Microbiological testing of devices used in maintaining peripheral venous catheters

Abstract

Objective:to evaluate the use of peripheral venous catheters based on microbiological analysis of devices (dressing and three-way stopcocks) and thus contribute to the prevention and infection control. Methods:this was a prospective study of microbiological analysis of 30 three-way stopcocks (external surfaces and lumens) and 30 dressing used in maintaining the peripheral venous catheters of hospitalized adult patients. Results:all external surfaces, 40% of lumens, and 86.7% of dressing presented bacterial growth. The main species isolated in the lumen were 50% coagulase-negative Staphylococcus, 14.3% Staphylococcus aureus, and 14.3% Pseudomonas aeruginosa. Fifty nine percent of multidrug-resistant bacteria were isolated of the three-way stopcocks, 42% of the lumens, and 44% of the dressing with a predominance of coagulase-negative Staphylococcus resistant to methicillin. Besides, 18% gram-negative bacteria with resistance to carbapenems were identified from multidrug-resistant bacteria on the external surfaces of the three-way stopcocks. Conclusion:it is important to emphasize the isolation of coagulase-negative Staphylococcus and gram-negative bacteria resistant to methicillin and carbapenems in samples of devices, respectively, which reinforces the importance of nursing care in the maintenance of the biologically safe environment as well as prevention and infection control practices.

Nursing Practices in Peripheral Venous Catheter: Phlebitis and Patient Safety

“…The poor peripheral venous access and the risks associated with PVC and CVC should not be the only criteria involved when selecting the cannulation site or the type of catheter. 13,[26][27] This selection should include a comprehensive assessment of the patient (irritative, vesicant, pH ≤5 or ≥9, osmolarity ≥500 mOsm/L and infusion), the characteristics of the prescribed drugs (irritants, vesicants, pH ≤5 or ≥9, with dextrose greater than 10%), and the risks and benefits to the patient according to each type of catheter. 13,[25][26] Although care to prevent phlebitis is related to the prevention of bloodstream infection and these are established in guidelines, 13,26 the present study highlights another practice in misalignment with these guidelines, namely the absence or inadequate disinfection of PVC needleless connector hubs.…”

“…According to a recent study, 40% of the PVC three-way taps or connectors present external and intraluminal contamination by microorganisms that present a microbial resistance profile. 27 In view of the risk of phlebitis and bloodstream infections, adherence to good safety practices for patient safety is essential. Therefore, new technologies, such as passive disinfection associated with the connectors have been used, which has evidenced lower rates of infection associated with the catheters.…”

“…[30][31] Non-adherence to the use of the sterile dressing which protects the PVC insertion site was another deviation identified in nursing practice, which is contrary to the recommendations for the prevention of phlebitis and infections. [13][14] The purpose of the dressing is to protect the PVC insertion site against dirt, moisture 8,27 and contact with external microorganisms, in addition to minimizing the movement of the catheter within the vein and prevent displacement, thus reducing the risk of peripheral vascular trauma. 5,11,32 In the present study, the non-adhesion to the sterile, impermeable transparent dressing by the nurses made it difficult to evaluate the PVC insertion site for the presence of signs and symptoms of vascular trauma, mainly phlebitis and infiltration.…”

Eficácia do álcool etílico e quaternário de amônio na desinfecção de equipamentos médicos hospitalares

“…[5][6][7][8] Assim como os equipamentos médicos hospitalares, que merecem especial atenção, as superfícies onde existe alta frequência de contato pelas mãos de profissionais e pacientes também funcionam como reservatório de microrganismos e necessitam de limpeza adequada. [9][10][11] Estudo realizado previamente sobre investigação de surto de infecção por S. aureus em uma unidade de terapia intensiva, identificou que os sensores de oxímetro eram o principal reservatório causador do surto. 9 Em uma revisão da literatura realizada por outros autores sobre contaminação de superfícies em serviços de saúde hospitalar permitiu identificar publicações que descreveram 19 superfícies diferentes, dentre elas, colchões, estetoscópios, esfigmomanômetros, aparelhos de ar-condicionado e botões da bomba de infusão.…”

“…10 Pesquisa realizada avaliando a presença de microrganismos em dispositivos utilizados na manutenção de cateteres venosos periféricos, os autores demonstraram que houve crescimento bacteriano em 40% dos lúmens dos cateteres e em 86,7% dos curativos, reforçando a necessidade e importância do cuidado de enfermagem na manutenção do ambiente biologicamente seguro, assim como práticas de prevenção e controle das IRAS. 11 Falhas nos processos de limpeza e desinfecção de equipamentos médicos hospitalares e de superfícies podem ter como consequência a disseminação e transferência de microrganismos nos ambientes dos serviços de saúde, colocando em risco a segurança dos pacientes e dos profissionais que atuam nesses serviços. 12 No sentido de orientar e estabelecer normas em relação a correta limpeza e desinfecção de superfícies em serviços de saúde, a Agência Nacional de Vigilância Sanitária (ANVISA) publicou em 2012 um manual, disponibilizando informações atualizadas sobre o tema.…”