Structure for prevention of health care-associated infections in Brazilian hospitals: A countrywide study

Abstract

Background: Minimal structure is required for effective prevention of health careeassociated 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 CareeAssociated 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. Copyright (C) 2016 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.