Eficácia do protocolo do banho diário com clorexidina em uma unidade de terapia intensiva cardiopediátrica

Abstract

Daily bathing with degerming chlorhexidine has been shown to reduce healthcare-related infections (HAI) and colonization by multidrug-resistant microorganisms in patients hospitalized in the Intensive Care Unit (ICU). Purpose: To evaluate the effectiveness of daily bathing with chlorhexidine in the reduction of bloodstream and surgical site infection in children with heart disease or with a diagnostic hypothesis of heart disease hospitalized in a Cardiopediatric ICU and in a clinical and surgical Inpatient Unit (UI) and to assess the impact and support for transfer of training in intensive care cardio-pediatrics. Material and method: This is a prospective longitudinal study with a descriptive design and a quantitative analytical approach with correlation between variables, carried out in an ICU of a teaching hospital. Data were collected through access to the patient's electronic medical record and the infection report of the Hospital Infection Control Commission (CCIH). The profile of the studied sample was drawn descriptively, considering the analyzed variables and their consequences. In the inferential scope, the analysis of independence and prediction between the variables proposed in the scope of the work was outlined as statistical objectives. For this, the Man-Whitney U test was used. Results: 325 children were included, 225 in the pre-intervention period and 100 in the post-intervention period. There was no statistically significant difference regarding infections between the pre- and post-intervention groups with p=1,000. However, there was a relationship with the development of infection in the admission site, surgical procedure, time of anoxia related to extracorporeal circulation (ECC), total length of stay in the postoperative period with a value of P<0.05. Regarding training, in the team's view, the impact received an overall average of 4.13 (±0.67). The perception of support to training transfer showed some trends, however, there was no statistical significance. Conclusion: The implementation of the daily chlorhexidine bath protocol in children with heart disease did not prove to be effective on the number of bloodstream and surgical site infections between the two investigated groups, which is associated with multifactorial causes and the small number of children with infections in the period. Regarding training, it was possible to understand the nursing staff's self-perception of support for transference and impact, including in relation to the profile, which can contribute when planning future training strategies.