Interventions to Decrease Catheter-Associated Bloodstream Infections in Newborns: An Integrative Review

Abstract

Objective: to perform an integrative review of strategies presented in care bundles to decrease central catheter-associated bloodstream infection among newborns. . Method a search was conducted of the Cochrane Library, IBECS, PubMed, Lilacs, Medline and Scielo catalogues, using the terms "bundle", "catheter-related infection", "infection control", "prevention", "evidence-based nursing"," evidence-based medicine" and" central venous catheter". Inclusion criteria were: papers published from 2009 to April 2014; written in Portuguese, English or Spanish; addressing both neonatal and pediatric populations or just neonatal populations; describing the use and/or assessing care bundles or protocols to control central catheter-associated infection. Results fifteen studies published between 2009 and 2013 were selected. The main information extracted from the studies was systematized as: 1) measures adopted to prevent central catheter-associated bloodstream infection according to level of scientific evidence, and 2) strategies used to implement evidence into health practice. Conclusion there was a variety of practices adopted, some of which are consistent with scientific evidence and some of which are not. Systematization conducted in this study is expected to contribute to practice, facilitating the use of the best evidence in each context, and research indicating gaps in knowledge to be explored in future studies

Prevalence of central venous catheter salvage in newborn with staphylococcal bloodstream infection

“…The bloodstream infection occurred with approximately ten days of CVC use, which differs from data found in the literature describing the posterior infection of these devices (1,19,21) . This result is directly related to work processes, where multidisciplinary team involvement is an essential condition for successful actions and better quality of care (12) .…”

“…However, there may be complications, such as infectious ones, associated with unfavorable health outcomes (9) . One of the most frequent complications is the catheter-related bloodstream infection (CRBSI) (10)(11) .The increased susceptibility of NB to infections is related to deficiencies of the immune system and the fragility of cutaneous and mucous barriers, therefore, this population has characteristics not observed in any group of patients at different periods of life (12) .…”

Utilização do cateter central de inserção periférica em neonatos: análise da indicação à remoção

“…Para degermação da pele, identifica-se utilização de clorexidina alcóolica 2,0% e álcool 70,0%, respectivamente, como primeira e segunda escolha, conforme recomendações internacionais e uso em outras realidades (16)(17) . Porém, salienta-se considerável ausência de registro quanto ao tipo de clorexedina (alcóolica e ou degermante) e respectivas concentrações (18) para degermação da pele de neonatos.…”

Bundle para manuseio do cateter central de inserção periférica em neonatos

“…(5,7) Even training the professionals, the development of protocols and guidelines are not sufficient to ensure adherence in practice of PICC care, evidenced by the high prevalence of Central Line-Associated Bloodstream Infection (CLABSI). (8,9) One of the strategies to minimize the CLABSI and ensure patient safety is the systematization of care, since it reduce the variability in care. (10) The bundle is a set of specific care and, when used together, provide significant improvement in health care.…”

“…(11)(12)(13) This is a light technology proposed by the Institute for Healthcare Improvement, (14) which has since been used to prevent various aggravations. (8,(15)(16)(17)(18) As protocols, guidelines and checklists, the bundles are tools developed by experts, based on best evidence for safer practice of health and its use provides reduction of adverse events. (19) The factors considered in the selection of care included in the bundle are: costs, ease of implementation and adherence to these interventions.…”