Adherence to central venous catheter maintenance bundle and analysis of primary bloodstream infection rates in an intensive careunit in Southern Brazil
Vigil Sanit Debate, Rio de Janeiro, 2025, v.13: e02281 | Published on: 18/03/2025
DOI:
https://doi.org/10.22239/2317-269X.02281Keywords:
Catheter-Related Infections, Patient Care Bundles, Nursing Care, Cross Infection, Intensive Care UnitsAbstract
Introduction: Primary catheter-related bloodstream infections (CRBSI) are associated with unfavorable health outcomes, particularly in critically ill patients. These events can be preventable through adequate maintenance of devices by a multidisciplinary team. The closed infusion system integrates the venous catheter (CVC) maintenance bundle recently adopted in the Intensive Care Unit (ICU) to reduce complications related to central venous catheters, especially infections. Objective: To evaluate adherence to the CVC maintenance bundle measures in the ICU and relate it to PBSI rates. Method: Quantitative cross-sectional study, carried out in an ICU of a public hospital in Southern Brazil. Seven bundle adherence practices were observed in September and October/2022. To assess compliance with practices, the Carter Positivity Index was used. Results: 322 CVC evaluations were performed. The practice with the greatest compliance was valid CVC dressing (97%); 78% of observations showed ≥ 80% adherence to the bundle, indicating safe assistance. The CRBSI rate decreased from 7.0/1000 catheter/day from 2019 to 2020 to 6.7/1000 catheter/day in 2021 and 2022, without statistical significance (p=0.351). Compared with the post-implantation period, there was a tendency for CRBSI rates to decrease [-0.1 (95% CI -0.42 – 0.21)] (p=0.522). Conclusion: The results made it possible to evaluate adherence to measures relating to the CVC maintenance bundle and, thus, the quality of nursing care and weaknesses to be addressed with the teams. Adequate adherence to the bundle positively impacts care and will serve as one of the pillars for reducing CRBSI in ICUs.
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Eduarda Bordini Ferro, Residência Multiprofissional em Saúde, Programa de Atenção ao Paciente Crítico, Grupo Hospitalar Conceição (GHC), Porto Alegre, RS, Brasil
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Natália Domingues dos Santos, Unidade de Terapia Intensiva, Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, RS, Brasil
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Rafaela da Costa Silva, Unidade de Terapia Intensiva, Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, RS, Brasil
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Sofia Louise Santin Barilli, Unidade de Terapia Intensiva, Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, RS, Brasil
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