Predictive value of nursing diagnosis risk of infection in patients with hospitalized AIDS
Nursing Diagnosis. Acquired Immunodeficiency Syndrome. Risk factors. Cross Infection.
The need for hospitalization of people living with Acquired Immunodeficiency Syndrome makes patients more susceptible to Health Care Related Infections as well as death. Infections related to care are among the main causes of morbidity and mortality, considering a relevant public health problem. Faced with the need to identify the risk of infection and factors related to them, in order to recognize deficits and patient needs with AIDS and improve the quality of health care, this study aims to analyze the predictive value of risk factors nursing diagnosis risk of infection in patients with AIDS. This is a retrospective study, analytical, observational, case control study in Statistical and Medical Archive Service of the Hospital Giselda Trigueiro, located in Natal, in the state of Rio Grande do Norte. The case group was formed by 104 patients who presented infection related to health care. The control group consisted of 104 individuals who did not evolve to hospital infection during the hospitalization period. The collection was performed between April and August 2017 through an instrument divided into four parts: sociodemographic data; clinical data; hospital infection data; and Risk Factors of Nursing Diagnosis Risk of Infection. For data analysis, we used statistical inference by applying the Pearson chi square test, we calculated the odds ratios with 95% confidence interval, and the prevalence of infected patients. The accuracy of the risk factors of the diagnosis was measured by sensitivity, specificity and predictive values. The results were organized in tables and discussed with the pertinent literature. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte, with Certificate of Presentation for Ethical Appraisal nº 46209215.0.0000.5537. The results showed that among the risk factors and prevalence of over 50% were identified: invasive procedure, changes in skin integrity, decreased hemoglobin, immunosuppression, abnormal peristalsis, chronic illness and leukopenia. There were three statistically significant associations with the nursing diagnosis investigated: three invasive procedures, altered skin integrity and decreased hemoglobin. Among those, the ones with the highest odds ratios were invasive procedure and altered skin integrity. The most sensitive risk factor was the invasive procedure and alteration in skin integrity and the suppressed inflammatory response and chronic disease were more prominent. It is concluded that the identification of accurate clinical indicators assist in the decision making of the nurse, which will facilitate the early identification of risk factors for developing an infection during care provided to people living with acquired immunodeficiency syndrome, thus ensuring patient safety.