Quality assessment of adult intensive care services: application of a tool adjusted to the reality of low-income countries

Abstract

Objective To assess the quality of adult intensive care units. Methods This population-based, cross-sectional, observational, analytical study evaluated management type in Maranhão, Brazil. An assessment instrument was applied that assigned scores to each service (maximum 124 points). The units were categorized as insufficient (< 50% of the maximum score), typical (≥ 50% and <80% of the maximum score), or sufficient (≥ 80% of the maximum score). Results Of the 26 intensive care units in Maranhão, 23 were evaluated; 15 (65.2%) were located in the state capital, and 14 (60.9%) were public. The mean final score was 67.2 (54.2% of the maximum). The worst performance was observed with regard to processes (50.9%) in the units located outside the capital (p = 0.037) and for hospitals with 68 beds or fewer (p = 0.027). The result of the assessment categorized services as a function of the overall total points earned. Specifically, 8 (34.8%) services were assessed as insufficient, 13 (56.5%) were assessed as typical, and 2 (8.7%) were assessed as sufficient. Conclusion The majority of the intensive care units in this study were assessed as typical. These services must be better qualified. The priorities are the processes of the units located outside the capital and in small hospitals.

Management actions for prevention and control of healthcare‐associated infections: A grounded theory approach

“…This practice is associated with a decrease in mortality indicators in this environment, as well as a reduction in infection levels. In addition, the process of daily visits does not entail additional costs for the institution, considering that all professionals who participate in the rounds are part of the hospital's clinical staff (Carvalho et al, 2019). Furthermore, the implementation of multi-professional visits promotes the development of a culture of safety and the opportunity to measure and qualify the health care offered to the patient.…”