Prática de enfermagem em antimicrobial stewardship no manejo do neonato crítico com candidíase sistêmica

Abstract

Assistance to critical neonates consists of care that requires qualified attention to prevent injuries and restore health. Some studies show the species Candida albicans as the main fungal species in the Neonatal Intensive Care Unit, being responsible for 60 to 75% of the identified cases of infection. Nevertheless, the application of the antimicrobial stewardship protocol is evidenced in the literature as the main tool to control the indiscriminate use of broad-spectrum antimicrobials. Therefore, the objective was to identify antimicrobial stewardship practices in the context of nursing care in the management of critical neonates with systemic candidiasis. This is an integrative review, developed in six stages, based on the search for primary studies in scientific databases: MEDLINE via PubMed, SciELO, BDENF and LILACS via the Virtual Health Library (VHL); Scopus, ScienceDirect, Web of Science and DOAJ, through Periodicals CAPES. In the search, controlled descriptors associated with the Boolean operators ―AND‖ and ―OR‖ were used. The sample consisted of 7 primary articles, published in international journals, between the years 2018 to 2022. It was possible to measure the various nursing actions in the implementation of antimicrobial stewardship measures, such as: participation in courses offered to update the team, collaborate with the daily audit and feedback, assess the culture of service quality and readiness of the team for changes, and train the team on the proper technique for blood culture collection. When investigated about the impacts of these nursing practices on antimicrobial stewardship, it includes optimizing the documentation indicating the use of antimicrobials and reducing the rate of prolonged use. The scientific production on the subject proved to be limited, especially in the Brazilian scenario. Although it was possible to dimension the activities which the nursing team is responsible for in the implementation of antimicrobial stewardship measures. When investigated about the impacts of these actions, as well as in the context of critical neonatal management with systemic candidiasis, the literature is extremely scarce, revealing the need for further investigations on the subject. Currently, with high cases of microbial resistance and HAI, it is essential to develop strategies that improve the situation, such as antimicrobial stewardship measures, which constitutes a great challenge, requiring the directing of joint efforts. It is hoped that this IR can stimulate the interest of health professionals in the topic addressed.