A carregar...
3 resultados
Resultados da pesquisa
A mostrar 1 - 3 de 3
- Effectiveness of Nursing Interventions on Preventing the Risk of Infection in Adult Inpatients: Protocol for a Systematic ReviewPublication . Todo Bom, Luís Filipe Pereira; Mata, Ema Soraia Fazenda; Cunha, Helena Margarida Pereira; Marquês, Maria do Céu Mendes Pinto; Dixe, Maria dos AnjosBackground/Objectives: Healthcare-associated infections (HAIs) are a major global public health concern, significantly impacting patient safety and healthcare quality. These infections are associated with high morbidity and mortality rates, prolonged hospital stays, and increased healthcare costs. Nurses play a critical role in infection prevention, implementing evidence-based interventions to reduce infection risks. This systematic review aims to identify and synthesize the most effective nursing interventions to prevent HAIs in hospitalized adults, analyzing their variability across different clinical settings and populations. Methods: This systematic review follows the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness and is reported according to PRISMA guidelines. The protocol is registered in the PROSPERO database (CRD42024582820). This review includes randomized controlled trials, quasi-experimental studies, and observational studies (cohort, case-control, and cross-sectional) assessing the effectiveness of nursing interventions in reducing HAIs. A comprehensive search is conducted in the PubMed, CINAHL, Scopus, Web of Science, and Cochrane databases. Study selection, data extraction, and quality assessment are performed by two independent reviewers, with disagreements resolved by a third reviewer. Results: The primary outcomes include reductions in HAI incidence rate, increased adherence to preventive interventions, decreased hospital length of stay, reduced readmission rates due to infections, and overall patient safety improvements. A meta-analysis is conducted when feasible; otherwise, results are synthesized narratively. Conclusions: The findings of this review contribute to the standardization of evidence-based nursing practices for HAI prevention, promoting safer healthcare environments. By identifying the most effective interventions, this study aims to support healthcare professionals and policymakers in implementing targeted infection control strategies.
- Prevalence and determinants of infection risk in hospitalised adults: a multicentre cross-sectional study using a structured risk assessment toolPublication . Bom, Luís Todo; Pragosa, Ângela; Mata, Ema; Costeira, Cristina; Duarte, Hugo; Mendes, Ana Rita; Gonçalves, Telma; Mendes, Maria José; Cunha, Helena; Cunha, Helena; Dixe, Maria dos Anjos; Maria dos Anjos Dixe; Marques, Maria do CéuBackground – Healthcare-associated infections remain a major public health challenge, contributing to increased morbidity, mortality, length of hospital stays, and healthcare costs. Systematic assessment of infection risk is essential to support preventive strategies and improve patient safety however remains insufficiently structured in many clinical settings. Objective – To estimate the prevalence of infection risk among hospitalised adults and to identify intrinsic and extrinsic factors associated with high infection risk using a structured risk assessment instrument. Methods – A multicentre, observational, cross-sectional study was conducted in adult inpatient wards across multiple Local Health Units of the Portuguese National Health Service during 2025. Infection risk was assessed using the Risk Assessment for Infection (RAC) scale, which evaluates intrinsic and extrinsic risk factors. Risk stratification was performed using complementary approaches, including receiver operating characteristics (ROC) analysis and percentile-based classification. The study was conducted in accordance with ethical requirements. Results – A total of 1, 092 hospitalised adults were included. Most participants were classified as having moderate (53.6%) or high (11.4%) infection risk according to percentile-based stratification. Higher risk levels were significantly associated with intrinsic factors such as older age, multimorbidity, impaired tissue integrity, and reduced mobility, as well as extrinsic factors including previous hospitalisation, intra- or inter-hospital transfer, prolonged length of stay, invasive procedures, and pharmacological therapy. ROC analysis identified a cut-off point with good discriminative performance, while percentile-based stratification enabled a more granular three-level risk classification. Patients hospitalised in medical wards had significantly higher risk scores compared with those in surgical wards. Conclusion – This study demonstrates a high prevalence of infection risk among hospitalised adults and confirms the multifactorial nature of infection risk in hospital settings. The RAC scale proved to be a useful tool for systematic risk stratification, with the three-level classification providing enhanced clinical applicability. Integrating structured infection risk assessment into routine care may support early identification of high-risk patients, enable targeted preventive interventions, and strengthen infection prevention and control programmes.
- Effectiveness of nursing interventions on preventing the risk of infection in hospitalized adults: a systematic reviewPublication . Bom, Luís Filipe Pereira Todo; Mata, Ema Soraia Fazenda; Cunha, Helena Margarida Pereira; Santos, Ana Rita Melo; Pereira, Ana Sofia Ferreira; Castanheira, Joana Antunes; Dixe, Maria dos Anjos Coelho Rodrigues; Marquês, Maria do CéuBackground Healthcare-associated infections (HAIs) remain a global challenge for patient safety and quality of care, affecting millions of individuals each year and resulting in substantial morbidity, mortality, and financial burden. In Europe alone, over 4.2 million episodes of HAI occur annually. Nurses play a pivotal role in infection prevention through the implementation of evidence-based interventions aimed at disrupting transmission chains and reducing infection risk. Despite the widespread dissemination of preventive strategies, marked heterogeneity persists in their implementation and effectiveness, influenced by institutional, behavioural, and contextual factors. Objective To critically evaluate the effectiveness of nursing interventions in preventing infection risk among hospitalised adults through a systematic review of the literature. Methods A systematic review of Randomised Controlled Trials (RCTs) was conducted following the Joanna Briggs Institute (JBI) methodology and PRISMA 2020 guidelines, with prior registration in PROSPERO (CRD42024582820). Searches were performed across MEDLINE, CINAHL, Scopus, Web of Science, and the Cochrane Library up to January 2025. Methodological quality was assessed using JBI critical appraisal tools, and the certainty of the evidence was rated using the GRADE approach. Given the heterogeneity of the included studies, a narrative synthesis was undertaken. Results Out of 8,123 records identified, 22 RCTs (1979–2024) met the inclusion criteria. Nursing interventions, including daily body bathing with chlorhexidine, prevention bundles for catheters and other devices, promotion of hand hygiene, educational strategies, and environmental disinfection (e.g. ultraviolet-C light) demonstrated a significant reduction in HAI incidence compared with usual care. Multimodal and integrated interventions proved more effective than isolated measures. The overall certainty of evidence was moderate for infection reduction and adherence improvement, but inconsistent for patient mortality and satisfaction outcomes. Conclusions Evidence-based nursing interventions, particularly when applied in a coordinated and multimodal manner, substantially reduce infection risk among hospitalised adults. These findings support the integration of such interventions into institutional programmes and infection control policies. Further multicentre RCTs are recommended to assess implementation fidelity, cost-effectiveness, and patient-centred outcomes.