Bundle: impacto na infecção relacionada a cateter central de inserção periférica

Juliana Dane Pereira Brachine, Maria Angélica Sorgini Peterlini, Mavilde da Luz Gonçalves Pedreira

Resumo

Verificar o efeito da aplicação de um bundle sobre a ocorrência de infecção de corrente sanguínea relacionada a cateter central de inserção periférica em neonatos. Estudo prospectivo, quasi-experimental, dividido em três fases, sendo a amostra composta por 169 RN, sendo 73 (43,2%) na fase controle e 96 (56,8%) na fase intervenção e 1596 observações da aplicação do bundle por um período de seis meses. A taxa média de adesão ao bundle foi de 83,4%. Observou-se queda na taxa média de infecção de corrente sanguínea de 3,9/mil cateteres/dia para zero durante o estudo. Não se identificou diferença quanto ao número de cateteres inseridos, porém o tempo de permanência dos cateteres foi menor na intervenção (p= 0,065). Não houve influência significativa no consumo de sabão antisséptico, porém observou-se aumento no consumo de álcool gel (p= 0,002). Os resultados evidenciaram que a aplicação do bundleauxiliou na melhoria do cuidado prestado, pois nenhum caso de infecção de cateter foi registrado.

Descritores: Infecções relacionadas a cateter, Prática Clínica Baseada em Evidências, Cateterismo Periférico.

 

Bundle: impact on peripheral insertion central catheter infection

Abstract: Verifying the effect of the application of a bundle on the occurrence of bloodstream infection related to a peripheral insertion of central catheter in neonates. Prospective, quasi-experimental study, divided into three phases, the sample consisting of 169 neonates, 73 (43,2%) in control phase and 96 (56,8%) in intervention phase, and 1596 observations of the application of the bundle for a period of six months. The average bundle adherence rate was 83.4%. A drop in mean bloodstream infection rate of 3.9 / 1000 catheters / day to zero was observed during the study. No difference was identified in the number of catheters inserted, but the catheter length of use the catheters stayed was lower in the intervention phase (p = 0.065). There was no significant influence on the consumption of antiseptic soap for hand hygiene, but an increase in alcohol consumption was observed (p = 0.002). The bundle application aided in the improvement of the care provided, since no case of catheter infection was recorded.

Descriptors: Catheter-related Infections, Evidence-based Clinical Practice, Peripheral Catheterization.

 

Bundle: impacto en la inserción periférica infección del catéter central

Resumen: Verificar el efecto de la aplicación de un lote sobre la ocurrencia de infección de corriente sanguínea relacionada a catéter central de inserción periférica en neonatos. Estudio prospectivo, cuasi-experimental, dividido en tres fases, siendo la muestra compuesta por 169  neonatos, 73 (43,2%) en la control,  96 (56,8%) en la intervención y 1596 observaciones de la aplicación del lote por un período de seis meses. La tasa media de adhesión al lote fue del 83,4%. Se observó un descenso en la tasa media de infección del flujo sanguíneo de 3,9 / mil catéteres / día a cero durante el estudio. No se identificó diferencia en cuanto al número de catéteres insertados, pero el tiempo de permanencia de los catéteres fue menor en la intervención (p = 0,065). No hubo influencia significativa en el consumo de jabón antiséptico, pero se observó un aumento en el consumo de alcohol gel (p = 0,002). Los resultados evidenciaron que la aplicación del lote ayudó en la mejora del cuidado prestado, pues ningún caso de infección de catéter fue registrado.

Descriptores: Infecciones Relacionadas con Cateter, Práctica Clínica Basada en Evidencias, Cateterismo Periférico.

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Referências

Pittet D, Donaldson L. Challenging the world: patient safety and health care-associated infection. Int J for Qual Health Care. 2006; 18(1):4-8.

Yokoe DS, Classen D. Introduction: improving patient safety through infection control: a new healthcare imperative. Infect Control Hosp Epidemiol. 2008; 29:s3-s11.

Geffers C, Baerwolff S, Schwab F, Gastmeier P. Incidence of healthcare associated infections in high-risk neonates: results from the German surveillance system for very-low-birth weight infants. J Hosp Infect. 2008; 68:214-21.

Sohn H, Garret DO, Sinkowitz-Cochran RL, Grohskopf LA, Levine GL, et al. Prevalence of nosocomial infections in neonatal intensive care unit patients: results from the first national point-prevalence survey. J Pediatr. 2001; 139:821-7.

Advani S, Reich NG, Sengupta A, Gosey L, Milstone AM. Central Line-Associated bloodstream infection in hospitalized children with peripherally inserted central venous catheters: Extending risk analyses outside the intensive care unit. Clin Infect Dis. 2011; 52(9):1108-15.

Safdar N, Maki DG. Risk of catheter-related bloodstream infection with peripherally inserted central venous catheters used in hospitalized patients. Chest. 2005; 128:489-95.

Cooley K, Grady S. Minimizing catheter-related bloodstream infections. Adv Neonatal Care. 2009; 9(5):209-25.

Posa PJ, Harrison D, Vollman KM. Elimination of central line-associated bloodstream infections: application of evidence. AACN Adv Crit Care. 2006; 17:446-54.

Institute for Healthcare Improvement (IHI). Intensive care: implementing the central line bundle. Disponível em: http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/Changes/ImplementtheCentralLineBundle.htm>. Acesso em 5 out 2011.

Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006; 355(26):2725-32.

O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, et al. Guideline for the prevention of intravascular catheter-related bloodstream infections. Atlanta: CDC. 2011. Disponível em: . Acesso em 20 fev 2012.

Halton KA, Cook D, Paterson DL, Safdar N, Graves N. Cost-Effectiveness of a central venous catheter care bundle. PLoS ONE. 2010; 5(9):e12815.

Organização Mundial de Saúde. OMS. Disponível em: . Acesso em 5 out 2011.

National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004; 32(8):470-85.

Richardson DK, Concoran JD, Escobar GJ, Lee SK. SNAP-II and SNAPPE-II: Simplified newborn illness severity and mortality risk scores. J Pediatr. 2001; 138:92-100.

Costello, J.M., Morrow, D.F., Graham, D.A., Potter-Bynoe, G., Sandora, T.J., Laussen, P.C. Systematic intervention to reduce central line-associated bloodstream infection rates in a pediatric cardiac intensive care unit. Pediatrics. 2008;121:915–923.

Burrell AR, McLaws ML, Murgo M, Calabria E, Pantle AC, et al. Aseptic insertion of central venous lines to reduce bacteremia. The Central Line Associated Bacteremia in NSW Intensive Care Units (CLAB ICU) Collaborative. Med J Aust. 2011; 194(11):583-7.

Butler-O’Hara M, Buzzard C, Reubens L, McDermott M, DiGrazzioW, et al. A randomized trial comparing long-term and short-term use of umbilical venous catheters in premature infants with birth weights of less than 1251 grams. Pediatrics. 2006; 118:e25-35.

McLaws ML, Burrel AR. Zero risk for central line-associated bloodstream infection: are we there yet? Crit Care Med. 2012; 40(2):388-93.

Rosenthal VD, Ramachandran B, Villamil-Gómez W, Armas-Ruiz A, Navoa-Ng JA, et al. Impact of a multidimensional infection control strategy on central line-associated bloodstream infection rates in pediatric intensive care units of five developing countries: findings of the International Nosocomial Infection Control Consortium (INICC). Infection. 2012; 40:415-23.


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