Nursing role in prevention and control of infections in ICUs associated with care: A systematic review
Rol de enfermería en prevención y control de infecciones en UCI asociadas a la atención: Revisión sistemáticaArticle Sidebar
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Introduction: Healthcare-associated infections (HAIs) constitute a significant threat in intensive care units (ICUs), increasing morbidity and mortality, prolonging hospital stays, and raising healthcare costs. Objective: To identify and evaluate the most effective nursing strategies for the prevention and control of HAIs in ICU patients. Methods: A systematic review was conducted following PRISMA 2020 and JBI guidelines. Five databases (PubMed: n=1,123; Scopus: n=892; Web of Science: n=654; CINAHL: n=108; LILACS: n=70) were searched for studies published between 2015 and 2025. An initial 2,847 records were identified, eliminating 892 duplicates. After screening 1,970 records and evaluating 89 full texts, 30 studies were included. Results: Nine systematic reviews/meta-analyses, 10 observational studies, 7 narrative reviews, 2 qualitative studies, 1 Delphi study, and 1 review protocol were included. Standardized nursing interventions such as hand hygiene, invasive device bundles, and chlorhexidine baths significantly reduce the incidence of ventilator-associated pneumonia and catheter-related bacteremia. These bundles can reduce HCAIs in the ICU by up to 40%. Increased nursing staffing is consistently associated with lower HCAI rates. In short, visible leadership, support from senior nurses, and staff motivation are key factors in maintaining protocol adherence. Conclusions: Effective HCAI prevention requires a comprehensive approach that combines evidence-based technical measures, strong leadership, sufficient resources, and ongoing training.
Introducción: Las infecciones asociadas a la atención de la salud (IAAS) constituyen una amenaza significativa en unidades de cuidados intensivos (UCI), incrementando la morbimortalidad, prolongando la estancia hospitalaria y elevando los costos sanitarios. Objetivo: Identificar y evaluar las estrategias de enfermería más efectivas para la prevención y control de IAAS en pacientes de UCI. Métodos: Revisión sistemática siguiendo guías PRISMA 2020 y JBI. Se realizó búsqueda en cinco bases de datos (PubMed: n=1,123; Scopus: n=892; Web of Science: n=654; CINAHL: n=108; LILACS: n=70) de estudios publicados entre 2015-2025. Se identificaron 2,847 registros iniciales, eliminando 892 duplicados. Tras cribado de 1,970 registros y evaluación de 89 textos completos, se incluyeron 30 estudios. Resultados: Se incluyeron 9 revisiones sistemáticas/meta-análisis, 10 estudios observacionales, 7 revisiones narrativas, 2 estudios cualitativos, 1 estudio Delphi y 1 protocolo de revisión. Las intervenciones estandarizadas de enfermería como higiene de manos, paquetes de medidas para dispositivos invasivos y baños con clorhexidina reducen significativamente la incidencia de neumonía asociada al ventilador y bacteriemia relacionada con catéter. Los paquetes de medidas pueden reducir hasta 40% las IAAS en UCI. El incremento del personal de enfermería se asocia consistentemente con menores tasas de IAAS. En definitiva, el liderazgo visible, apoyo de enfermeras jefe y motivación del personal son factores clave para mantener adherencia a protocolos. Conclusiones: La prevención efectiva de IAAS requiere un enfoque integral que combine medidas técnicas basadas en evidencia, liderazgo sólido, recursos suficientes y formación continua.
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