EFFECTIVENESS OF A CONTINUOUS IMPROVEMENT CYCLE FOR THE PREVENTION OF PRIMARY BLOODSTREAM INFECTION IN CENTRAL VENOUS CATHETER PATIENTS
Quality; Improvement cycle; Catheter-related infections; Teaching.
Healthcare-associated infections (HAIs) are frequent incidents and a serious public health problem, since they increase costs, length of hospital stay, and morbidity and mortality, negatively impacting the quality of health services. It is evident that the prevention of primary bloodstream infections associated with the central venous catheter (CVC-IPCS) is closely related to the implementation of evidence-based measures, such as adherence to the bundles of good insertion practices and the optimization of device maintenance practices, as well as interventions aimed at facilitating teamwork and safety culture. The objective of this study was to evaluate the effectiveness of the implementation of a continuous improvement cycle for the prevention of primary bloodstream infection in patients with central venous catheter (CVC-IPCS). This is a quantitative research with a quasi-experimental design, of the before-after type, of a single group, using the implementation of a quality improvement cycle, developed in the period from September 2023 to July 2024, at Hospital Giselda Trigueiro (HGT), in Natal, Rio Grande do Norte (RN), and is taking place through seven (07) phases: 1) Identification of the opportunity for improvement; 2) Analysis of opportunities for change; 3) Selection of criteria for quality assessment; 4) Design of the format of the intervention; 5) Pre-intervention quality assessment; 6) Implementation of the intervention; and 7) Measurement of effectiveness after the intervention. The study is being carried out with the 37 professionals who provide care to critically ill patients in the Intensive Care Unit (ICU), respecting the ethical principles recommended for research carried out with human beings. Based on the participants' answers, in phase 1 it was observed that 66.67% of the mentions of improvement opportunities are related to material, 45.45% to hand hygiene, and 42.42% to the need to improve material changes. In stage 2, the professionals prioritized, through the use of the GUT matrix, the improvement in hand hygiene (62.2%). Phase 3 resulted in the updating of the checklist with the evaluation and training criteria of the fellows to apply it in phases 5 and 7. In stage 4, a schedule of educational action was obtained from the result of a scope review and survey of the professionals' preference for active learning methodologies. Stage 5 is underway and 6 and 7 are scheduled to take place from April to July 2024.