Medidas de prevenção da pneumonia associada à ventilação mecânica: compreensão e cuidados de enfermeiros.

Abstract

Ventilator-Associated Pneumonia (VAP) is a nosocomial lung infection, affecting patients in the use of mechanical ventilation within 48 hours of endotracheal intubation within 72 hours after extubation. OBJECTIVE: To assess the understanding and care provided by nurses for the prevention of VAP in ICU. METHODS: This was a descriptive qualitative study conducted with 19 nurses of ICU's Adult University Hospital Alcides Carneiro, the Federal University of Campina Grande and the Municipal Hospital Pedro I in Campina Grande, 14 professional first and 5 of the second. Data were collected through a semi-structured instrument for the period 16 November to 7 December 2014. This research followed the Resolution 466/12 which regulates research involving human subjects and was approved by the Ethics in Research as UFCG Protocol 872,339. RESULTS: Regarding the profile of the participants, 18 (94.7%) were female; 11 (57.9%) were aged 23-31 years; 17 (89.4%) had 2-10 years of training; 11 (57.9%) have graduated from a private institution and 15 (78, 9%) had a specialization. As regards the understanding of the VAP, 13 (68.4%) nurses defined as an infection resulting from the use of mechanical ventilation through endotracheal intubation or tracheostomy; 5 (26.3%) cited being an infection caused by bacteria, viruses or fungi associated with length of stay in VM and 1 (5.3%) nurses set be due to contamination of intubation technique and develop after 24 hours. Regarding risk factors, stood out: the patient's immunity and its clinical condition, mentioned by 6 (30%) nurses and incorrect technique of aspiration cited by 7 (36.8%). Among the care and actions performed by nurses in their practice, the most cited was the use of aseptic technique of aspiration and microbiological control, reported by 14 (73.6%) and 1 (5.3%) nurses said he was unaware of specific care nursing. Of the 19 respondents, 8 (42.1%) said they did not have any difficulty or obstacle to implementation of care, 11 (57.9%) reported encountering difficulties, highlighting the patient handling by various professionals, cited by 4 (21.0 %) nurses. CONCLUSIONS: Given the statements by the subjects is evident that although they pointed material respects in relation to the VAP, only 1 (5.3%) nurses defined the VAP as closely as pointed to in the literature, showing that there are still gaps in concerning the proper conceptualization of VAP. Regarding risk factors and care and prevention actions of VAP, several were cited, demonstrating that these have a good scientific knowledge, however we can not state its application in practice of these professionals, setting a limitation. As for the implementation of care and actions to prevent VAP, most said face problems as well as the non-use of care protocols. Thus, we suggest the implementation of lifelong learning measures in health for the protocols institution, covering this subject in order to improve nursing care in intensive care.