Analysis of healthcare practices for prevention of primary bloodstream infections
Abstract
Objective: to analyze healthcare practices in the use of central venous catheters for the prevention of Primary Bloodstream Infections in an Intensive Care Unit. Method: cross-sectional study conducted in a University Hospital between March and June 2018 with professionals working in an Intensive Care Unit. A structured questionnaire and non-participant observation of the procedures related to insertion, preparation and administration of drugs and change of central catheter dressings were used. The data were analyzed using descriptive statistics and applying the Chi-square and Fisher’s exact tests. Results: a total of 83 nursing professionals and 25 physicians participated. There were 260 drug administrations, 32 catheter insertions and 29 dressing changes. There was inadequacy of the hand hygiene practice in maintenance procedures, especially among nursing technicians. The best results were: skin preparation (94%), spontaneous drying of the antiseptic before punctures (96.87%) and respect for the changes of continuous and intermittent infusion sets (93.42%). Conclusion: the follow-up of preventive measures was undermined in important opportunities to avoid Primary Bloodstream Infections, being necessary to reinforce continuing education and implementation of healthcare protocols.
Downloads
References
Pereira F, Chagas A, Freitas M, Barros L, Caetano J. Description of infections related to health care (iras) of patients in an intensive care unit. Vigil. sanit. debate.2016; 4(1):70-7. Doi: 10.3395/2317-269x.00614.
Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária. Medidas de prevenção de infecção relacionada à assistência à saúde. Brasília, DF [on-line]. 2017. [citado 17 mai 2017]. Disponível em: http://portal.anvisa.gov.br/documents/33852/271855/Medidas+de+Preven%C3%A7%C3%A3o+de+Infec%C3%A7%C3%A3o+Relacionada+%C3%A0+Assist%C3%AAncia+%C3%A0+Sa%C3%BAde/6b16dab3-6d0c-4399-9d84-141d2e81c809.
Silva AG, Oliveira AC. Preventionofbloodstreaminfectionrelatedto central venouscatheter: Anintegrative review. Vigil.sanit. debate. 2016; 4 (2): 117–25. Doi: https://doi.org/10.3395/2317-269x.00705.
Sousa AFFL, Oliveira LB, Moura MEB. Perfil epidemiológico das infecções hospitalares causadas por procedimentos invasivos em unidade de terapia intensiva. Rev. Prev. Infecç. Saúde. 2016; 2 (1-2): 11-17. Doi: https://doi.org/10.26694/repis.v2i1-2.6048.
Brasil. Ministério da saúde. Documento de referência para o Programa Nacional de Segurança do Paciente. 2014 [citado 03 mai 2020]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/documento_referencia_programa_nacional_seguranca.pdf.
Souza LM, Ramos MF, Becker ESS, Meirelles LCS, Monteiro SAO. Adherence to the five moments for hand hygiene among intensive care professionals. Rev.Gaúch.Enferm. 2015; 36(4):21-8. Doi: 10.1590/1983-1447.2015.04.49090.
Oliveira CG, Rodas ACD. Postmarketing surveillance in brazil: vascular catheters – an overview of notifications of adverse events and technical complaints. Ciênc.Saúde Colet. 2017; 22(10):3247-3257. Doi.org/10.1590/1413-812320172210.17612017.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. Strengthening the reporting of observational studies in epidemiology (strobe statement: guidelines for reporting observational studies. J. Clin. Epidemiol. 2007; 335(7624):806-8. Doi:10.1136/bmj.39335.541782.AD
Oliveira FT, Stipp MAC, Silva LD, Frederico M, Duarte SCM. Behavior of the multidisciplinary team about bundle of central venous catheter in intensive care. Esc. Anna Nery. 2016; 20(1):55-62. Doi: 10.5935/1414-8145.20160008
Padilla Fortunatti CF. Impact of two bundles on central catheter-related bloodstream infection in critically ill patients. Rev.Latino-Am.Enfermagem. 2017; 25: e2951. Doi: http://dx.doi.org/10.1590/1518-8345.2190.2951.
Manzo FB, Rodrigues DR, Ferreira FMC, Matozinhos FP, Simão DAS, Costa ACL, et al. Knowledge and behavior of professionals about bundled strategies of central venous catheter. Rev.Bras.Enferm. 2019; 72 (1): 56–62. Doi: https://doi.org/10.1590/0034-7167-2018-0164.
Kawagoe JY. Trends and challenges of surgical hand preparation. Rev. SOBECC. 2016; 21(4):217-222. Doi:10.5327/Z1414-4425201600040008.
Oliveira AC, Gama CS. Surgical antisepsis practices and use of surgical gloves as a potential risk factors to intraoperative contamination. Esc. Anna Nery. 2016; 20(2):370-377. Doi: 10.5935/1414-8145.20160051.
Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária. Nota técnica nº01/2018 gvims/ggtes/anvisa: orientações gerais para higiene das mãos em serviços de saúde. Brasília, DF(BR) [on-line]. 2018. [citado 12 jan 2019]. Disponível em: http://nascecme.com.br/2014/wp-content/uploads/2018/08/545.pdf.
Silva AG, Oliveira AC. Impact of the bundles implementation on the reduction of bloodstream infections: an integrative review. Texto Contexto Enferm. 2018; 27(1):e3540016. Doi: 1590/0104-07072018003540016.
Llapa-Rodríguez EO, Oliveira JKA, Melo FC, Silva GG da, Mattos MCT, Macieira VP. Insertion of central vascular catheter: adherence to infection prevention bundle. Rev. Bras. Enferm. 2019; 72 (3): 774-779. Doi: https://doi.org/10.1590/0034-7167-2018-0124
Lee KH, Cho NH, Jeong SJ, Kim MN, Han SH, Song YG. Effect of central line bundle compliance on central line-associated bloodstream infections. Yonsei med. j. 2018; 59 (3): 376-382. Doi: https://doi.org/10.3349/ymj.2018.59.3.376
Atilla A, Doğanay Z, Çelik HK, Tomak L, Günal Ö, Sırrı Kılıç S. Central line-associated bloodstream infections in the intensive care unit: Importance of the care bundle. Korean J. Anesthesiol.. 2016; 69 (6): 599–603. Doi: https://doi.org/10.4097/kjae.2016.69.6.599
Santos GS, Cauduro FLF, Cruz EDA. The promotion of hygiene of the hands as a strategy for safe care. Ciênc., Cuid.Saúde. 2017; 16(1). Doi: https://doi.org/10.4025/cienccuidsaude.v16i1.31632.
Silva AG, Oliveira AC. Adesão às medidas para prevenção da infecção da corrente sanguínea relacionada ao cateter venoso central. Enferm. Foco. 2017; 8(2): 36–41. Doi: https://doi.org/10.21675/2357-707X.2017.v8.n2.977
Paula DG, Pinto FF, Silva RFA, Paula VG. Estratégias de adesão à higienização das mãos por profissionais de saúde. Rev.Epidemiol.ControleInfecç. 2017; 7(2): 113-121. Doi: http://dx.doi.org/10.17058/reci.v7i2.7731
Boyce JM, Pittet D. Healthcare Infection Control Practices Advisory Committee. Society for Healthcare Epidemiology of America. Association for Professionals in Infection Control. Infectious Diseases Society of America. Hand Hygiene Task Force. 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. Infect. Control Hosp. Epidemiol. 2002; 23(12 Suppl): S3-S40. Doi: http://dx.doi.org/10.1086/503164.
O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin. Infect. Dis. 2011; 52(9): e162–e193. Doi:http://dx.doi.org/10.1093/cid/cir257
Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, et al. Epic3: national evidence-based guidelines for preventing healthcare-associated infections in nhs hospitals in england. J. Hosp. Infect. 2014; 86(S1): S1-70. Doi:http://dx.doi.org/10.1016/S0195-6701(13)60012-2
Jenks M, Craig J, Green W, Hewitt N, Arber M, Sims A. Tegaderm CHG IV Securement Dressing for Central Venous and Arterial Catheter Insertion Sites: a nice medical technology guidance. Appl Health Econ Health Policy. 2016; 14(2): 135–149. Doi: http://dx.doi.org/10.1007/s40258-015-0202-5
Copyright (c) 2021 Ciência, Cuidado e Saúde
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
