Efetividade de intervenção educativa na prevenção de infecção primária de corrente sanguínea em pacientes com cateter venoso central em uma unidade de terapia intensiva do nordeste

Abstract

Introduction: healthcare-associated infections are frequent incidents and a serious public health issue, as they increase costs, hospitalization time, and morbidity and mortality rates. These infections include various types acquired during hospitalization, with central venous catheter-associated primary bloodstream infection being one of the most significant. Its prevention is closely linked to the implementation of evidence-based measures, such as adherence to best practice bundles for insertion and maintenance of devices, as well as interventions aimed at facilitating teamwork and fostering a culture of safety. Objective: to evaluate the implementation of a educative intervention for the prevention of primary bloodstream infection in patients with central venous catheters in an Intensive Care Unit in the Northeast region of Brazil. Method: this is a quantitative, quasi-experimental, before-and-after study with a single group, using the implementation of a continuous improvement cycle. The study was conducted from September 2023 to July 2024 in a reference hospital for infectious diseases in Natal, Rio Grande do Norte. It involved seven (07) stages: 1) Identification of improvement opportunities; 2) Analysis of change opportunities; 3) Selection of quality assessment criteria; 4) Development of an educational activity; 5) Pre-intervention quality assessment; 6) Implementation of the educational intervention; and 7) Measurement of effectiveness after the intervention. The study included 39 healthcare professionals providing care to critically ill patients in the Intensive Care Unit, adhering to ethical principles recommended for research involving human subjects. Data were analyzed using simple descriptive statistics. Results: a reduction in non-compliance was observed in four out of the twelve analyzed variables (1, 4, 7, and 12), with statistical significance (p < 0.05). Improvements were identified in the justification for maintaining the central venous catheter, catheter hygiene with circular movements for 10 seconds before use, system replacement within the recommended timeframe, and the presence of the replacement date on the dressing. These findings indicate progress in adherence to best practices for catheter maintenance when comparing the pre- and post-educational intervention periods. Conclusion: The improvement cycle proved to be effective in preventing primary bloodstream infections in patients with central venous catheters. This study was crucial in strengthening and implementing educational practices that encourage healthcare professionals to reflect on their care actions, motivating them to reduce existing non-compliance, organize a work process that can be monitored, discussed, and improved to lower infection rates.