Palavras-chave
pacotes de assistência ao paciente
lista de checagem
Unidade de Terapia Intensiva
custos hospitalares
Como Citar
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Resumo
Objetivo: Avaliar o impacto econômico da implementação de bundles e checklists na prevenção de ICSRC em UTIs. Métodos: Revisão sistemática da literatura sem metanálise, conduzida conforme diretrizes PRISMA 2020 e PRISMA-P, registrada no PROSPERO (CRD 42023470441). Foram pesquisadas nove bases de dados (BDENF, CINAHL, EMBASE, LILACS, PsycINFO, PubMed, SciELO, Scopus e Web of Science) entre 2012 e 2022. A qualidade metodológica foi avaliada pela Escala de Newcastle-Ottawa (NOS). Resultados: Foram identificados 1.432 estudos, dos quais 9 atenderam aos critérios de elegibilidade. A maioria foi composta por estudos observacionais pré e pós-intervenção. A implementação de bundles e checklists reduziu significativamente as taxas de ICSRC e os custos hospitalares, com reduções de infecção de até 89% e economia superior a US$ 1 milhão por instituição. A heterogeneidade metodológica e a variabilidade na adesão foram limitações identificadas. Considerações finais: A implementação estruturada de bundles associada ao uso de checklists reduz ICSRC e custos hospitalares, configurando estratégia eficaz para segurança do paciente e otimização de recursos em UTIs.
Referências
ALKHAWAJA S, et al. Impact of International Nosocomial Infection Control Consortium's multidimensional approach on central line-associated bloodstream infection rates in Bahrain. The Journal of Vascular Access, 2019; 21(4):481-489.
ALVES SB, et al. Tendência de infecção da corrente sanguínea associada a cateter central em unidades de terapia intensiva adulta brasileiras: um estudo ecológico. Jornal de infecção em países em desenvolvimento. 2021; 15(11): 1744-9.
BARRETO AFG, et al. Infection of Central Venous Catheter and the Non-Compliance of Protocols in the Intensive Care Unit. Revista de Enfermagem UFPE, 2013;7(2): 43-437.
BION J, et al. “Matching Michigan”: A 2-Year Stepped Interventional Program to Minimize Central Venous Catheter-Blood Stream Infections in Intensive Care Units in England. BMJ quality & safety. 2013; 22(2): 110-23.
BÖLL B, et al. Central Venous Catheter Related Infections in Hematology and Oncology: 2020 Updated Guidelines on Diagnosis, Management, and Prevention by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Annals of Hematology. 2021; 100(1): 239-59.
BRASIL. Agência Nacional de Vigilância Sanitária (ANVISA). Medidas de Prevenção de Infecção Relacionada à Assistência à Saúde. Brasília: Anvisa, 2017.
BUETTI N, et al. Strategies to Prevent Central Line Associated Bloodstream Infections in Acute-Care Hospitals: 2022 Update. Infection Control & Hospital Epidemiology. 2022;43(5): 553-69.
BURDEN AR, et al. Prevention of Central Venous Catheter-Related Bloodstream Infections: Is It Time to add Simulation Training to the Prevention Bundle? Journal of Clinical Anesthesia. 2012; 24(7): 555-60.
CHAN KS e ZARY N. Applications and Challenges of Implementing Artificial Intelligence in Medical Education: Integrative Review, JMIR Medical Education, 2019; 5(1): e13930
GAMEIRO AJR, et al. A Cohort Study on Nurse-Led Checklist Intervention to Reduce Catheter-Related Bloodstream Infection in an Intensive Care Unit, Journal of Intensive & Critical Care, 2017; 3(1).
HORNER DL e BELLAMY MC. Care Bundles in Intensive Care, Continuing education in Anaesthesia, Critical care & Pain. 2012; 12(4): 199-202.
ISTA E, et al. Effectiveness of Insertion and Maintenance Bundles to Prevent Centralline-Associated Bloodstream Infections in Critically ill Patients of all Ages: A Systematic Review and Meta-Analysis, The Lancet Infectious Diseases. 2016;16(6): 724-34.
LOVEDAY HP, et al. Epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England. Journal of Hospital Infection. 2014; 86:S1-70.
LUCCHINI A et al. Impact of a ‘Catheter Bundle’ on Infection Rates and Economic Costs in the Intensive Care Unit: A Retrospective Cohort Study, Nursing Reports. 2024; 14(3): 1948-1960.
MARSCHALL J, et al. Strategies to Prevent Central Line-Associated Bloodstream Infections in Acute Care Hospitals: 2014 update. Infection Control and Hospital Epidemiology. 2014; 35(7): 753-71.
MCPEAKE J, et al. Central Line Insertion Bundle: Experiences and Challenges in an Adult ICU. Nursing in Critical care. 2012;17(3): 123-9.
NASSAR JÚNIOR AP, et al. Patient-Level Costs of Central Line-Associated Bloodstream Infections Caused by Multidrug-Resistant Microorganisms in a Public Intensive Care Unit in Brazil: A Retrospective Cohort Study. Revista Brasileira de Terapia Intensiva. 2023; 34: 529-33.
NUCKOLS TK, et al. The Value of Quality Improvement Interventions for Blood Stream Infections Related to Central Catheters: A Systematic Review of Economic Evaluations Teryl. JAMA Intern Med. 2019;176(12): 1843–54.
PAGE MJ, et al. Updating Guidance for Reporting Systematic Reviews: Development of the PRISMA 2020 Statement. Journal of Clinical Epidemiology. 2021; 134: 103-12.
PARK JY, et al. The Impact of Infection Control Cost Reimbursement Policy on Central Line Associated Bloodstream Infections. American Journal of Infection Control. 2020;48(5): 560-5.
ROSENTHAL VD. Central Line-Associated Bloodstream Infections in Limited-Resource Countries: A Review of the Literature. Clinical Infectious Diseases; 2009; 49(12): 1899-907.
SACKS GD, et al. Reducing the Rate of Catheter-Associated Bloodstream Infections in a Surgical Intensive Care Unit Using the Institute for Healthcare Improvement Central Line Bundle. The American Journal of Surgery. 2014; 207(6): 817-23.
SAGANA R e HYZY RC. Achieving Zero Central Line Associated Bloodstream Infection Rates in your Intensive Care Unit. Critical Care Clinics. 2013; 29(1):19.
TIMSIT JF, et al. Bloodstream Infections Incritically ill Patients: An Expert Statement. Intensive Care Medicine. 2020;46(2): 266-84.
TOPOL EJ. High-Performance Medicine: The Convergence of Human and Artificial Intelligence. Nature Medicine. 2019; 25(1): 44–56.
WINTERS BD et al. Clinical Review: Checklists – Translating Evidence Into Practice. Critical Care. 2009; 13(6):1-9.
WITTEKAMP BH, et al. Decontamination Strategies and Bloodstream Infections with Antibiotic-Resistant Microorganisms in Ventilated Patients: A Randomized Clinical Trial. Jama. 2018; 320(20): 208798.
YOSHIDA T, et al. Incidence of Central Venous Catheter-Related Bloodstream Infections: Evaluation of Bundle Prevention in Two Intensive Care Units in Central Brazil. The Scientific World Journal. 2019: 1025032.