Journal des soins intensifs et critiques Libre accès

Abstrait

A Cohort Study on Nurse-Led Checklist Intervention to Reduce Catheter-Related Bloodstream Infection in an Intensive Care Unit

Ariana Julião Ramos Gameiro, Roberto Focaccia, Georgia Marostica da Silva, Cassia Vidotti de Souza, Claudio Ramos Oliveira Scorcine and Delcio Matos

Background: Several collaborative studies have shown that infectious complications arising from the use of central venous catheters (CVC) in intensive care units (ICU) are preventable and that the implementation of a safety program can reduce the incidence of infection.

Objective: To structure, based on the best available scientific evidence, and evaluate the results of implementation by the nursing staff of a checklist to prevent these complications.

Methods: The sample analysed comprised 164 patients and was selected based on criteria of inclusion/exclusion. The accepted procedures and concepts were standardized, and both the questionnaire and the factsheets for the collection of clinical and laboratory data had been structured previously. The variables analysed in the study were: gender, age, duration of CVC maintenance, length of stay, mortality, type of condition on admission, type of dressing, chlorohexidine use, association with other concomitant venous access, anatomical region of CVC insertion, presence of consumptive disease, use of chemotherapy and awareness of the importance of professional intervention in implementing the checklist. The primary outcome measure was the presence or absence of bloodstream infection.

Results: Statistical analysis showed that the test and control groups were homogeneous. The study findings revealed significant differences (p<0.05) for the presence of bloodstream infection, length of hospital stay and the duration of catheter maintenance, in both the univariate analysis and the linear regression.

Conclusions: The application of the checklist used here prevents infection of the bloodstream by CVC and reduces the length of hospital stay as well as the duration of catheter maintenance, thus influencing the incidence of bloodstream complications.

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