Assistência de enfermagem na prevenção de pneumonia associada à ventilação mecânica: revisão integrativa / Asistencia en enfermería para prevenir la neumonía asociada a la ventilación mecánica: revisión integradora / Nursing assistance in preventing pneumonia associated with mechanical ventilation: integrative review

Objetivo: investigar como a literatura científica aborda a assistência de enfermagem na prevenção de pneumonia associada à ventilação mecânica. Método: revisão integrativa da literatura na biblioteca eletrônica de periódicos científicos, disponíveis online nas bases de dados Literatura Latino-americana e do Caribe em Ciências da Saúde e Medical Literature Analysis and Retrieval System Online. Foram utilizados, para as buscas, os descritores controlados "Pneumonia", "Ventilação Mecânica", "Prevenção e Controle" e "Assistência de Enfermagem". Resultados: os estudos foram sintetizados em duas categorias A Enfermagem nos Protocolos ou medidas de prevenção da Pneumonia Associada à Ventilação Mecânica; e Conhecimento dos Profissionais de Enfermagem sobre a prevenção da Pneumonia Associada à Ventilação Mecânica. Conclusão: a Pneumonia associada à ventilação mecânica deve ser prevenida através de ações e intervenções da equipe multiprofissional. Embora seja uma infecção que pode ser evitada pelo cuidado de enfermagem, fundamentado em evidências científicas.(AU)

Objective: to investigate how the scientific literature approaches nursing care in the prevention of pneumonia associated with mechanical ventilation. Method: an integrative literature review was carried out in the electronic library of scientific journals, available online in the databases Latin American and Caribbean Literature in Health Sciences and Medical Literature Analysis and Retrieval System Online. The controlled keywords "Pneumonia", "Mechanical Ventilation", "Prevention and Control" and "Nursing Assistance" were used for the searches. Results: the studies were summarized in two categories Nursing in Protocols or preventive measures for Pneumonia Associated with Mechanical Ventilation; and Knowledge of Nursing Professionals on the prevention of Pneumonia Associated with Mechanical Ventilation. Conclusion: pneumonia associated with mechanical ventilation must be prevented through actions and interventions by the multi-professional team. Although it is an infection that can be avoided by nursing care, based on scientific evidence.(AU)

Objetivo: investigar cómo la literatura científica aborda los cuidados de enfermería en la prevención de la neumonía asociada a la ventilación mecánica. Método: revisión integradora de la literatura en la biblioteca electrónica de revistas científicas, disponible en línea en las bases de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud y Medical Literature Analysis and Retrieval System Online. Para las búsquedas se utilizaron las palabras clave controladas "Neumonía", "Ventilación mecánica", "Prevención y control" y "Asistencia de enfermería". Resultados: los estudios se sintetizaron en dos categorías Enfermería en Protocolos o medidas preventivas de Neumonía Asociada a Ventilación Mecánica; y Conocimiento de los profesionales de enfermería sobre la prevención de la neumonía asociada a la ventilación mecánica. Conclusión: la neumonía asociada a la ventilación mecánica debe prevenirse mediante acciones e intervenciones del equipo multiprofesional. Aunque es una infección que puede evitarse con cuidados de enfermería, según la evidencia científica.(AU)

High rates of methicillin-resistant Staphylococcus aureus colonisation in a Brazilian Intensive Care Unit.

OBJECTIVE: To evaluate the colonisation rate of Staphylococcus aureus in the oropharynx and the insertion site of central venous catheters in intensive care unit patients. DESIGN: Cross-sectional study. SETTING: Brazilian intensive care unit. MEASUREMENTS: Samples were collected from October to December 2015 from the oropharyngeal cavity and central venous catheter insertion site of 110 patients. Samples that presented growth of Staphylococcus aureus were isolated and their sensitivity profiles were tested for several antimicrobials. FINDINGS: The study participants (110) were mostly females older than 60 years (53.6%). The mean length of hospitalisation was 15.5 days (±31.3). A total of 188 biological samples were collected: 110 collected from the oropharynx and 78 from the central venous catheter insertion site. A 35% (n = 38/110) S. aureus colonisation rate of the patients was observed in at least one collection site. In the oropharynx alone, a 31% rate (n = 34/110) was found, and a 12.8% rate (n = 10/78) at central venous catheter insertion sites only. MRSA colonisation in the oropharynx or at the central venous catheter occurred in 29 (26.4%) patients and vancomycin resistant Staphylococcus aureus was present in 24 (22.4%) of the patients studied. Patients hospitalised for seven days or more were 4.8 times more likely to be colonised compared to patients hospitalised less than seven days (95% CI = 1.2-28.5). CONCLUSION: The oropharynx and the central venous catheter are important reservoirs of this bacterium that in critical conditions may become pathogenic. The data showed a high degree of resistance of the bacterial populations isolated to different drugs, which may hinder the control of these organisms.