Assistência de enfermagem na prevenção de infecção em pacientes neutropênicos com leucemia aguda: revisão de escopo

Abstract

Infection in neutropenic patients is considered a medical emergency case, and requires actions and measures of assistance from the whole health team. Therefore, considering the peculiarity and complexity of the care, besides the fast response to the attendance of possible intercurrences to onco-hematologic patients, the nursing team needs technical and scientific knowledge in order to minimize the occurrence of serious infections with the purpose of guaranteeing a quality nursing care. Objective: To evaluate and map the literature regarding nursing care measures to prevent infection in neutropenic patients diagnosed with acute leukemia. Method: This is a Scoping Review on nursing care to neutropenic patients diagnosed with acute leukemia to prevent infection, which during the entire process of preparation and investigation, adopted the methodology proposed by the JBI for review of espoco. This review used the mnemonic PCC (P: patients with acute leukemia; C: care measures and actions of the nursing team in infection prevention and control; C: systematized actions for infection prevention and reduction of clinical complications secondary to the involvement of preventable infections in neutropenic patients), for the construction of the research question, definition of objectives and construction of the search strategy. The search was carried out in three stages. Publications in PubMed, CINAHL, COCHRANE, Web of Science, Scopus, Embase, and Lilacs databases were searched, in addition to gray literature. There was no time or language limitation of the sources. The search corresponded to the period of 7 months. After the search, all identified records were grouped and sent to Mendeley. The entire process of study selection, was two independent reviewers. The data were extracted using a data extraction tool developed by the reviewers. After extraction, the data were presented in graphs to ensure alignment with the objective of this scoping review. Results: Eleven studies were included, published between the year 2003 and 2018, all published in the English language. The samples were composed of five literature reviews (45.45%), four by observational studies (36.36%), one retrospective study (9.09%) and one methodological study (9.09%). Regarding risk factors, the main intrinsic and extrinsic factors were established, as well as the risk factors associated with infection. The main nursing interventions, 72.72% pointed out that health education to patients/family members are essential measures, followed by antibiotic therapy administration (63.63%), hand hygiene (54.54%) and management of invasive devices (45.45%). Conclusion: Infectious complications continue to be an important issue in the care of patients with hematologic malignancies; however, it was possible to verify through analysis of the studies the strong association between neutropenia and infection, as well as nursing actions to prevent and minimize the development of infection. As a limitation of the study, the scarcity of national studies on the theme is highlighted.