BLOOD CURRENT INFECTION RELATED TO CENTRAL VENOUS CATHETER USE: BUNDLE INTERVENTIONS (Atena Editora)

Abstract

Objective: To identify and describe the interventions that make up the bundle for the prevention of bloodstream infection related to the use of central venous catheters. Method: Integrative literature review through the steps: development of the guiding question, search for primary studies in the databases, extraction of data from studies, evaluation of selected studies, analysis and synthesis of results and presentation of the result. Respecting what was proposed to be evaluated, the guiding question was: which interventions make up the bundle for the prevention of bloodstream infection related to central venous catheter use? Primary articles, in Portuguese and Spanish, published in the last 10 years (2010-2020) were included. Secondary articles, that is, validation or review articles and those that did not answer the guiding question, were excluded. The search was carried out in the Latin American and Caribbean Literature on Health Sciences (LILACS) and Scientific Electronic Library Online (SCIELO) databases. For the search, the following descriptors were used: catheter-related infections, central venous catheterization, infection control, patient safety and patient care packages. The initial selection of studies was performed by carefully reading titles and abstracts, including those that met the established inclusion criteria. For the final selection, the articles were read in full. All the processes, from the search to the selection, were carried out by all the researchers. To assess the level of evidence of the works, the Agency for Healthcare Research and Quality categorization was used. Results: From the full reading of the selected articles, the following interventions were found as a component of the bundle for the prevention of bloodstream infection associated with the central venous catheter: hand hygiene (100%), use of maximum barrier for insertion (100% ), skin preparation with alcoholic chlorhexidine (40%); skin preparation with germanium chlorhexidine (40%), deinfection of hubs and connectors with alcoholic solution (40%), recording of insertion site and dressing characteristics (40%), daily assessment of the need for permanence and maintenance of the CVC (40%), avoid access through the femoral vein (20%), give preference to the subclavian vein (20%), perform percutaneous insertion (20%), change the coverage with alcoholic chlorhexidine every seven days with a transparent film or forty-eight days. eight hours segaze (20%), daily cleaning with degerming chlorhexidine (20%), maintaining an occlusive dressing after insertion (20%), changing the dressing as recommended by the institution (20%), using a sterile technique to perform the dressing and keep it dated and signed (20%) and hand hygiene in exchanges of infusion systems, medication administration, dressing change and blood collection (20%). Conclusion: It was observed that, although not all interventions have been described unanimously in the articles, their use contributed to reducing the incidence rates of CRBSI. Therefore, the implementation of the bundle in the routine of institutions allows professionals to perform care safely and effectively, in addition to reducing costs by preventing infections. Thus, knowing the interventions that can compose is the first step.