Prevention of nosocomial pneumonia: health team intervention on a pacient wich mechanical ventilation

Abstract

Descriptive exploratory study, prospective with quantitative approach, in Emergency Hospital Intensive Care and Emergency Units, aimed at identifying the association between MV the care given by professionals and the occurrence of pneumonia. The population was of 68 professionals. The results show that from the 38 intubated patients, 17 died and 04 were extubated before the first 48 hours of their admission; 13 were diagnosed with MVAP, 04 within 72 hours and 09 after that period. The tracheal secretion culture was performed on 10 patients and the most frequent etiological agent was pseudonomas aureus. As for the procedures performed before MV on the mechanical ventilators, respiratory and moisturizing circuits, on 25 cleansing and disinfection was not performed; 21were assembled without asseptic techiques; after assembly, the ventilator was tested 26 times with non-sterile lungs; the condensation when present (87 times) was discarded on 70; on 52 times the professionals did not wash their hands after this procedure; on 11 from the 17 intubations, the physician did not wash his hands before performing it; none used IPE; from 313 observed aspirations, on 249 the hands were not previously washed; from 176 introduced diets, on 141 times there was no interruption during aspiration; on 288 times not all IPEs were used; on less than half (156 times) the hands were washed after the procedure; the respiratory phyisiotherapy was performed 70 times and from those, on 45 the professionals did not previously wash their hands; 33 did not interrupt the diet. From the remaining 17, 13 were diagnosed with MVAP between 48 and 72 hours since the use of MV and the data obtained on the structured observations point to the risk of these patients having MVAP.