Avaliação da adesão de profissionais da saúde às medidas de prevenção de infecção de corrente sanguínea relacionada ao cateter central.

Abstract

Bloodstream infections are characterized as an important patient safety problem, especially in the Intensive Care Units, due to numerous invasive procedures, especially the use of the central venous catheter (CVC). Objective: To evaluate the adherence of health professionals to measures of prevention of central venous catheter-related infections (ICSR-CVC) in Intensive Care Units. Methods: This was a descriptive study, with a quantitative approach, carried out at the Adult Intensive Care Unit of the Alcides Carneiro University Hospital of the Federal University of Campina Grande, Campina Grande, Brazil, from January to February 2017. Four physicians, seven Nurses and fifteen nursing technicians. The data collection was aided by structured questionnaires and occurred in two stages - application of the instrument to the professionals and systematic observation of the behaviors of the same one in the care to the patient with CVC. Data analysis was performed using descriptive statistics. The research was approved by the Research Ethics Committee under protocol number 1,869,315 according to resolution nº 466/12. Results: Of the nursing team 16 (72.7%), they did not mention the measures of prevention of SCI-CVC recommended by the Center for Desertion Control and Prevention and of the National Agency of Sanitary Surveillance. In the preparation of medications, 13 (59.1%) reported disinfecting ampoules and vials and nine (40.9%) said they did not perform. In drug administration, 21 (95.5%) reported disinfecting the catheter hub and one (4.5%) said they did not disinfect the CVC pathways. At the time of observation, disinfection of ampoules and vial ampoules was not detected and disinfection of the catheter hub was also not visualized. When they were observed during the dressing, the professionals did not perform the hygiene of the hands immediately before performing the dressing. With regard to the medical team, two (50%) did not mention the ICSR-CVC prevention measures, four (100%) cited the subclavian vein as the one with the lowest infection development and three (33.3%) mentioned S . Aureus as the main microorganism involved in ICSR-CVC. In order to perform the CVC insertion, three (75%) participants of the medical team said that they washed their hands with soap and water before and one (33.3%) stated that besides the hygienization, it performs friction with alcohol at 70%. The main difficulties that may be hindering good practices in the insertion and manipulation of CVC are the theoretical doubts presented by the nursing team and the lack of knowledge of the protocols developed by CDC and ANVISA by both teams. Conclusion: It was concluded that the nursing team participating in this study has weaknesses in adherence to the measures of prevention of CVS-ICSR. It is not possible to describe the adhesion of the medical team since it was not possible to visualize the moments of insertion of CVC. However, both teams demonstrated partial knowledge about the measures of prevention of CVS-CVS advocated by ANVISA and CDC. These findings point to the importance of the implementation of educational interventions for the prevention of ICSR-CVC for both teams in the sector.