Maria Clara Padoveze1, Carlos Magno Castelo Branco Fortaleza2, Carlos Kiffer3, Afonso Luís Barth4, Irna Carla do Rosário Souza Carneiro5, Heloisa Ilhe Garcia Giamberardino6, Jorge Luiz Nobre Rodrigues7, Lauro Santos Filho8, Maria Júlia Gonçalves de Mello9, Milca Severino Pereira10, Paulo Gontijo Filho11, Mirza Rocha12, Eduardo Alexandrino Servolo de Medeiros13, Antonio Carlos Campos Pignatari13. 1. Department of Collective Health Nursing, School of Nursing of University of São Paulo, São Paulo, Brazil. Electronic address: padoveze@usp.br. 2. Department of Infectious Diseases, Botucatu School of Medicine, State University of São Paulo, Botucatu, Brazil. 3. Special Clinical Microbiology Laboratory, Infectious Diseases Discipline, Federal University of São Paulo, São Paulo, Brazil. 4. Laboratory of Research in Bacterial Resistance, Center for Experimental Research, Clinical Hospital of Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. 5. Department of Infectious Diseases, Federal University of Pará, Belém do Pará, Brazil. 6. Epidemiology and Infection Control Department, Pequeno Principe Hospital, Curitiba, Brazil. 7. Department of Community Health, Faculty of Medicina, Federal University of Ceará, Ceará, Brazil. 8. Clinical Microbiology Discipline, Federal University of Paraíba, João Pessoa, Brazil. 9. Hospital Infection Control Committee, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil. 10. Department of Nursing, Pontifical Catholic University, Goias, Brazil. 11. Microbiology, Biomedical Sciences Institute, Uberlândia Federal University, Uberlândia, Brazil. 12. Núcleo de Vigilância Hospitalar, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. 13. Division of Infectious Diseases, Federal University of São Paulo, São Paulo, Brazil.
Abstract
BACKGROUND: Minimal structure is required for effective prevention of health care-associated infection (HAI). The objective of this study was to evaluate the structure for prevention of HAI in a sample of Brazilian hospitals. METHODS: This was a cross-sectional study from hospitals in 5 Brazilian regions (n = 153; total beds: 13,983) classified according to the number of beds; 11 university hospitals were used as reference for comparison. Trained nurses carried out the evaluation by using structured forms previously validated. The evaluation of conformity index (CI) included elements of structure of the Health Care-Associated Prevention and Control Committee (HAIPCC), hand hygiene, sterilization, and laboratory of microbiology. RESULTS: The median CI for the HAIPCC varied from 0.55-0.94 among hospital categories. Hospitals with >200 beds had the worst ratio of beds to sinks (3.9; P < .001). Regarding alcoholic product for handrubbing, the worst ratio of beds to dispensers was found in hospitals with <50 beds (6.4) compared with reference hospitals (3.3; P < .001). The CI for sterilization services showed huge variation ranging from 0.0-1.00. Reference hospitals were more likely to have their own laboratory of microbiology than other hospitals. CONCLUSION: This study highlights the need for public health strategies aiming to improve the structure for HAI prevention in Brazilian hospitals.
BACKGROUND: Minimal structure is required for effective prevention of health care-associated infection (HAI). The objective of this study was to evaluate the structure for prevention of HAI in a sample of Brazilian hospitals. METHODS: This was a cross-sectional study from hospitals in 5 Brazilian regions (n = 153; total beds: 13,983) classified according to the number of beds; 11 university hospitals were used as reference for comparison. Trained nurses carried out the evaluation by using structured forms previously validated. The evaluation of conformity index (CI) included elements of structure of the Health Care-Associated Prevention and Control Committee (HAIPCC), hand hygiene, sterilization, and laboratory of microbiology. RESULTS: The median CI for the HAIPCC varied from 0.55-0.94 among hospital categories. Hospitals with >200 beds had the worst ratio of beds to sinks (3.9; P < .001). Regarding alcoholic product for handrubbing, the worst ratio of beds to dispensers was found in hospitals with <50 beds (6.4) compared with reference hospitals (3.3; P < .001). The CI for sterilization services showed huge variation ranging from 0.0-1.00. Reference hospitals were more likely to have their own laboratory of microbiology than other hospitals. CONCLUSION: This study highlights the need for public health strategies aiming to improve the structure for HAI prevention in Brazilian hospitals.
Authors: Maria Clara Padoveze; Sara Melo; Simon Bishop; Vanessa de Brito Poveda; Carlos Magno Castelo Branco Fortaleza Journal: Rev Saude Publica Date: 2017-12-11 Impact factor: 2.106