Infection risks associated with care in prehospital care: impacts on patient safety
DOI:
https://doi.org/10.33448/rsd-v9i8.5846Keywords:
Patient safety; Ambulances; Hand hygiene; Infection.Abstract
Objectives: To identify incidents related to the risk of infection in land mobile pre-hospital care and to analyze the interfaces of this care with patient safety. Method: Observational, prospective study with evaluation of 239 occurrences. Data were analyzed using Epi-info and Statistical Package for Social Science statistical programs. The research was submitted to and approved by the ethics committee under registration number: 2,764,855. Results: 218 (92.8%) occurrences there was no hand hygiene between the procedures; gloves were not exchanged in 159 (69.1%) cases; hand hygiene was not performed before applying the dressing in 19 (46.3%) cases involving injuries; peripheral venipuncture was not performed using aseptic technique in 101 (60.8%) cases and in 06 occurrences aseptic bladder catheterization was not performed (85.7%). Conclusion: It is observed that mobile prehospital care is an environment of risk for infection associated with the care process. The results achieved in the research demonstrate that the objectives were achieved by presenting, quantitatively, the specific points that put the patient at risk with regard to their safety. Thus, it is necessary to invest in facilitating strategies for the proper performance of hand hygiene and control of the risk of infection in ambulance services, as well as the implementation of Patient Safety Centers strategically and operationally adapted to the mobile prehospital follow-up.
References
Bigham, L. B., Jason, E. B., Steven, C. B., Merideth, M., Kaveh, G. S., & Laurie, J. M. (2014). Patient safety in emergency medical services: asystematic review of the literature. Prehosp Emerg Care, 6(1), 20-35.
Brasil. Ministério da Saúde. Portaria n º 2048, de 5 de novembro de 2012. Brasília: Diário oficial da União, 2002.
Brasil. Ministério da Saúde. Portaria n. 1863/GM de 29 de setembro de 2003. Brasília: Diário Oficial da União,2003.
Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária: Indicadores nacionais de infecções relacionadas à assistência à saúde. Brasília: ANVISA, 2010.
Brasil. Ministério da Saúde. Portaria nº. 529: Institui o Programa Nacional de Segurança do Paciente (PNSP). Brasília: Diário Oficial da União,2013.
Brasil. Ministério da Saúde. Resolução da Diretoria Colegiada-RDC 36: Institui ações para segurança do paciente em serviços de saúde e dá outras providências. Brasília: Diário oficial da União,2013.
Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária: Segurança do Paciente em Serviços de Saúde: Higienização das Mãos. Brasília: Anvisa, 2009.
Barr, N., Holmes, M., Roiko, A., Dunn, P., & Lord, B. (2017). Self-reported behaviors and perceptions of Australian paramedics in relation to hand hygiene and gloving practices in paramedic-led health care.
American J. of Infect Control, 45(7), 771-8.
Belela-anacleto, A. S. C., Peterlini, M. A. S., & Pedreira, M. L. G. (2017). Hand hygiene as a caring practice: a reflection on professional responsibility. Rev Bras Enferm, 70(2), 461-4.
Batista, K. C; Tipple, A. F., Leão-Vasconcelos, L. S., Ribeiro, E. L., & Prado, M. A.(2015) Contaminação de torniquetes para punção intravenosa periférica. Acta Paul Enferm, 28(5), 426-32.
Boyce, B. B., & Yee, B. H. (2012) Incidence and severity of phlebitis in patients receiving peripherally infused amiodarone. Crit Care Nurse, 32, 27-34.
Buzatto, L. L., Massa, G. P., Peterlini, M. A., & Whitaker, I. Y.(2016). Factors associated with phlebitis in elderly patients with amiodarone intravenous infusion. Acta Paul Enferm, 29(3),260-6.
Campos, C. C., Alcoforado, C. L. G. C., Franco, L. M. C., Carvalho, R. L. R., & Ercole, F. F.(2016). Incidence of catheter-related urinary tract infecions: a cohort study. REME – Rev Min Enferm, 20:e973.
Danski, M. T., Johann, D. A., Vayego, S. A., Oliveira, G. L., & Lind, J. (2016). Complications related to the use of peripheral venous catheters: a randomized clinical trial. Acta Paul Enferm, 29(1), 84-92.
Gorski, L., Hadaway, L., Hagle, M. E., McGoldrick, M., Orr, M., Doellman, G. L., Hadaway, L., Hagle, M. E., McGoldrick, M., Orr, M., & Doellman, D.(2016). Infusion therapy standards of practice. J Infus Nurs, 39 (1S), S11-S159.
Graveto, J. M. G. N., Rebola, R., Fernandes, E., & Costa, P. S. (2018). Hand hygiene: nurses’ adherence after training. Rev Bras Enferm, 71(3), 1189-93.
Graveto, J. M., Santos, C., Costa, O. S., Fernandes, E., Alarico, S., & Osorio, N. (2018). Hand hygiene management among nurses: collective health challenges. Rev Bras Enferm, 71(Suppl 1), 562-7.
Hagiwara, A. M., Suserud, B-O., Gäre, B. A., Sjöqvist, B. A., Henricson, M., & Jonsson, A. (2014). The effect of a Computerised Decision Support System (CDSS) on a compliance with the prehospital assesstement process: results of an interrupted time-series study. BMC medical informatics & decision making, 14(70).
Jonathan, T., Michael, G. M., & Rick B. Hand Hygiene in Emergency Medical Services. (2015). Prehospital Emerg Care, 19(2), 313-319.
Malta, M., Silva, C. M. F. P., Bastos, F. I., Magnanini, M. M. F., & Cardoso, L. O. (2010) STROBE initiative: guidelines on reporting observational studies. Rev Saúde Pública, 44(3), 559-65.
Mohr, D. C., Eaton, J. L., McPhaul, K. M., & Hodgson, M. J. (2015). Does Employee Safety Matter for Patients Too? Employee Safety Climate and Patient Safety Culture in Health Care. Journal of Patient Safety, 14(03), 181-185.
Nurses: a force for change -Care effective, cost effective. International Council of Nurses. EUA: ICN,2015.
Rocha, I. V., Ferraz, P. M., Farias, T. G., Oliveira, S. R. (2015) Resistência de bactérias isoladas em equipamentos em unidade de terapia intensiva. Acta Paul Enferm, 28(5), 433-9.
World Health Organization. World Alliance for Patient Safety. Forward Programme 2008 – 2009. Switzerland: WHO,2009.
World Health Organization. Guidelines on Hand Hygiene in Health Care: first global patient safety challenge clean care is safer care. Switzerland: WHO,2009.
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Copyright (c) 2020 Eric Rosa Pereira, Ronilson Gonçalves Rocha, Natália da Conceição Andrade Monteiro, Alexandre Barbosa de Oliveira, Graciele Oroski Paes
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