Relação entre carga de trabalho em enfermagem e as taxas de infecção em uma Unidade de Terapia Intensiva Cardiológica de um Hospital Universitário

Abstract

INTRODUCTION: The Intensive Care Unit (ICU) is a place with high rates of Healthcare Related Infection (HAI) because the clinical characteristics of the profile of their patients, constantly require care and procedures. In order to analyze the quality and risks of the services provided, they have been evaluated through specific indicators. In ICUs, the most commonly used are SAPS and APACHE mortality prognostic indicators and the nursing staff workload measured using the Nursing Activities Score (NAS). OBJECTIVE: To analyze whether patient severity and nursing staff workload are related to a higher incidence of HAI in patients admitted to a cardiac ICU. MATERIAL AND METHODS: This is an ecological, retrospective, documentary, longitudinal quantitative study conducted at the Hospital de Clínicas de Uberlândia in a cardiac ICU. Indicator data were from January 2017 to June 2019. We used a correlation analysis between the variables that assess the workload of the monthly average nursing staff: NASA-m (NAS of admission), NAS-m (NAS monthly average) and PNAS50 (Percentage of NAS over 50); prognostic indices for in hospital death SAPS III and APACHE II and monthly IRAS incidence rates: HAI rate (TIRAS), rate of patients with HAI (TPIRAS), current infection rate blood associated with central venous catheter (TIPCS), pneumonia rate associated with mechanical ventilation (TPAV) and urinary tract infection rate associated with Delay Bladder Catheter (TITUAC) and Sepsis Rate (TSEPSE). RESULTS: There were 1033 hospitalizations during the period, accounting for 5818 NAS assessments. NASA-m and NAS-m showed a positive and significant correlation with TIRAS (respectively rs = 0,541; rs = 0,530; p < 0,01) and with TPIRAS (respectively rs = 0,506; p < 0,01 rs = 0,456; p < 0,05). SAPSP was positively correlated with TIRAS (rs = 0,616; p < 0,01) and with TPIRAS (rs = 0,491; p < 0,01) both correlated with SAPS. APACHE was correlated with TIPCS (rs = 0,418; p < 0,05). CONCLUSION: The increased workload of the nursing team and the clinical severity of patients increasing influence the occurrence of infections related to health care in a cardiac ICU, reinforcing the need for association and analysis of hospital indicators.