PROTOCOLO DE HIGIENE DE PACIENTES EN LA CAMA PARA REDUCIR INFECCIONES: ESTUDIO CUASIEXPERIMENTAL

Mioto, Juliane Zagatti Alves Pereira; Santos, Bruna Nogueira dos; Margatho, Amanda Salles; Guimarães, Carolina Scoqui; Garbin, Lívia Maria; Silveira, Renata Cristina de Campos Pereira

Juliane Zagatti Alves Pereira Mioto

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Review and final approval of the final version

Hospital de Base de São José do Rio Preto. São José do Rio Preto, São Paulo, Brasil.

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Fundamental. Ribeirão Preto, São Paulo, Brasil

http://orcid.org/0000-0002-8744-0775

Bruna Nogueira dos Santos

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Review and final approval of the final version

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Fundamental. Ribeirão Preto, São Paulo, Brasil

http://orcid.org/0000-0002-1939-6194

Amanda Salles Margatho

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Review and final approval of the final version

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Fundamental. Ribeirão Preto, São Paulo, Brasil

http://orcid.org/0000-0002-1006-9357

Carolina Scoqui Guimarães

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Review and final approval of the final version

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Fundamental. Ribeirão Preto, São Paulo, Brasil

http://orcid.org/0000-0001-6482-4277

Lívia Maria Garbin

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Review and final approval of the final version

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Fundamental. Ribeirão Preto, São Paulo, Brasil

http://orcid.org/0000-0001-9035-6286

Renata Cristina de Campos Pereira Silveira

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Review and final approval of the final version

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Fundamental. Ribeirão Preto, São Paulo, Brasil

http://orcid.org/0000-0002-2883-3640

CORRESPONDING AUTHOR Renata Cristina de Campos Pereira Silveira recris@eerp.usp.br

CONFLICT OF INTEREST

There is no conflict of interest.

EDITORS

Associated Editors: Manuela Beatriz Velho, Ana Izabel Jatobá de Souza. Editor-in-chief: Elisiane Lorenzini.

Variables	Group		p-value
Variables	CG^* (n=157)	IG^† (n=169)	p-value
Gender [n (%)]			0.45^‡
Male	92 (58.6)	106 (62.7)
Female	65 (41.4)	63 (37.3)
Age			0.37^§
[Mean (SD^\|\|)]	56.4 (18.1)	54.4 (18.9)
[Median (Minimum-Maximum)]	59 (19-92)	56 (19-93)
ICU^¶ hospitalization time in days			<0.01^§
[Mean (SD^\|\|)]	7.8 (7.2)	5.1 (4.8)
[Median (Minimum-Maximum)]	6 (0-36)	4 (0-41)
Duration of the antibiotic therapy in days			<0.01^§
[Mean (SD^\|\|)]	12.8 (17.6)	8 (12.0)
[Median (Minimum-Maximum)]	8 (0-156)	3 (0-83)
Number of antibiotics [n (%)]			<0.01^§
None	19 (12.1)	46 (27.2)
1-2	81 (51.6)	88 (52.0)
3-4	44 (28.0)	27 (16.0)
5+	13 (8.3)	8 (4.7)
Main reason for admission [n (%)^**]
Post-surgical care	52 (33.1)	47 (27.8)	0.30^‡
Respiratory failure	45 (28.7)	30 (17.7)	0.02^‡
Cardiovascular diseases	10 (6.4)	7 (4.1)	0.37^‡
Liver diseases	10 (6.4)	9 (5.3)	0.69^‡
Gastrointestinal diseases	13 (8.3)	12 (7.1)	0.69^‡
Neurological diseases	17 (10.8)	23 (13.6)	0.44^‡
External causes	27 (17.2)	44 (26.0)	0.05^‡
Orthopedic reasons	10 (6.4)	9 (5.3)	0.69^‡
Other shocks	5 (3.2)	3 (1.8)	0.41^‡
Other diagnoses	12 (7.6)	24 (14.2)	0.06^‡
Number of chronic diseases [n (%)]			0.52^§
None	37 (23.6)	49 (29.0)
One	66 (42.0)	62 (36.7)
Two	35 (22.3)	33 (19.5)
More than two	19 (12.1)	25 (14.8)
Presence of chronic diseases [n (%)^‡]
Systemic Arterial Hypertension	72 (45.9)	53 (31.4)	<0.01^‡
Diabetes Mellitus	32 (20.4)	38 (22.5)	0.64^‡
Heart diseases	16 (10.2)	20 (11.8)	0.64^‡
Psychiatric disorders	16 (10.2)	13 (7.7)	0.43^‡
Chronic Renal Failure	13 (8.3)	12 (7.1)	0.69^‡
Liver diseases	8 (5.1)	11 (6.5)	0.59^‡
Human Immunodeficiency Virus	9 (5.7)	6 (3.5)	0.35^‡
Stroke	8 (5.1)	6 (3.5)	0.49^‡
Cancer	8 (5.1)	5 (3.0)	0.32^‡
Chronic Obstructive Pulmonary Disease	1 (0.6)	3 (1.8)	0.35^‡
Dyslipidemia	1 (0.6)	6 (3.5)	0.07^‡
ICU^¶ hospitalization outcome [n (%)]			<0.01^‡
Discharge	96 (61.1)	129 (76.3)
Death	61 (38.8)	40 (23.7)

Variables	Group		p-value
Variables	CG^* (n=157)	IG^† (n=169)	p-value
Central venous catheter use, [n (%)]	125 (79.62%)	107 (63.31%)	<0.01^‡
Total central venous catheter dwell time in days, [Median (Q1 - Q3)]	7 (3.5 - 12)	5 (2 - 7)	<0.01^§
Hemodialysis catheter use, [n (%)]	32 (20.38%)	18 (10.65%)	0.01^‡
Total hemodialysis catheter dwell time in days, [Median (Q1 - Q3)]	7.5 (3.5 - 11)	6 (3 - 9)	0.50^§
Arterial catheter use, [n (%)]	121 (77.07%)	115 (68.05%)	0.07^‡
Total arterial catheter dwell time in days, [Median (Q1 - Q3)]	5 (3 - 8)	4 (2 - 6)	<0.01^§
Indwelling urinary catheter use, [n (%)]	137 (87.26%)	137 (81.07%)	0.13^‡
Total indwelling urinary catheter dwell time in days, [Median (Q1 - Q3)]	5 (3 - 10)	4 (2 - 6)	<0.01^§
Mechanical ventilation use, [n (%)]	94 (59.87%)	83 (49.11%)	0.05^‡
Chest drain use, [n (%)]	59 (37.58%)	48 (28.4%)	0.08^‡

Variables	CG^* (n=157)	IG^† (n=169)	Unadjusted		Adjusted
Variables	CG^* (n=157)	IG^† (n=169)	RR^‡(95%CI)	p-value	RR^‡(95%CI)	p-value
Healthcare-Associated Infections [n (%)]
No	125 (79.6)	159 (94.1)	-	p-value		p-value
Yes	32 (20.4)	10 (5.9)	3.44 (1.75; 6.77)	<0.01	2.86^§ (1.4; 5.83)	<0.01
Healthcare-Associated Infections [n (%)]
Ventilator-Associated Pneumonia	20 (12.7)	7 (4.1)	3.08 (1.34; 7.07)	<0.01	2.76^§ (1.13; 6.77)	0.03
Urinary Tract Infection	4 (2.5)	3 (1.8)	1.44 (0.33; 6.31)	0.63	0.95^\|\| (0.25; 3.68)	0.94
Primary Bloodstream Infection	3 (1.9)	1 (0.6)	3.23 (0,34; 30,72)	0.31	3.09^\|\| (0.19; 50.29)	0.43
Surgical Site Infection	8 (5.1)	2 (1.2)	4.31 (0,93; 19,97)	0.06	2.91^¶ (0.51; 16.54)	0.23

Infection-free time in the ICU^*	Groups
Infection-free time in the ICU^*	CG^† (n=157)	IG^‡ (n=169)
Kaplan-Meier
Number of patients with events (infections) [n (%)]	32 (20.4)	10 (5.9)
Non-infection probability at 15 days [days (95%CI)]	0.57 (0.39;0.72)	0.78 (0.59;0.89)
Non-infection probability at 30 days [days (95%CI)]	0.37 (0.17; 0.58)	0.78 (0.59; 0.89)
Cox regression
Hazard ratio: GC vs. GI (95%CI)^§	2.46 (1.18; 5.11)	Ref.
p-value	0.02

[1] CORRESPONDING AUTHOR Renata Cristina de Campos Pereira Silveira recris@eerp.usp.br

Brasil

Brasil

PROTOCOLO DE HIGIENE DE PACIENTES EN LA CAMA PARA REDUCIR INFECCIONES: ESTUDIO CUASIEXPERIMENTAL

RESUMEN

Objetivo:

Método:

Resultados:

Conclusión: