Comparison of fungal contamination between hospitals and companies food units

A descriptive study was developed to compare air and surfaces fungal contamination in ten hospitals’ food units and two food units from companies. Fifty air samples of 250 litres through impaction method were collected from hospitals’ food units and 41 swab samples from surfaces were also collected, using a 10 by 10 cm square stencil. Regarding the two companies, ten air samples and eight surface samples were collected. Air and surface samples were collected in food storage facilities, kitchen, food plating and canteen. Outdoor air was also collected since this is the place regarded as a reference. Simultaneously, temperature, relative humidity and meal numbers were registered. Concerning air from hospitals’ food units, 32 fungal species were identified, being the two most commonly isolated genera Penicillium sp.

Air fungal contamination in ten hospitals’ food units from Lisbon

A descriptive study was developed to monitor air fungal contamination in ten food units from hospitals. Fifty air samples of 250 litres were collected through impaction method. Samples were collected in food storage facilities, kitchen, food plating, canteen and also, outside premises, since this is the place regarded as reference. Simultaneously, environmental parameters were also monitored, including temperature and relative humidity through the equipment Babouc, LSI Sistems and according to the International Standard ISO 7726.

Avaliação do projecto - Formalização da consulta de enfermagem em pneumologia

Mestrado em Intervenção Sócio-Organizacional na Saúde - Área de especialização: Políticas de Administração e Gestão de Serviços de Saúde.

Manutenção preventiva de um edifício hospitalar

Os Hospitais, equipamentos de interesse público, são edifícios cujos desempenho e disponibilidade das suas instalações e equipamentos podem comprometer a prestação de cuidados de saúde, pelo que nestes estabelecimentos, a Manutenção Preventiva assume um papel relevante. Nesse sentido, pretendeu-se nesta dissertação definir uma estratégia específica que permita efectuar o planeamento da manutenção preventiva de um edifício hospitalar, enquanto infraestrutura para desenvolvimento da actividade clínica. Para tal, foi efectuada uma pesquisa bibliográfica, com a qual se identificaram conceitos de manutenção e requisitos a serem tidos em conta na manutenção de edifícios hospitalares. Foi efectuada uma caracterização genérica do objecto de manutenção, limitada no âmbito desta dissertação às principais componentes dos sistemas de construção e das instalações de águas e esgotos, que podem integrar um edifício hospitalar actual, atendendo às especificações e recomendações técnicas vigentes para este tipo de edifícios. Foram identificados os objectivos e requisitos de manutenção nestes edifícios, estabelecidos pelas condições de funcionamento pretendidas, pelos critérios de durabilidade exigidos pelo Dono de Obra, pelo nível de desempenho funcional requerido para as suas componentes e pelo grau de operacionalidade imposto nas suas diferentes unidades funcionais. Tendo em consideração que a criticidade de uma componente não depende só do contexto operacional da área funcional em se insere mas também das consequências que o seu estado de funcionamento pode acarretar para a unidade funcional. Foi exemplificada a análise dos modos de falha, sua criticidade e seus efeitos para hierarquização do risco associado nas componentes estudadas. As fichas exemplificativas dos planos de manutenção preventiva, que se apresentam no âmbito desta dissertação para algumas componentes básicas, integram acções e procedimentos que derivam de uma análise aos seus modos de falha e seus efeitos, bem como de recomendações técnicas exigências da regulamentação em vigor.

Surfaces contamination with 5-Fluorouracil in two Portuguese hospitals

During the last years there has been an increasing concern about occupational exposure to cytostatic drugs in hospitals. The first findings on occupational exposures among hospital personnel administering chemotherapy were reported only in 1979. Since then, a great number of studies have been publishing describing possible exposure-related health effects. Consequently, rigorous guidelines for the safe handling of cancer chemotherapeutic agents were devised and the handling facilities in hospitals were extensively improved. However, recent studies developed in European countries revealed detectable amounts of several drugs in surface wipe samples. Dermal absorption after contact with contaminated surfaces can play an important role in exposure to antineoplastic drugs. Therefore, the existence of contamination in workplace surfaces implies an increased risk of exposure for health care workers. Since there is no recent report in Portugal, regarding the occupational exposure to antineoplastic drugs, a study was developed aiming to determine the 5-fluorouracil (5-FU) contamination on work surfaces of two Portuguese hospitals.

Utilização de materiais anti-vibráteis e de isolamento acústico na via férrea

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de Vias de Comunicação e Transportes

The hospital survey on patient safety culture in Portuguese hospitals: instrument validity and reliability

Purpose – Quantitative instruments to assess patient safety culture have been developed recently and a few review articles have been published. Measuring safety culture enables healthcare managers and staff to improve safety behaviours and outcomes for patients and staff. The study aims to determine the AHRQ Hospital Survey on Patient Safety Culture (HSPSC) Portuguese version's validity and reliability. Design/methodology/approach – A missing-value analysis and item analysis was performed to identify problematic items. Reliability analysis, inter-item correlations and inter-scale correlations were done to check internal consistency, composite scores. Inter-correlations were examined to assess construct validity. A confirmatory factor analysis was performed to investigate the observed data's fit to the dimensional structure proposed in the AHRQ HSPSC Portuguese version. To analyse differences between hospitals concerning composites scores, an ANOVA analysis and multiple comparisons were done. Findings – Eight of 12 dimensions had Cronbach's alphas higher than 0.7. The instrument as a whole achieved a high Cronbach's alpha (0.91). Inter-correlations showed that there is no dimension with redundant items, however dimension 10 increased its internal consistency when one item is removed. Originality/value – This study is the first to evaluate an American patient safety culture survey using Portuguese data. The survey has satisfactory reliability and construct validity.

Antineoplastic drugs contamination of workplace surfaces in two Portuguese hospitals

Despite the classification as known or suspected human carcinogens, by the International Agency for Research on Cancer, the antineoplastic drugs are extensively used in cancer treatment due to their specificity and efficacy. As human carcinogens, these drugs represent a serious threat to the healthcare workers involved in their preparation and administration. This work aims to contribute to better characterize the occupational exposure of healthcare professionals to antineoplastic drugs, by assessing workplace surfaces contamination of pharmacy and administration units of two Portuguese hospitals. Surface contamination was assessed by the determination of cyclophosphamide, 5-fluorouracil, and paclitaxel. These three drugs were used as surrogate markers for surfaces contamination by cytotoxic drugs. Wipe samples were taken and analyzed by HPLCDAD. From the total of 327 analyzed samples, in 121 (37%) was possible to detect and quantify at least one drug. Additionally, 28 samples (8.6 %) indicate contamination by more than one antineoplastic drug, mainly in the administration unit, in both hospitals. Considering the findings in both hospitals, specific measures should be taken, particularly those related with the promotion of good practices and safety procedures and also routine monitoring of surfaces contamination in order to guarantee the appliance of safety measures.

Surfaces contamination with 5-Fluorouracil in two Portuguese hospitals

Background - The use of antineoplastic drugs in cancer therapy is increasing due to their action in cancer cells. Carcinogenic, mutagenic and teratogenic effects. Some studies demonstrated that nurses and pharmacy personnel involved in preparation or administration are exposed to antineoplastic drugs. Aim: assess 5-Fluorouracil (5-FU) contamination on the surfaces of two Portuguese Hospitals (preparation and administration units). 5-FU is one of the most frequently antineoplastic agent used in Portuguese Hospitals and can be easily absorbed through the skin. This drug can be used as an marker of surfaces contamination and exposure and have been extensively discussed in other studies.

Occupational stress and coping resources in physiotherapists: a survey of physiotherapists in three general hospitals

Objectives - To identify occupational stressors and coping resources in a group of physiotherapists, and to analyse interactions between subjective levels of stress, efficacy in stress resolution and coping resources used by these professionals. Design - A sample of 55 physiotherapists working in three general hospitals in Portugal completed the Coping Resources Inventory for Stress, the Occupational Stressors Inventory and two subjective scales for stress and stress resolution. Main results - Most physiotherapists perceived that they were moderately stressed (19/55, 35%) or stressed (20/55, 36%) due to work, and reported that their efficacy in stress resolution was moderate (25/54, 46%) or efficient (23/54, 42%). Issues related to lack of professional autonomy, lack of organisation in the hierarchical command chain, lack of professional and social recognition, disorganisation in task distribution and interpersonal conflicts with superiors were identified as the main sources of stress. The most frequently used coping resources were social support, stress monitoring, physical health and structuring. Perceived efficacy in stress resolution was inversely related to perceived level of occupational stress (r = −0.61, P < 0.01). Significant correlations were found between several coping resources and the perceived level of stress and efficacy in stress resolution. Associations between problem solving, cognitive restructuring and stress monitoring and both low levels of perceived stress and high levels of perceived efficacy were particularly strong. Implications for practice - The importance of identifying stressors and coping resources related to physiotherapists’ occupational stress, and the need for the development of specific training programmes to cope with stress are supported.

Inclusion of children identified as having special educational needs (SEN) within the Austrian compulsory educational system

Este artigo pretende descrever vários aspetos da segregação, integração e inclusão dentro do sistema educativo obrigatório austríaco. Após uma introdução que contém definições e um resumo internacional, será brevemente descrito o sistema educativo da Áustria. Subsequentemente, três temas de interesse serão debatidos. Primeiro será caracterizada a situação atual referente à inclusão de crianças com necessidades educativas especiais. Esta situação difere bastante entre estados federais. Serão descritos os desenvolvimentos que conduziram à situação atual. Em segundo serão apresentados estudos empíricos recentes relativos ao movimento austríaco que almeja a inclusão. Em terceiro e a título exemplificativo serão apresentados em detalhe alguns desenvolvimentos recentes, alguns planos e visões futuras de três estados federais austríacos.