Prevenção e controle de infecção hospitalar e unidade de terapia intensiva neonatal: enfoque na equipe de enfermagem

Abstract

Introduction: The prevention and control of nosocomial infection in the neonatal environment constitute parameters in ensuring the quality of care provided by nursing staff. Objective: To analyze the role of nurses in the prevention and control of nosocomial infection in neonatal intensive care units by the vulnerability of the newborn. Methods: A descriptive, cross-sectional observational and quantitative approach, conducted in two public reference hospitals in Maceió, Alagoas. The sample was 91 nurses working in the NICU, who consented to participate, 41 of which belonged to the institution A ( 8 nurses, 14 nursing technicians, 19 nursing assistants), and 50 to the Institution B (10 nurses, 18 nursing technicians and 22 nursing assistants). Data were collected through a semi-structured questionnaire in the period from December 2011 to January 2012, analyzed through descriptive and inferential statistics, and presented through graphs and tables. Results: The following results were observed: predominance of adults group in both institutions (31 to 60 years old) was observed; professional experience time ranging from 1 to 10 years in Institution A, and 6-20 years for Institution B; 1 to 20 years of training for both institutions; a percentage of 58.5% (Institution A) and of 66.0% (Institution B) of all participants of the nursing staff has no training in higher education; shortage of trainings to the members of the nursing staff under surveyof the Neonatal Intensive Care Units; updating on biosafety with little impact on nursing practice; emphasized measures of prevention and control pointed out handwashing; nursing report with sporadic occurrence in both health institutions; clinical case discussions occurred at a low level only in the Institution B. In relation to knowledge about intrinsic risk factors, there was a predominance of gestational age, followed by low birth weight, and low degree of immune development, according to nursing team. Regarding extrinsic risk factors, the use of invasive procedures and duration of hospitalization were considered the most prevalent. Regarding invasive procedures, a predominance of arterial and venous catheterization was detected in both Health Institutions. As for the characterization of risk factors for neonatal infection related to environment and nursing staff, a predominantly result related to overcrowding of beds was analyzed in both institutions. Conclusion: These results indicate that the improvement in the performance of the nursing staff in caring for newborns is intrinsically linked to the practice of preventive and control, being related to the organizational structure, interpersonal relationships and intersectoral work; newborn vulnerability to infections; professional involvement; adherence to prevention and control as well as the commitment to service and patient; professional training; epidemiology of infections; implementation of public policies constituting parameters in ensuring the quality of care provided by nursing staff; and significant strategies to diminish the incidence of neonatal infection.