Prevenção de infecções de corrente sanguínea relacionada a cateteres centrais: entendimento e prática da equipe de enfermagem.

Abstract

Introduction: Health - care - related infections (HRE) constitute a public health problem, with emphasis on central venous catheter - related bloodstream infections (CVS - ICSR). The risk of this infection is high in the intensive care unit (ICU) patient, due to the insertion and constant manipulation of central venous catheters (CVC). In this context, the nursing team is present a large part of the time with the patient, thus, the possibility of performing care aimed at the prevention and control of the RCV-ICSR. Objective: To investigate the nursing team's understanding and practice about the prevention and control of central venous catheter-related infections in ICU. Methodology: A descriptive study with a qualitative approach was carried out from November 14, 2016 to January 31, 2017, with 7 nurses and 17 nursing technicians from the adult and mixed pediatric ICUs of the University Hospital Alcides Carneiro, Federal University of Campina Grande (UFCG), Brazil. The data were collected through a semi-structured instrument and analyzed using the content analysis technique proposed by Laurence Bardin. The research was approved by the UFCG Research Ethics Committee with protocol number 1,749,814 and CAAE 59490416.6.0000.5182. Results: Regarding the understanding about the ICSR-CVC, only five (20.8%) of the nursing professionals mention a more precise concept about CVS-ICSR. Regarding the risk factors, 16 (66.7%) of the respondents highlighted errors in the manipulation or insertion of CVC. On the pathways that microorganisms reach the bloodstream, eleven (45.8%) of the professionals understand the main pathogenic pathways (intraluminal and extraluminal). Among the care and actions performed by the team in their practice, 24 (100%) mentioned conduct related to the handling and maintenance of the device and 12 (50%) of them do not know the guidelines designated by national and international entities. Obstacles were identified for good CVC practices: lack of care by other professionals, difficulties in hand washing, poor CVC quality, lack of material and human resources, lack of knowledge and lack of protocols. Finally, the suggested suggestions to improve the evidenced problems are: the creation and implementation of protocols, continuing education, hand hygiene, among others. Conclusion: Although the nursing team has pointed out relevant aspects regarding CVC-ICSR, this study revealed gaps in the knowledge of evidence-based actions for good practices in the prevention of this infection. For the most part, the team said that it performed adequate care for the prevention of CVRD-ICSR, but it is not possible to say that it is applied in daily practice and is therefore a limitation of this study and refers to the need for other studies investigating the conformity between speeches And practice. The lack of knowledge of national and international guidelines is another factor that compromises care. It is suggested the implementation of measures of continuing education and protocols in the institution, to promote patient safety and the improvement of nursing care.