Patient safety in nursing care during medication administration 1

ABSTRACT Objective: to evaluate the conformity of care practices of the nursing team during the administration of drugs through central vascular catheter. Method: a descriptive, prospective, observational study conducted in an Intensive Care Unit. The non-probabilistic intentional sample consisted of 3402 observations of drug administrations in patients with central vascular catheters. The previously validated collection instrument was constructed based on the Guideline for Prevention of Intravascular catheter-related infections. Data was collected through direct observations of nursing practices performed by the nursing team. The analysis used analytical, descriptive and inferential statistics (Chi-square test and Fisher’s exact test). Results: a total of 3402 procedures of drug administrations were observed. Female nursing technicians performed the highest number of actions. In none of the procedures did the professional perform all necessary actions. 0.2% of drug administrations were preceded by hand hygiene and 1.3% by disinfection of the multidose vial, ampoule or injectors. Conclusion: the practice evaluated was classified as undesirable. Failure to achieve the desired conformity was probably due to the low adherence of professionals to the practice of hand hygiene and disinfection of materials, injectors and connectors.

[1]  A. Dias,et al.  [Multidimensional Strategy Regarding the Reduction of Central-Line Associated Infection in Pediatric Intensive Care]. , 2016, Acta Médica Portuguesa.

[2]  M. Haddad,et al.  Qualidade da assistência de enfermagem: ambiente do paciente em hospital público de média complexidade [Quality of nursing care: patient environment in a medium-complexity public hospital] , 2016 .

[3]  Marluci Andrade Conceição Stipp,et al.  Behavior of the multidisciplinary team about Bundle of Central Venous Catheter in Intensive Care , 2016 .

[4]  Marluci Andrade Conceição Stipp,et al.  Comportamento da equipe multiprofissional frente ao Bundle do Cateter Venoso Central na Terapia Intensiva , 2016 .

[5]  J. Breen,et al.  Aseptic Technique for Accessing Central Venous Catheters: Applying a Standardised tool to Audit ‘Scrub the Hub’ Practices , 2016, The journal of vascular access.

[6]  E. Barlem,et al.  Technology in nursing care and workload in an ICU , 2016 .

[7]  Francisco Gilberto Fernandes Pereira,et al.  COMPLIANCE AND NON-COMPLIANCE IN THE PREPARATION AND ADMINISTRATION OF ANTIBACTERIAL DRUGS , 2016 .

[8]  Viviane Martins da Silva,et al.  USE OF CLINICAL INDICATORS IN THE EVALUATION OF PREVENTION AND CONTROL PRACTICES FOR BLOODSTREAM INFECTION , 2015 .

[9]  P. Almeida,et al.  EL USO DE INDICADORES EN LA EVALUACIÓN DE LAS PRÁCTICAS CLÍNICAS PARA LA PREVENCIÓN Y CONTROL DE LA INFECCIÓN DEL TORRENTE SANGUÍNEO , 2015 .

[10]  G. S. Rodríguez,et al.  Análisis de los factores contribuyentes en incidentes relacionados con la seguridad del paciente en Medicina Intensiva , 2015 .

[11]  G. S. Rodríguez,et al.  Analysis of contributing factors associated to related patients safety incidents in Intensive Care Medicine , 2015 .

[12]  G. Sirgo Rodríguez,et al.  Analysis of contributing factors associated to related patients safety incidents in Intensive Care Medicine. , 2015, Medicina intensiva.

[13]  Z. Silvino,et al.  Segurança no desempenho e minimização de riscos em terapia intensiva: tecnologias duras [Safety performance and risk prevention in intensive care: hard technologies] , 2014 .

[14]  D. Andrade,et al.  The nursing team’s compliance with hand hygiene: motivational factors , 2014 .

[15]  Edivane Pedrolo,et al.  Curativo de clorhexidina y gasa y esparadrapo para catéter venoso central: ensayo clínico aleatorio , 2014 .

[16]  Camila Eugênia Roseira,et al.  Higiene de las manos en el hospital: uso de indicadores de cumplimiento , 2014 .

[17]  R. M. de Figueiredo,et al.  [Hand hygiene in hospital environments: use of conformity indicators]. , 2014, Revista gaucha de enfermagem.

[18]  Daisy Maria Rizatto Tronchin,et al.  Avaliação da conformidade da prática assistencial de manutenção do cateter temporário duplo lúmen para hemodiálise , 2014 .

[19]  Lolita Dopico da Silva,et al.  Fatores de risco e recomendações atuais para prevenção de infecção associada a cateteres venosos centrais: uma revisão de literatura Risk factors and current recommendations for prevention of infections associated with central venous catheters: a literature review , 2014 .

[20]  Elisabete Silva,et al.  A challenge to professionals in infection control: nurse's lack of compliance with prevention and control measures , 2013 .

[21]  Janaína Bathke,et al.  [Infrastructure and adherence to hand hygiene: challenges to patient safety]. , 2013, Revista gaucha de enfermagem.

[22]  J. Jardim,et al.  [Evaluation of practices for the prevention and control of bloodstream infections in a government hospital]. , 2013, Revista da Escola de Enfermagem da U S P.

[23]  Laura Misue Matsuda,et al.  Qualidade dos cuidados de enfermagem em terapia intensiva: avaliação por meio de auditoria operacional , 2011 .

[24]  L. M. Matsuda,et al.  [Quality of nursing care in intensive therapy: evaluation through operational auditing]. , 2011, Revista brasileira de enfermagem.

[25]  D. Kovacevich,et al.  The effects of needleless connectors on catheter-related bloodstream infections. , 2011, American journal of infection control.

[26]  Sanjay Saint,et al.  Guidelines for the prevention of intravascular catheter-related infections. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[27]  Daniela Mascarenhas,et al.  Precauções de contato em Unidade de Terapia Intensiva: fatores facilitadores e dificultadores para adesão dos profissionais , 2010 .

[28]  Clareci Silva Cardoso,et al.  [Contact precautions in intensive care units: facilitating and inhibiting factors for professionals' adherence]. , 2010, Revista da Escola de Enfermagem da U S P.

[29]  Eleine Aparecida Penha Martins Nonino,et al.  Evaluación de la calidad de los procedimientos curativos en pacientes internados en un hospital universitario , 2008 .

[30]  J. Dalmas,et al.  Quality assessment of the wound dressing procedure in patients at a university hospital. , 2008, Revista latino-americana de enfermagem.

[31]  S. Cuffari,et al.  Recommendations and reports about central venous catheter-related infection. , 2006, Surgical infections.

[32]  D. Kovacevich,et al.  Guidelines for the prevention of intravascular catheter-related infections: Centers for Disease Control and Prevention. , 2003, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.