Padoveze Maria Clara, Fortaleza Carlos Magno Castelo Branco, Kiffer Carlos, Barth Afonso Luís, Carneiro Irna Carla do Rosário Souza, Giamberardino Heloisa Ilhe Garcia, Rodrigues Jorge Luiz Nobre, Santos Filho Lauro, de Mello Maria Júlia Gonçalves, Pereira Milca Severino, Gontijo Filho Paulo, Rocha Mirza, de Medeiros Eduardo Alexandrino Servolo, Pignatari Antonio Carlos Campos
Department of Collective Health Nursing, School of Nursing of University of São Paulo, São Paulo, Brazil.
Department of Infectious Diseases, Botucatu School of Medicine, State University of São Paulo, Botucatu, Brazil.
Am J Infect Control. 2016 Jan 1;44(1):74-9. doi: 10.1016/j.ajic.2015.08.004. Epub 2015 Sep 26.
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.
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.
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.
This study highlights the need for public health strategies aiming to improve the structure for HAI prevention in Brazilian hospitals.
有效预防医疗保健相关感染（HAI）所需的结构最少。本研究的目的是评估巴西医院样本中预防HAI的结构。
这是一项对巴西5个地区医院的横断面研究（n = 153；病床总数：13,983），根据病床数量进行分类；11所大学医院用作比较参考。训练有素的护士使用先前验证过的结构化表格进行评估。合规指数（CI）评估包括医疗保健相关预防与控制委员会（HAIPCC）的结构要素、手卫生、消毒和微生物实验室。
HAIPCC的CI中位数在不同医院类别中为0.55 - 0.94。病床数>200张的医院病床与水槽的比例最差（3.9；P <.001）。关于用于手部揉搓的酒精类产品，病床数<50张的医院病床与分配器的比例最差（6.4），而参考医院为（3.3；P <.001）。消毒服务的CI显示出从0.0到1.00的巨大差异。参考医院比其他医院更有可能拥有自己的微生物实验室。
本研究强调了制定公共卫生策略以改善巴西医院HAI预防结构的必要性。
