Incidência de infecções por dispositivos invasivos em UTI após utilização do método da Ciência da Melhoria.

• Ano de defesa: 2020
• Autor(a) principal: Michels Jr, Vilto
• Outros Autores: Parma, Gabriel Oscar Cremona, Fabiana, Schuelter-Trevisol
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Palavras-chave em Português: Cuidados intensivos; Infecções relacionadas a cateter; Garantia da qualidade dos cuidados de saúde; Gestão da qualidade em saúde; Infecção relacionada à assistência a saúde; Prevenção
• Link de acesso: https://repositorio.animaeducacao.com.br/handle/ANIMA/3085

Introduction: Health care-related infections (HAIs) are the most common adverse event in the world. In the United States, these infections are complications in 4% of hospital admissions in general and half of all are attributed to the Intensive Care Unit (ICU). Evidence-based recommendations and organizational changes adapted to the local context can be effective in reducing these infections. Improvement Science is a methodology used to promote and accelerate the improvement of the quality of health care. Objective: Evaluate the incidence of pneumonia associated with mechanical ventilation, primary bloodstream infection related to central vascular access, and urinary tract infection related to bladder catheter in ICU after application of the methodology of Improvement Science. Methods: A retrospective cohort study was conducted in a single center. A team was trained by the Institute of Healthcare Improvement in Improvement Science to develop and implement local changes in processes and routines related to HAIs. The variables were separated in three periods: pre-intervention, intervention and post-intervention. Interrupted time series analysis with segmented linear regression was performed to analyze the effect of the intervention on the trend of variables and simple correlation were calculated with Excel 365®. The means and hypothesis tests were performed with IBM SPSS® v.21. A p value of 0.05 was considered statistically significant. Results: There was a reduction in all infection densities. Pneumonia was reduced from 27.2% to 7.2% (p<0.001), bloodstream infection from 3.0% to 0.9% (p<0.017) and urinary infection from 8.3% to 1.8% (p<0.001). There was also a reduction in ICU stay from 6.7 days to 6 days (p<0.018). Conclusion: The application of the Improvement Science methodology can reduce the incidence of infections caused by invasive devices in the ICU.