Adesão ao calendário vacinal por profissionais de saúde de Unidades de Terapia Intensiva de Minas Gerais

Introduction: Immunization of intensive healthcare personnel (IHCP), in general, protects against the respective diseases, reduces susceptibility, minimizes disease transmission, and mitigates absenteeism. The World Health Organization (WHO) points out that healthcare professionals are inadequately vaccinated. Objectives: To estimate the prevalence of adherence to the occupational vaccination schedule proposed by the Brazilian Society of Immunizations (SBIM) and Regulatory Norm 32 (NR 32) among physicians, nurses, and nursing technicians, associated with SOMITI, in the state of Minas Gerais. Methodology: Cross-sectional study, using a structured, anonymous electronic questionnaire on the Google Forms™ platform, which was sent via email to 14,241 physicians, nurses, and nursing technicians working in public and private intensive care units (ICUs) in the state of Minas Gerais and associated with the Minas Gerais Intensive Care Society (SOMITI). The data collection period ranged from November 17, 2020, to July 31, 2021. Results: Among the 14,241 associates, 375 ICHPs were included in the survey. The highest number of respondents was concentrated in the metropolitan regions of Belo Horizonte and Zona da Mata, and the increase in COVID-19 cases reduced the response rate. Of the respondents, 170 (45.4%) were aged between 31 and 40; 244 (65.1%) were female; 205 (54.6%) were physicians; 130 (34.6%) were nurses, and 40 (10.6%) were nursing technicians. Among them, 81.3% worked in adult ICUs, and 308 (82.1%) had between 1 month and 15 years of experience in ICUs, with 238 (63.5%) having their highest working hours in public ICUs. The rates of incomplete vaccination were as follows: hepatitis B (14.9%), diphtheria/tetanus/pertussis (33.3%), measles/mumps/rubella (20.3%), varicella (15.2%), hepatitis A (80.8%), and influenza (15.7%); 89.1% of ICHPs had incomplete vaccination for all proposed vaccines, and 141 ICHPs (37.6%) had comorbidities: obesity (14.4%), hypertension (13.1%), and asthma (8.5%). The most impactful facilitating factors for vaccination adherence were "awareness of the severity of vaccine-preventable diseases," "belief in the benefits of vaccines," and "preserving one's own health." The most impactful hindering factors were "high cost of vaccines," "lack of time for vaccination," and "lack of guidance from the Occupational Medicine department regarding vaccination." Regarding vaccine-preventable diseases, the costs of vaccination schedules were lower than the costs of absenteeism. Conclusions: A low level of adherence to the occupational vaccination schedule was observed among ICHPs. Despite their knowledge of the morbidity and mortality of vaccine-preventable diseases, these professionals do not prioritize complete vaccination as part of their self-care, indicating a lack of monitoring of vaccination adherence by the Occupational Medicine department, leading to illness and impacting healthcare delivery. ICHPs with comorbidities such as obesity and hypertension are more susceptible to illness and require differentiated attention in their vaccination strategy. The novelty of this research, with no similar studies in Brazil, is to highlight a correctable public health problem dependent on vaccine selfcare and a change in the vision of health authorities regarding the importance of vaccinating ICHPs.Introdução: A imunização de profissionais de saúde intensivistas (PSIs), de forma geral, protege contra a doença em causa, reduz suscetíveis, minimiza a transmissão de doenças e o absenteísmo. A Organização Mundial de Saúde (OMS) aponta que profissionais de saúde estão inadequadamente vacinados. Objetivos: Estimar a prevalência da adesão ao calendário vacinal ocupacional proposto pela Sociedade Brasileira de Imunizações (SBIM) e Norma Regulamentadora 32 (NR 32) pelos PSIs médicos, enfermeiros e técnicos de enfermagem, associados à Sociedade Mineira de Terapia Intensiva (SOMITI), no estado de Minas Gerais. Metodologia: Estudo transversal, usando um questionário eletrônico estruturado, anônimo, na plataforma Google Forms™, enviado por e-mail a 14.241 PSIs médicos, enfermeiros e técnicos de enfermagem que exercem atividades em UTIs públicas e privadas do estado de Minas Gerais, associados à SOMITI. O corte cronológico dos dados abrangeu o período de 17/11/2020 a 31/07/2021. Resultados: Entre 14.241 associados, 375 PSIs foram incluídos na pesquisa. O maior número de respondentes concentra-se nas mesorregiões Metropolitanas de Belo Horizonte e da Zona da Mata, e o aumento de casos de COVID-19 reduz o percentual de respondentes. Dos respondentes, 170 (45,4%) têm entre 31 e 40 anos; 244 (65,1%) são do gênero feminino; 205 (54,6%) são médicos; 130 (34,6%) são enfermeiros e 40 (10,6%) são técnicos de enfermagem, sendo que 81,3% desses atuam em UTI-Adulto e 308 (82,1%) têm entre 1 mês e 15 anos de trabalho em UTIs, sendo que 238 (63,5%) exercem sua maior carga horária de trabalho em UTIs públicas. O percentual de incompletude vacinal ocorre para as vacinas contra hepatite B (14,9%), difteria/tétano/coqueluche (33,3%), sarampo/caxumba/rubéola (20,3%), varicela (15,2%), hepatite A (80,8%) e influenza (15,7%); 89,1% dos PSIs têm incompletude vacinal para todas as vacinas propostas, sendo que 141 PSIs (37,6%) são portadores de comorbidades: obesidade (14,4%), hipertensão arterial (13,1%) e asma (8,5%). Os fatores facilitadores de maior impacto para a adesão vacinal são “saber da gravidade das doenças imunopreveníveis”, “acreditar nos benefícios das vacinas” e “preservar a própria saúde”; os dificultadores de maior impacto são “as vacinas terem alto custo”, “não ter tempo para se vacinar” e “não ter sido orientado pelo setor de Medicina do Trabalho quanto à vacinação”. Para as Doenças imonopreveníveis (DIMs), os custos dos esquemas vacinais são inferiores aos custos do absenteísmo. Conclusões: Notou-se baixo grau de adesão dos PSIs ao calendário vacinal ocupacional. Mesmo sendo conhecedores da morbimortalidade das DIMs, esses profissionais não têm como autocuidado de saúde a completude vacinal e presume-se um descuido do setor de Medicina do Trabalho no monitoramento da adesão ao calendário vacinal, propiciando adoecimento e impactos na assistência à saúde. Há PSIs com comorbidades (obesidade e hipertensão arterial) que facilitam adoecimentos, necessitando atenção diferenciada em sua estratégia de vacinação. A inovação desta pesquisa, sem estudos semelhantes no Brasil, é exibir um problema de saúde pública corrigível, dependente do autocuidado vacinal e da mudança de visão das autoridades sanitárias acerca da importância da vacinação dos PSIs

Gestão de suprimentos da farmácia hospitalar com a implantação de métodos gerenciais de insumos utilizados na manufatura

A farmácia hospitalar abriga medicamentos de alto custo, e sua gestão profissionalizada pode garantir a sobrevivência mercadológica dessas instituições e viabilizar o exercício profissional da medicina. O objetivo é apresentar uma proposta de gestão dos estoques de uma farmácia, empregando-se três métodos da manufatura: (1) Padronização, (2) Protocolos e (3) Classificação ABC Este estudo de caso quantitativo utilizou a estatística descritiva simples no processo de gestão de estoques da farmácia de uma instituição hospitalar privada da cidade de Juiz de Fora, Minas Gerais. Coletaram-se dados pré e pós-implementação dos métodos citados, entre janeiro de 2003 e outubro de 2004. Obteve-se redução de 23,07% no número de itens abrigados no estoque; entre esses 271 (32,26%), voltavam-se aos cuidados diretos com o paciente, e apenas 128 desses itens eram medicamentos. A instituição não utilizava a Classificação ABC, e esta mostrou que os produtos da classe A representaram 71 % do valor do estoque, sinalizando diferenciar sua gestão. Conclui-se que os medicamentos representam parcela relevante na composição dos custos hospitalares, o que implica emprego de processos inovadores na gestão da farmácia, com redução dos custos institucionais e democratização do acesso aos serviços de saúde

Assessing vaccine data recording in Brazil

ABSTRACT: Objectives: Vaccines represent an important advancement for improving the general health of a population. The effective recording of vaccine data is a factor for the definition of its supply chain. This study investigated vaccine data recording relatively to data collected from vaccination rooms and data obtained from a government-developed Internet platform. Methods: The monthly recorded total number of diphtheria and tetanus toxoids and pertussis vaccine (alone or in combination with the Haemophilus influenzae type b conjugate vaccine) doses administered in a medium-sized city of the Southeast region of Brazil was collected for the period January/2006 through December/2010 from two sources: City level (directly from vaccination rooms, the study "gold standard"), and Federal level (from an Internet platform developed by the country government). Data from these sources were compared using descriptive statistics and the Percentage error. Results: The data values made available by the Internet platform differed from those obtained from the vaccination rooms, with a Percentage error relatively to the actual values in the range [-0.48; 0.39]. Concordant values were observed only in one among the sixty analyzed months (1.66%). Conclusions: A frequent and large difference between the number of diphtheria and tetanus toxoids and pertussis vaccine doses administered in the two levels was detected

Development of the CMS detector for the CERN LHC Run 3

International audienceSince the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Development of the CMS detector for the CERN LHC Run 3

International audienceSince the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Development of the CMS detector for the CERN LHC Run 3

International audienceSince the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Development of the CMS detector for the CERN LHC Run 3

Since the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger.Since the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Development of the CMS detector for the CERN LHC Run 3

International audienceSince the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Development of the CMS detector for the CERN LHC Run 3

Since the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger