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      Bundle para manuseio do cateter central de inserção periférica em neonatos Translated title: Bundle para manipulación de catéter central de inserción periférica en neonatos Translated title: Bundle for handling peripherally inserted central catheter in newborns

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          Abstract

          Resumo Objetivo Construir um bundle para prevenção de infecção primária da corrente sanguínea relacionada a cateter que contemple cuidados de enfermagem para manuseio do cateter de acesso venoso central por inserção periférica em neonatos. Métodos Pesquisa metodológica, desenvolvida no ano de 2017 em três etapas: levantamento bibliográfico, construção do instrumento e validação de conteúdo por cinco juízes. O instrumento para validação foi composto por 21 cuidados de enfermagem selecionados na primeira etapa. O índice de validade de conteúdo acima de 80% foi utilizado para avaliar a concordância entre os juízes, esta etapa foi realizada em uma única rodada. Resultados Dos 21 itens avaliados pelos juízes, dez foram excluídos por apresentarem índice de validade de conteúdo menor que 0,80 e três foram agrupados ao demais cuidados elencados. A versão final do bundle foi composta por oito itens. Os cuidados incluídos foram relacionados a higienização das mãos antes e após as manuseio, o uso de seringas com calibre adequado, troca e desinfecção das dânulas e dos conectores com álcool 70%, teste de permeabilidade e cuidados com curativos. Conclusão O estudo permitiu elaborar e validar junto a juízes um bundle para manuseio do cateter central de inserção periférica em neonatos com vistas a redução de infecção primária da corrente sanguínea relacionada ao cateter de acesso venoso central por inserção periférica.

          Translated abstract

          Resumen Objetivo Construir un bundle para la prevención de infección primaria del flujo sanguíneo relacionada con el catéter, que contemple cuidados de enfermería para la manipulación del catéter de acceso vascular central por inserción periférica en neonatos. Métodos Investigación metodológica, llevada a cabo en 2017 en tres etapas: análisis bibliográfico, construcción del instrumento y validación de contenido por cinco jueces. El instrumento para validación consistía en 21 cuidados de enfermería seleccionados en la primera etapa. El índice de validez del contenido superior a 80% fue utilizado para evaluar la concordancia entre los jueces, esta etapa se realizó en una única ronda. Resultados De los 21 ítems analizados por los jueces, 10 fueron excluidos por presentar índice de validez de contenido inferior a 0,80 y se agruparon otros 3 con los demás cuidados presentados. La versión final del bundle quedó compuesta por ocho ítems. Los cuidados que se incluyeron están relacionados con la higienización de las manos antes y después de la manipulación, el uso de jeringas de calibre adecuado, cambio y desinfección de llaves de tres vías y de conectores con alcohol 70%, prueba de permeabilidad y cuidados con los vendajes. Conclusión El estudio permitió elaborar y validar con jueces un bundle para la manipulación del catéter central de inserción periférica en neonatos con el objetivo de reducir la infección primaria del flujo sanguíneo relacionada con el catéter de acceso vascular central por inserción periférica.

          Translated abstract

          Abstract Objective To build a bundle for prevention of primary infection of the bloodstream related to catheter that contemplates nursing care for handling the peripherally inserted central venous catheter in newborns. Methods Methodological research, developed in 2017 in three stages: bibliographic survey, instrument building and content validation by five judges. The instrument for validation was composed of 21 nursing care selected in the first stage. The Content Validity Index above 80% was used to assess concordance among the judges. This step was performed in a single round. Results Of the 21 items assessed by the judges, ten were excluded because they had a Content Validity Index under 0.80 and three were grouped to the other care listed. The final version of bundle was composed of eight items. The care included was related to hand hygiene before and after handling; use of syringes of proper caliber; exchange and disinfection of the stopcocks and connectors using alcohol 70%; and permeability test and care with dressing. Conclusion The study made it possible to create and validate among judges a bundle for handling peripherally inserted central catheter in newborns aiming to prevent primary infection of the bloodstream related to peripherally inserted central venous catheter.

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          Most cited references23

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          Catheter dwell time and CLABSIs in neonates with PICCs: a multicenter cohort study.

          To determine whether the daily risk of central line-associated bloodstream infections (CLABSIs) increases over the dwell time of peripherally inserted central catheters (PICCs) in high-risk neonates.
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            A National Survey of Neonatal Peripherally Inserted Central Catheter (PICC) Practices

            The purpose of this study was to assess and describe the practices involved in the insertion and maintenance of peripherally inserted central catheters (PICCs) in neonates in level III neonatal intensive care units (NICUs) in the United States and to compare the findings with current recommendations and evidence.
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              Evidence-based interventions to reduce adverse events in hospitals: a systematic review of systematic reviews

              Objective To provide an overview of effective interventions aimed at reducing rates of adverse events in hospitals. Design Systematic review of systematic reviews. Data sources PubMed, CINAHL, PsycINFO, the Cochrane Library and EMBASE were searched for systematic reviews published until October 2015. Study selection English-language systematic reviews of interventions aimed at reducing adverse events in hospitals, including studies with an experimental design and reporting adverse event rates, were included. Two reviewers independently assessed each study's quality and extracted data on the study population, study design, intervention characteristics and adverse patient outcomes. Results Sixty systematic reviews with moderate to high quality were included. Statistically significant pooled effect sizes were found for 14 types of interventions, including: (1) multicomponent interventions to prevent delirium; (2) rapid response teams to reduce cardiopulmonary arrest and mortality rates; (3) pharmacist interventions to reduce adverse drug events; (4) exercises and multicomponent interventions to prevent falls; and (5) care bundle interventions, checklists and reminders to reduce infections. Most (82%) of the significant effect sizes were based on 5 or fewer primary studies with an experimental study design. Conclusions The evidence for patient-safety interventions implemented in hospitals worldwide is weak. The findings address the need to invest in high-quality research standards in order to identify interventions that have a real impact on patient safety. Interventions to prevent delirium, cardiopulmonary arrest and mortality, adverse drug events, infections and falls are most effective and should therefore be prioritised by clinicians.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ape
                Acta Paulista de Enfermagem
                Acta paul. enferm.
                Escola Paulista de Enfermagem, Universidade Federal de São Paulo (São Paulo, SP, Brazil )
                0103-2100
                1982-0194
                June 2019
                : 32
                : 3
                : 261-266
                Affiliations
                [2] Uberaba Minas Gerais orgnameUniversidade Federal do Triângulo Mineiro orgdiv1Hospital de Clínicas Brazil
                [1] Uberaba Minas Gerais orgnameUniversidade Federal do Triângulo Mineiro Brazil
                Article
                S0103-21002019000300261
                10.1590/1982-0194201900036
                d272b4bc-13b5-4fb3-9a05-0b4f470c0330

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 09 March 2018
                : 01 April 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 6
                Product

                SciELO Brazil

                Categories
                Artigos Originais

                Patient care bundles,Infant, newborn,Catheterization,Catheter-related infections,Intensive care units,Paquetes de atención al paciente,Recién nacido,Cateterismo,Infecciones Relacionadas con cateteres,Unidades de cuidados intensivos,Pacotes de assistência ao paciente,Recém-nascido,Infecções relacionadas a cateter,Unidades de terapia intensiva

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