Fortini YV

Language: Spanish
References: 7
Page: 82-93
PDF size: 262.48 Kb.

ABSTRACT

Introduction: Infections associated with health care are defined as those acquired during hospitalization and that were not present, or in incubation, at the time of the patient's admission. They constitute an important public health problem and an indicator of the quality of services. Objectives: To implement management strategies for the prevention of nosocomial infections. Material and methods: A quasi-experimental, intervention study with time series analyses before and after program implementation. The monitoring of hand hygiene and the application of control measures are proposed to prevent central line-associated bloodstream infections (CLABSI), ventilator-associated pneumonias (VAP), or urinary catheter-associated urinary tract infections (CAUTI), in children hospitalized in a multipurpose pediatric intensive care of a public hospital in Buenos Aires. Results: It was possible to reduce the utilization rate of the devices, avoiding prolonging their unnecessary use. The lowest rate of CLABSI was recorded in 2018, and during the year 2019 it remained at 4.02. The VAP rate decreased after the intervention. In the last three years no CAUTI was reported. 81% of professionals achieved adherence to hand hygiene. Conclusions: Staff education, adherence to good practices and epidemiological surveillance were the central axes. The implementation of the different strategies allowed to evaluate the final impact of preventive measures and promoted teamwork.

REFERENCES

1. Ivalo S. Programa de vigilancia y control de las infecciones asociadas a los cuidados de la salud. En: Rezzónico R, Menzica C, Rezzónico M. Auditoría médica y garantía de calidad de la gestión sanitaria. Buenos Aires: Ediciones Journal; 2016. pp. 690-715.

2. Cornistein W. Control de infecciones en cuidados intensivos. En: Gallesio A, Schnitzler E, Cosenza S, Arias López M. Gestión de áreas críticas. Buenos Aires: Editorial Panamericana; 2018. pp. 379-386.

3. Shekelle PG, Pronovost PJ, Wachter RM, McDonald KM, Schoelles K, Dy SM et al. The top patient safety strategies that can be encouraged for adoption now. Ann Intern Med. 2013; 158 (5 Pt 2): 365-368.

4. Klevens RM, Edwards JR, Richards CL Jr, Horan TC, Gaynes RP, Pollock DA et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep. 2007; 122 (2): 160-166.

5. Aranaz-Andrés JM, Aibar-Remón C, Limón-Ramírez R, Amarilla A, Restrepo FR, Urroz O et al. Prevalence of adverse events in the hospitals of five Latin American countries: results of the 'Iberoamerican Study of Adverse Events' (IBEAS). BMJ Qual Saf. 2011; 20 (12): 1043-1051.

6. Morillo-García A, Aldana-Espinal JM, Olry de Labry-Lima A, Valencia-Martín R, López-Márquez R, Loscertales-Abril M et al. Hospital costs associated with nosocomial infections in a pediatric intensive care unit. Gac Sanit. 2015; 29 (4): 282-287.

7. Gallesio A. Componentes generales de un proceso y proceso central de atención en la unidad de cuidados intensivos. En: Gallesio A, Schnitzler E, Cosenza S, Arias López M. Gestión de áreas críticas. Buenos Aires: Editorial Panamericana; 2018. pp. 145-160.