SHORT-TERM HEMODIALYSIS CENTRAL VENOUS CATHETER–ASSOCIATED INFECTIONS: EVIDENCE ON THE NURSE’S ROLE IN INTENSIVE CARE UNITS

Abstract

Acute kidney injury (AKI) is a frequent and severe complication among critically ill patients, often requiring renal replacement therapy through short-term hemodialysis central venous catheters, which are strongly associated with primary bloodstream infections and increased morbidity and mortality. In this context, nurses play a central role in the prevention of catheter-related infections, combining technical, managerial and educational dimensions of care. This integrative literature review aimed to analyze the role of nurses in preventing infections related to short-term hemodialysis central venous catheters in patients with acute kidney injury hospitalized in intensive care units. The review followed six methodological stages and was guided by the PICo strategy (Population, Interest, Context). Searches were conducted in LILACS, BDENF, SciELO and PubMed using controlled descriptors and Boolean operators. Original articles in Portuguese, English or Spanish, published between 2013 and 2025 and addressing nursing actions to prevent catheter-related infections in AKI patients in intensive care were included. Studies were classified according to the Joanna Briggs Institute levels of evidence. Ten studies met the eligibility criteria, predominantly descriptive and cross-sectional designs (Level IV), complemented by analytical retrospective studies (Level III.c) and integrative reviews. The findings revealed recurrent risk factors such as inadequate hand hygiene, poor adherence to preventive bundles, suboptimal antisepsis, prolonged catheter dwelling time, inappropriate insertion sites and insufficient clinical surveillance. Three analytical axes emerged: continuing education and clinical competence as preventive pillars; nursing leadership and care management as organizational devices for patient safety; and the materiality of care expressed in dressing techniques, site surveillance and use of adjunct technologies (chlorhexidine-impregnated dressings, antimicrobial locks and biofilm-control strategies). The review concludes that effective prevention of catheter-related infections depends on the integration of technical expertise, organizational support and permanent education, reinforcing the nurse’s protagonism in building safer hemodialysis care in intensive care settings.