Adoção de bundles como estratégia para redução de infecção de corrente sanguínea

Abstract

INTRODUCTION: Bloodstream infection is one of the most recurrent, characterized as a severe systemic infection such as bacteremia or sepsis, with no identifiable primary focus. 90% of bloodstream infections are at the expense of the use of invasive devices such as central venous catheters (CVC). In order to reduce the number of bloodstream infections related to the use of central venous catheters, some measures have been included in clinical practice based on scientific evidence, called Bundles OBJECTIVES: To identify in the literature whether adherence to Bundles in clinical practice contributes to reducing CVC-associated bloodstream infections; Identify the difficulties in implementing Bundles in clinical practice; METHOD: This is a study that was developed through a descriptive literature review, covering the following steps: Identification of the theme and guiding research question, inclusion and exclusion criteria, literature search, collecting data, analysis and criticism of articles, discussion, results and conclusion. The study included the databases of academic Google, (Scientific Electronic Library Online), SciELO and LILACS (Latin American and Caribbean Literature in Health Sciences). For the literature search, the following descriptors were used: “Bundle”, “Nursing” and “Central Venous Catheter” separated by the Boolean operator “AND”. Access to the databases took place between March 2021 and December 2021. Inclusion criteria were scientific articles published in national journals, original and published in full, in Portuguese in the period between 2016 and 2021. Monographs, dissertations, were excluded. theses, experience reports, editorials, debates, not convergent with this study. RESULTS: 1,987 articles were found, 15 in SciELO, 1,950 in Google Scholar and 22 in LILACS. After applying the eligibility criteria and reading the titles, 10 articles remained. Of the 10 articles selected, only one (10%) reported the positive impact of the bundles' relationship with the reduction of bloodstream infections. As for the difficulties encountered in implementing the bundles in clinical practice, 9 (90%) articles emphasized that the lack of continuing education effectively contributes to the difficulty in implementing preventive measures, as most professionals have already heard about these measures, but few know the application in practice. Studies have also shown for these measures to work it is necessary to use them in full. DISCUSSION: In this study, it was possible to show that the greatest difficulty in implementing the bundles is due to the lack of knowledge of the teams regarding preventive measures; this may be related to a deficiency in training in the clinical setting, which reflects how important continuing education is. It was also demonstrated in this study that bundles can positively contribute to the reduction of ICS, and that the effectiveness of the measures has a high percentage, but the recommendations are for these measures to be used in their entirety. FINAL CONSIDERATIONS: The results found reflect the need for studies that seek to understand the obstacles most present in the clinical practice of a multidisciplinary team, as well as studies that demonstrate the importance of nurses to change the scenario of clinical practice, since they are the professional who is directly linked to assistance.