Success factors of a collaborative project to reduce healthcare-associated infections in intensive care units in Northeastern Brazil

Abstract

Objective To describe the implementation and results of the collaborative PROADI-SUS project by the Brazilian Ministry of Health to reduce healthcare-associated infections: ventilator-associated pneumonia, primary central line-associated bloodstream infection and catheter-associated urinary tract infections. Methods This was a prospective observational study that investigated the implementation stages and outcomes during 18 months in five intensive care units in the city of Recife. Reductions in healthcare-associated infections in each unit were calculated using previous medians compared to those of the study period. Results The goal of reducing the three healthcare-associated infections, i.e., 30% in 18 months, was achieved in at least one of the healthcare-associated infections and was also achieved for two healthcare-associated infections in two hospitals and three healthcare-associated infections in just one hospital; the latter reached the target of 36 months. Implementing the bundles and monitoring the results by the professionals were considered essential actions by the local management teams. In addition, the acquisition of supplies and their availability alongside the beds, signage, checklists, staff awareness, adaptation, team building, training and celebration of achievements were assessed as being relevant for reducing healthcare-associated infections. Conclusion The collaborative approach reduced healthcare-associated infections, despite partial adherence to the bundles. The hypothesis is that success is related to the project methodology and motivated multidisciplinary teams, especially nursing teams.

Motivational Drivers for Health Professionals in a Large Quality Improvement Collaborative Project in Brazil: A Qualitative Study

“…The quality improvement collaborative project achieved positive results even with di culties concerning the motivation of health professionals. Although data cannot assure that hospitals with motivated professionals are more likely to achieve goals, achieving them re ects a positive balance in motivation [43]. In a quality improvement collaborative project from the United Kingdom, a sense of personal achievement, priorities of organizations, engagement of multidisciplinary team members, and support of senior managers were related to motivation [44].…”

Tackling healthcare-associated infections in Brazilian intensive care units: we need more than collaboration

“…In this issue of Revista Brasileira de Terapia Intensiva , Melo et al report the perceived success factors of a collaborative quality improvement project conducted from 2018 to 2019 in five ICUs from hospitals in the metropolitan region of Recife. ( 10 ) Some ICUs started from a high baseline level in ventilator-associated pneumonia (VAP) rates, with median VAP rates in the 20’s range, with an observed reduction after the collaborative effort. For catheter-related bloodstream infections (BSI), median rates ranged from 5 to 10, but no reductions were observed.…”