisivamente para a sobrecarga dos serviços de urgência/emergência. O conhecimento desta realidade é de importância fundamental, no sentido de valorizar as necessidades de reestruturação do atual sistema de saúde, na perspectiva de consolidação dos princípios do SUS. Descritores: Serviços Médicos de Emergência; Organização e Administração; Enfermagem.

Demand for the Emergency Department (ED) has increased, making the organization of work difficult. This quantitative, descriptive and documental study identifies and analyzes the characteristics of clinical care in the ED of a General Hospital in Ribeirão Preto, SP, in 2007, according to organizational variables. The study population included all clinical care consultations registered in the Hospital Management Information System. Data were analyzed through descriptive statistics and discussed considering the theoretical framework of the Single Health System (SUS). A total of 5,285 consultations were registered in the period, which were more frequent in patients from the city itself, in January (10%), on Mondays (16%), from 12pm to 12am (67.1%). The main reason for discharge from the unit was hospitalization (63.8%) and the predominant length of stay in the unit was less than six hours (39.8%). The results support the management of human resources, materials and equipment, indicating the desirability of reorganizing emergency care in the hospital.

To evaluate the incorporation of the technologies of the Windows Project by health professionals. Methods: This is an evaluation research with triangulation methods using the four levels of evaluation of Kirkpatrick. The subjects of study were physicians and nurses of the Basic Units of the Western Region Health Project. Results: Three Teams incorporated the technology, nine partially incorporated and six non-incorporated the technology. Three nurses and two physicians incorporated the technology, nine nurses and five physicians incorporated partially-five nurses and two physicians failed to incorporate the technology. Five categories of behavior change and four dimensions related to the incorporation of technology were identified. Conclusions: The incorporation of the Technologies of the Windows Project proved to be closely related to the process of continuing education. The professional work routine analysis provides clues about the technologies already in use by the teams and the needs of incorporating a new technology

Keywords: Urinary catheterization and nursing careIntrodução A infecção relacionada a assistência à saúde (IRAS) é qualquer processo infeccioso adquirido pelo paciente após sua admissão nos serviços de saúde, podendo se manifestar durante a internação ou após a alta, desde que esteja associada a internação ou procedimentos. Também são consideradas IRAS aquelas infecções que se manifestam antes de 72 horas de internação e podem ser relacionadas com a realização de procedimentos diagnósticos e/ou terapêuticos, realizado durante este período (1) . Estudo realizado nos Estados Unidos identificou as infecções mais frequentes em uma unidade de terapia intensiva, a primeira foi a pneumonia, seguida por infecção do trato urinário (ITU) e infecção de corrente sanguínea, estas últimas relacionadas diretamente a manipulação de cateter vesical e de punção periférica respectivamente (2) .