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巴西三家医院的良好感染预防措施:对患者安全政策的启示。

Good infection prevention practices in three Brazilian hospitals: Implications for patient safety policies.

机构信息

Departamento de Saúde Coletiva, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.

Centro de Investigación en Calidad y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.

出版信息

J Infect Public Health. 2019 Sep-Oct;12(5):619-624. doi: 10.1016/j.jiph.2019.02.016. Epub 2019 Mar 8.

Abstract

OBJECTIVE

Healthcare-associated infections (HAI) are a serious patient safety problem. There are effective preventive practices, but little information on adherence in Brazilian hospitals. This study aims at assessing adherence to good HAI prevention practices.

METHODS

A cross-sectional observational study was conducted at 3 different types of hospitals (public-federal, public-state and private) in Rio Grande do Norte state, Brazil. A total of 19 structure and process indicators were measured based on 7 National Quality Forum Patient Safety Practices.

RESULTS

Overall adherence was low, but higher in the private hospital, followed by the public-federal and public-state institutions. There was adequate maintenance of central venous catheters and high vaccine coverage against the influenza virus among health professionals. However, hand hygiene adherence was low, and surgical antibiotic prophylaxis and prevention of multidrug-resistant bacteria transmission, urinary tract infection by urinary catheter and associated with mechanical ventilation were inadequate.

CONCLUSIONS

Despite the availability of evidence-based recommendations, there is ample room for improvement in adherence to safe practices in the hospitals under study, contributing to the heightened risk of unnecessary harm to patients.

摘要

目的

医疗保健相关感染(HAI)是严重的患者安全问题。有有效的预防措施,但关于巴西医院的遵守情况的信息很少。本研究旨在评估对良好的 HAI 预防措施的遵守情况。

方法

在巴西北里奥格兰德州的 3 种不同类型的医院(公立联邦、公立州立和私立)进行了一项横断面观察性研究。共测量了 19 个结构和过程指标,这些指标基于 7 个国家质量论坛患者安全实践。

结果

总体上的遵守情况较低,但私立医院较高,其次是公立联邦和公立州立机构。卫生专业人员对中心静脉导管的维护以及流感疫苗的高覆盖率较好。然而,手卫生的遵守情况较低,手术抗生素预防和多药耐药菌传播的预防、导尿管相关尿路感染以及与机械通气相关的感染预防情况较差。

结论

尽管有循证建议,但在所研究的医院中,安全实践的遵守情况仍有很大的改进空间,这增加了对患者造成不必要伤害的风险。

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