Medidas utilizadas em unidades de terapia intensiva para prevenção de infecção: revisão integrativa

Ana Clara Dantas; Jéssica Naiara de Medeiros Araújo; Anália Andréia de Araújo Nascimento; Quenia Camille Soares Martins; Mércio Gabriel de  Araújo

doi:10.15253/2175-6783.20202144043

Autores

Ana Clara Dantas Universidade Federal do Rio Grande do Norte https://orcid.org/0000-0002-5634-7498
Jéssica Naiara de Medeiros Araújo Universidade Federal do Rio Grande do Norte https://orcid.org/0000-0002-9115-3285
Anália Andréia de Araújo Nascimento Universidade Federal do Rio Grande do Norte https://orcid.org/0000-0001-7492-2735
Quenia Camille Soares Martins Universidade Federal do Rio Grande do Norte https://orcid.org/0000-0002-4036-2423
Mércio Gabriel de Araújo Universidade Federal do Rio Grande do Norte https://orcid.org/0000-0002-5607-4135

DOI:

https://doi.org/10.15253/2175-6783.20202144043

Palavras-chave:

Controle de Infecções; Unidades de Terapia Intensiva; Enfermagem; Revisão; Precauções Universais.

Resumo

Objetivo: verificar medidas utilizadas em unidades de terapia intensiva para prevenção de infecção relacionada à assistência à saúde. Métodos: revisão integrativa, a partir das fontes de dados LILACS, SCOPUS, PubMed Central, Science Direct, Web of Science e CINAHL, cujos descritores utilizados foram Infection Control e Intensive Care Units. Amostra constituída por 146 estudos. Resultados: elencaram-se categorias temáticas relacionadas às medidas de prevenção de infecção pertinentes, desenvolvidas em Unidades de Terapia Intensiva: medidas de prevenção de infecção da corrente sanguínea, medidas de prevenção de pneumonia relacionada à assistência, medida de prevenção de infecção do trato urinário e medidas de prevenção associadas aos cuidados gerais. Conclusão: dentre as categorias temáticas estabelecidas, identificou-se com maior frequência o cuidado com a preparação da pele, a higiene oral, o manuseio correto do cateter urinário e o banho diário com antisséptico.

Referências

Basso ME, Pulcinelli RSR, Aquino ARC, Santos KF. Prevalência de infecções bacterianas em pacientes internados em uma unidade de terapia intensiva. Rev Bras Anal Clin. 2016; 48(4):383-8. doi: http://dx.doi.org/10.21877/2448-3877.201600307

Agência Nacional de Vigilância Sanitária. Critérios diagnósticos de infecções relacionadas à assistência à saúde [Internet]. 2017 [cited Apr 19, 2020]. Available from: http://portal.anvisa.gov.br/documents/33852/3507912/Caderno+2+-+Crit%C3%A9rios+Diagn%C3%B3sticos+de+Infec%C3%A7%C3%A3o+Relacionada+%C3%A0+Assist%C3%AAncia+%C3%A0+Sa%C3%BAde/7485b45a-074f-4b34-8868-61f1e5724501

Agência Nacional de Vigilância Sanitária. Boletim Segurança do Paciente e Qualidade em Serviços de Saúde nº 17: Avaliação dos indicadores nacionais das infecções relacionadas à assistência à saúde (IRAS) e resistência microbiana do ano de 2017 [Internet]. 2017 [cited Apr 19, 2020]. Available from: https://bit.ly/2Is5KPf

Centers for Disease Control and Prevention. 2018 National and State Healthcare-Associated Infections Progress Report [Internet]. 2019 [cited Apr 19, 2020]. Available from: https://www.cdc.gov/hai/pdfs/progress-report/2018-Progress-Report-Executive-Summary-H.pdf

Walaszeka M, Rozanskab A, Bulandab M, Wojkowska-Machb J, Polish Society of Hospital Infections Team. Epidemiology of healthcare-associated infections in Polish intensive care. A multicenter study based on active surveillance. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2018; 162(3):190-7. doi: http://dx.doi.org/10.5507/bp.2018.006

Centers for Disease Control and Prevention. CDC winnable battles final report [Internet]. 2016 [cited Apr 19, 2020]. Available from: https://www.cdc.gov/winnablebattles/report/docs/wb-hai.pdf

Soares CB, Hoga LAK, Peduzzi M, Sangaleti C, Yonekura T, Silva DRAD. Integrative review: concepts and methods used in nursing. Rev Esc Enferm USP. 2014; 48(2):335-45. doi: https://doi.org/10.1590/S0080-6234201400002000020

Karino ME, Felli VEA. Enfermagem baseada em evidências: avanços e inovações em revisões sistemáticas. Ciênc Cuid Saúde. 2012; 11(Suppl1):11-5. doi: http://dx.doi.org/10.4025/cienccuidsaude.v10i5.17048

Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA Group 2009. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PLoS Med. 2009; 6(6):e1000097. doi: https://doi.org/10.1371/journal.pmed.1000097

Maunoury F, Farinetta C, Ruckly S, Guenezan J, Lucet JC, Lepape A, et al. Cost-effectiveness analysis of chlorhexidine-alcohol versus povidone iodine-alcohol solution in the prevention of intravascular-catheter-related bloodstream infections in France. PLoS One. 2018; 13(5):e0197747. doi: http://dx.doi.org/10.1371/journal.pone.0197747

Lin WP, Chang YC, Wu UI, Hung MC, Chuang PY, Wang JT, et al. Multimodal interventions for bundle implementation to decrease central line-associated bloodstream infections in adult intensive care units in a teaching hospital in Taiwan, 2009-2013. J Microbiol Immunol Infect. 2018; 51(5):644-51. doi: http://dx.doi.org/10.1016/j.jmii.2017.08.008

Atilla A, Dooğanay Z, Çelik HK, Tomak L, Günal O, Kılıç SS. Central line-associated bloodstream infections in the intensive care unit: importance of the care bundle. Korean J Anesthesiol. 2016; 69(6):599-603. doi: http://dx.doi.org/10.4097/kjae.2016.69.6.599

Álvarez-Moreno CA, Valderrama-Beltrán SL, Rosenthal VD, Mojica-Carreño BE, Valderrama-Márquez IA, Matta-Cortés L, et al. Multicenter study in Colombia: impact of a multidimensional International Nosocomial Infection Control Consortium (INICC) approach on central line–associated bloodstream infection rates. Am J Infect Control. 2016; 44(11):235-41. doi: http://dx.doi.org/10.1016/j.ajic.2016.03.043

Zhou Q, Lee SK, Hu X, Jiang S, Chen C, Wang C, et al. Successful reduction in central line–associated bloodstream infections in a Chinese neonatal intensive care unit. Am J Infect Control. 2015; 43(3):275-9. doi: http://dx.doi.org/10.1016/j.ajic.2014.12.001

Khan R, Al-Dorzi HM, Al-Attas K, Ahmed FW, Marini AM, Mundekkadan S, et al. The impact of implementing multifaceted interventions on the prevention of ventilator-associated pneumonia. Am J Infect Control. 2016; 44(3):320-6. doi: http://dx.doi.org/10.1016/j.ajic.2015.09.025

Khaky B, Yazdannik A, Mahjoubipoor H. Evaluating the efficacy of nanosil mouthwash on the preventing pulmonary infection in intensive care unit: a randomized clinical trial. Med Arch. 2018; 72(3):206-9. doi: http://dx.doi.org/10.5455/medarh.2018.72.206-209

Meidani M, Khorvash F, Abbasi S, Cheshmavar M, Tavakoli H. Oropharyngeal irrigation to prevent ventilator-associated-pneumonia: comparing potassium permangenate with chlorhexidine. Int J Prev Med. 2018; 9(1):93-7. doi: http://dx.doi.org/10.4103/ijpvm.ijpvm_370_17

Gomaa MM, Wahba Y, El-Bayoumi MA. Pre versus post application of a 0.12% chlorhexidine based oral hygiene protocol in an Egyptian pediatric intensive care unit: Practice and effects. Egypt J Crit Care Med. 2017; 5(3):87-91. doi: http://dx.doi.org/10.1016/j.ejccm.2017.11.002

Burja S, Belec T, Bizjak N, Mori J, Markota A, Sinkovič A. Efficacy of a bundle approach in preventing the incidence of ventilator associated pneumonia (VAP). Bosn J Basic Med Sci. 2018; 18(1):105-9. doi: http://dx.doi.org/10.17305/bjbms.2017.2278

Al-Hameed FM, Ahmed GR, AlSaedi AA, Bhutta MJ, Al-Hameed FF, AlShamrani MM. Applying preventive measures leading to significant reduction of catheter-associated urinary tract infections in adult intensive care unit. Saudi Med J. 2018; 39(1):97-102. doi: http://dx.doi.org/10.15537/smj.2018.1.20999

Menegueti MG, Ciol MA, Bellissimo-Rodrigues F, Auxiliadora-Martins M, Gaspar GG, Canini SRMS, et al. Long-term prevention of catheter-associated urinary tract infections among critically ill patients program and a daily checklist for maintenance of indwelling urinary catheters: a quase-experimental study. Medicine. 2019; 98(8):e144117. doi: http://dx.doi.org/10.1097/MD.0000000000014417

Menegueti MG, Ciol MA, Bellissimo-Rodrigues F, Auxiliadora-Martins M, Gaspar GG, Canini SRMS, et al. Long-term prevention of catheter-associated urinary tract infections among critically ill patients through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheters. Medicine. 2019; 98(8):e14417. doi: http://dx.doi.org/10.1097/md.0000000000014417

Duszyńska W, Adamik B, Lentka-Bera K, Kulpa K, Nieckula-Schwarz A, Litwin A, et al. Effect of universal chlorhexidine decolonisation on the infection rate in intensive care patients. Anaesthesiol Intensive Ther. 2016; 49(1):28-33. doi: http://dx.doi.org/10.5603/ait.2017.0007

Vianna PG, Jr CRD, Simmons S, Stibich M, Licitra CM. Impact of pulsed xenon ultraviolet light on hospital-acquired infection rates in a community hospital. Am J Infect Control. 2016; 44(3):299-303. doi: http://dx.doi.org/10.1016/j.ajic.2015.10.009

Ethington T, Newsome S, Waugh J, Lee LD. Cleaning the air with ultraviolet germicidal irradiation lessened contact infections in a long-term acute care hospital. Am J Infect Control. 2018; 46(5):482-6. doi: http://dx.doi.org/10.1016/j.ajic.2017.11.008

Ben-Chetrit E, Wiener-Well Y, Lesho E, Kopuit P, Broyer C, Bier L, et al. An intervention to control an ICU outbreak of carbapenem-resistant Acinetobacter baumannii: long-term impact for the ICU and hospital. Crit Care. 2018; 22(1):327-45. doi: http://dx.doi.org/10.1186/s13054-018-2247-y

Spatenkova V, Bradac O, Fackova D, Bohunova Z, Suchomel P. Low incidence of multidrug-resistant bacteria and nosocomial infection due to a preventive multimodal nosocomial infection control: a 10-year single centre prospective cohort study in neurocritical care. BMC Neurol. 2018; 18(1):23. doi: https://dx.doi.org/10.1186/s12883-018-1031-6