Prevention of pneumonia associated with neonatal mechanical ventilation: knowledge and practice of nursing professionals
DOI:
https://doi.org/10.17267/2317-3378rec.2023.e5141Keywords:
Ventilator-Associated Pneumonia, Newborn, Nursing Care, Neonatal Intensive Care Unit, NeonatologyAbstract
INTRODUCTION: Analyzing the knowledge and practices of nursing professionals about the prevention of Mechanical Ventilator-Associated Pneumonia in neonates. METHODOLOGY: Descriptive exploratory research, with a quantitative approach. Participants were 19 nurses and 39 nursing technicians working in a Neonatal Intensive Care Unit of a teaching maternity hospital, a reference in a state in the northeast region. Data collection took place through the application of a questionnaire between December 2019 and February 2020. For data analysis, descriptive statistics was used. RESULTS: It was found that 77.6% of professionals know about preventive measures that must be adopted. However, measures with robust scientific evidence are not performed, such as performing the hygiene of the oral cavity (52.2%), elevating the headboard (49%), humidifying and heating the air (44.3%), removing condensate from the circuit (28.7%) and sanitizing hands (12.9%). The reasons are factors intrinsic to management and work processes, such as lack of training (2.4%), supplies (4.8%), standardization of preventive measures (24.3%), in addition to work overload (24 .3%), inadequate staffing (29.2%) and patient complexity (4.8%). FINAL CONSIDERATIONS: Nursing professionals cannot fully carry out measures strongly recommended in the scientific literature for the prevention of Mechanical Ventilator-Associated Pneumonia, although they know their importance.
Downloads
References
(1) Araújo BT, Pereira DCR. Policies for control Health Care-Related Infections (IRAS) in Brazil, 2017. Com Ciências Saúde [Internet]. 2017;28(3/4):333-42. Available from: https://www.arca.fiocruz.br/handle/icict/40729
(2) Wachholtz MA, Costa AEK, Pissaia LF. Knowledge of nurses in an intensive therapy unit on health care-infected infections. Res Soc Dev. 2019;8(10):e378101397. https://doi.org/10.33448/rsd-v8i10.1397
(3) Ceparano M, Sciurti A, Isonne C, Baccolini V, Migliara G, Marzuillo C, et al. Incidence of Healthcare-Associated Infections in a Neonatal Intensive Care Unit before and during the COVID-19 Pandemic: A Four-Year Retrospective Cohort Study. J Clin Med. 2023;12(7):2621. https://doi.org/10.3390/jcm12072621
(4) Freitas FTM. Impacto das infecções relacionadas à assistência à saúde em um serviço de neonatologia de referência do Distrito Federal [dissertação] [Internet]. Brasília: Universidade de Brasília; 2017. Available from: https://repositorio.unb.br/handle/10482/25265
(5) Agência Nacional de Vigilância Sanitária. Critérios Diagnósticos de Infecção Associada à Assistência à Saúde Neonatologia [Internet]. 2nd. ed. Brasília: ANVISA; 2017. Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/caderno-3-criterios-diagnosticos-de-infeccao-associada-a-assistencia-a-saude-neonatologia.pdf/view
(6) Weber CD. Applying Adult Ventilator-associated Pneumonia Bundle Evidence to the Ventilated Neonate. Adv Neonatal Care. 2016;16(3):178-90. https://doi.org/10.1097/anc.0000000000000276
(7) Fan Y, Gao F, Wu Y, Zhang J, Zhu M, Xiong L. Does ventilator-associated event surveillance detect ventilator-associated pneumonia in intensive care units? A systematic review and meta-analysis. Crit Care. 2016;20(1):338. https://doi.org/10.1186/s13054-016-1506-z
(8) Centers for Disease Control and Prevention. Pneumonia (Ventilator-associated [VAP] and non-ventilator-associated Pneumonia [PNEU]) Event: Patient Safety Component Manual [Internet]. 2023. Available from: https://www.cdc.gov/nhsn/pdfs/pscmanual/6pscvapcurrent.pdf
(9) Lamotte GV, Vicente CM. Neumonía adquirida en el hospital. Protoc diagn ter pediatr [Internet]. 2017;1:147-56. Available from: https://www.aeped.es/sites/default/files/documentos/10_neumonia_adquirida_en_el_hospital.pdf
(10) Tan B, Zhang F, Zhang X, Huang YL, Gao YS, Liu X, et al. Risk factors for ventilator-associated pneumonia in the neonatal intensive care unit: a meta-analysis of observational studies. Eur J Pediatr. 2014;173(4):427-34. https://doi.org/10.1007/s00431-014-2278-6
(11) Alecrim RX, Taminato M, Belasco A, Longo MCB, Kusahara DM, Fram D. Strategies for preventing ventilator-associated pneumonia: an integrative review. Rev Bras Enferm. 2019;72(2):521-30. https://doi.org/10.1590/0034-7167-2018-0473
(12) Busanello J, Härter J, Bittencourt CM, Cabral TS, Silveira NP. Best practices for airway aspiration of intensive care patients. J Nurs Health. 2021; 11(1):e2111119127. https://doi.org/10.15210/jonah.v11i1.19127
(13) Resolução COFEN nº 557/2017 (Brasil). Normatiza a atuação da equipe de enfermagem no procedimento de aspiração de vias aéreas. Diário Oficial da União. 2017 set. 5. http://www.cofen.gov.br/resolucao-cofen-no-05572017_54939.html
(14) Contreiro KS, Jantsch LB, Arrué AM, Oliveira DC, Bandeira D. Adhesion to the hand hygienization of health professionals in a neonatal intensive care unit. Rev Enf Contemp. 2020;10(1):25-32. https://doi.org/10.17267/2317-3378rec.v10i1.3094
(15) Santos CG, Brandão ES, Sanchez MCO, Azevedo SL. Strategies for adherence to hand hygiene. Ver Enferm UFPE on line. 2019;13(3):763-72. https://doi.org/10.5205/1981-8963-v13i3a238374p763-772-2019
(16) Zottele C, Magnago TSBS, Dullius AIS, Kolankiewicz ACB, Ongaro JD Hand hygiene compliance of healthcare professionals in an emergency department. Rev Esc Enferm USP. 2017;51:e03242. https://doi.org/10.1590/S1980-220X2016027303242
(17) Gouvêa NS, Demogalski JT, Pomini MC, Pedroso CM, Weinert MCC, Alves FBT. The multidisciplinary workof the resident in neonatal hospital dentistry inthe Brazilian Healthcare System: an experience report. Rev ABENO. 2018;18(4):48-57. https://doi.org/10.30979/rev.abeno.v18i4.597
(18) Alhumaid S, Al Mutair A, Al Alawi Z, Alsuliman M, Ahmed GY, Rabaan AA, et al. Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: a systematic review. Antimicrob Resist Infect Control. 2021;10(1):86. https://doi.org/10.1186/s13756-021-00957-0
(19) Silveira SC, Cruz ICF. The importance of oral hygiene in patients submitted to mechanical ventilation in ICU: systematic review of the literature. J Special Nurs Care [Internet]. 2017;9(1). Available from: http://www.jsncare.uff.br/index.php/jsncare/article/view/2904/725
(20) Silva Junior AC, Xavier IP, Silveira LM, Stabile AM, Cárnio EC, Gusmão JL, et al. Oral hygiene: performance of the nursing team in a hospital environment. Rev Enf Ref [Internet]. 2020;5(1):e19099. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1115136
(21) Rangelova VR, Raycheva RD, Kevorkyan AK, Krasteva MB, Kalchev YI. Ventilator-Associated Pneumonia in Neonates Admitted to a Tertiary Care NICU in Bulgaria. Front Pediatr. 2022;10:909217. https://doi.org/10.3389%2Ffped.2022.909217
(22) Portaria nº 930, de 10 de maio de 2012 (Brasil). Define as diretrizes e objetivos para a organização da atenção integral e humanizada ao recém-nascido grave ou potencialmente grave e os critérios de classificação e habilitação de leitos de Unidade Neonatal no âmbito do Sistema Único de Saúde (SUS) [Internet]. Diário oficial da União. 2012 maio 12. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2012/prt0930_10_05_2012.html
(23) Chicayban LM, Terra ELVS, Ribela JS, Barbosa PF. Bundles de prevenção de pneumonia associada à ventilação mecânica: a importância da multidisciplinaridade. Persp Online Biol Saúde. 2017;7(25):25-35. https://doi.org/10.25242/886872520171200
(24) Nascimento ACST, Morais AC, Amorim RC, Santos DV. The care provided by the family to the premature newborn: analysis under Leininger’s Transcultural Theory. Rev Bras Enferm. 2020;73(suppl 4):e20190644. https://doi.org/10.1590/0034-7167-2019-0644
(25) Oliveira AIB, Wernet M, Facio BC, Dias PLM, Fabbro MRC. Motivation for vocational training: significance to nurses in neonatal intensive care. Rev Bras Enferm. 2021;74(1):e20190793. https://doi.org/10.1590/0034-7167-2019-0793
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Paula Isis Nascimento Silva, João Vitor Gomes Guilherme, Louziane Karina Tavares de Sousa Teixeira, Brenda Naya Carlos Ferreira, Elisângela Franco de Oliveira Cavalcante
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
