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

Gama, Zenewton André da Silva; Saturno-Hernández, Pedro Jesús; Freitas, Marise Reis de; Padoveze, Maria Clara; Saraiva, Cecília Olívia Paraguai de Oliveira; Paulino, Laiane G.; Araújo, Sibele Ferreira de

doi:10.1016/j.jiph.2019.02.016

Cited by 7 publications

(7 citation statements)

References 24 publications

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“…A Brazilian study showed that adherence to hand hygiene and contact precautions was lower in public hospitals compared with private hospitals. 29 This study had several limitations. First, we analyzed secondary data, which implies a certain imprecision in the details of each infection.…”

Section: Discussionmentioning

confidence: 93%

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A surveillance program for long-term central venous access–associated infections in outpatient chemotherapy services

Freire

Assis²,

Carlesse

et al. 2023

Infect. Control Hosp. Epidemiol.

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Objective: In this study, we described the first results of a surveillance system for infections associated with long-term central venous catheters (LT-CVC) in patients under outpatient chemotherapy. Design: This was a multicentric, prospective study. Setting: Outpatient chemotherapy services. Participants: The study included 8 referral cancer centers in the State of São Paulo. Intervention: These services were invited to participate in a newly created surveillance program for patients under chemotherapy. Several meetings were convened to share previous experiences on LT-CVC infection surveillance and to define the surveillance method. Once the program was implemented, all bloodstream infection (LT-CVC BSIs), tunnel infection, and exit-site infections associated with LT-CVC were reported. Data from January to May 2021 were analyzed. The median monthly number of chemotherapy sessions per clinic was 925 (IQR, 270–5,855). We used Poisson regression to analyze the association of rates with the characteristics of the services. Results: In total, 107 LT-CVC infections were reported, of which 95% were BSIs, mostly associated with totally implantable devices (76%). Infections occurred a median of 4 days after the last catheter manipulation and 116 after the LT-CVC insertion. Also, 102 microorganisms were isolated from LT-CVC BSIs; the most common pathogen was Staphylococcus epidermidis, at 22%. Moreover, 44 infections (44%) fulfilled the criteria for CVC-related LT-CVC BSI and 27 infections (27%) met the criteria for mucosal barrier injury. The 1-year cumulative LT-CVC BSI rate was 1.94 per 1,000 CVC days of use. The rates were higher in public hospitals (IRR, 6.00; P < .001) and in hospitals that already had in place surveillance for LT-CVC infections (IRR, 2.01; P < .01). Conclusion: Our study describes an applicable surveillance method for infections in cancer outpatients using LT-CVC.

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Section: Discussionmentioning

confidence: 93%

“…A Brazilian study showed that adherence to hand hygiene and contact precautions was lower in public hospitals compared with private hospitals. 29…”

Section: Discussionmentioning

confidence: 99%

A surveillance program for long-term central venous access–associated infections in outpatient chemotherapy services

Freire

Assis²,

Carlesse

et al. 2023

Infect. Control Hosp. Epidemiol.

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“…It was not possible to identify significant differences between private and public financing of the evaluated institutions in the present study with regard to the HAIPCP CI. A Brazilian study carried out in Rio Grande do Norte state sought to assess and compare adherence to HAI prevention practices according to the type of hospital administration (private, public with direct administration, public with indirect administration), but did not find conclusive results regarding the differences (28) . This is an important aspect, which has still been little studied, and which should receive attention from researchers in the future.…”

Section: Discussionmentioning

confidence: 99%

Desempenho dos programas de prevenção e controle de infecções em pequenos hospitais

Santos

Padoveze

Lacerda

2020

Rev. esc. enferm. USP

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RESUMO Objetivo Avaliar a conformidade de estrutura e processo dos programas de prevenção e controle de infecções relacionadas à assistência à saúde. Método Estudo prospectivo, transversal, realizado de 2015 a 2016, em pequenos hospitais de até 70 leitos de uma região do estado de São Paulo. Foram avaliados 4 indicadores previamente validados, expressos em índice de conformidade (porcentagem em relação aos itens avaliados). Resultados Dentre os 27 hospitais recrutados, 14 consentiram em participar. Os valores médios de conformidade para cada indicador foram: Estrutura dos programas 61,0%; Diretrizes operacionais 84,5%; Vigilância epidemiológica 57,9%; Atividades de prevenção 74,5%. Maior conformidade foi observada em hospitais privados (73,9%) e com presença de unidade de terapia intensiva (90,3%). Os hospitais possuíam enfermeiros designados para o programa (92,9%), mas somente 23,1% das instituições privadas atuavam com dedicação exclusiva de seis horas. Conclusão Apenas o indicador referente às Diretrizes Operacionais dos programas avaliados esteve acima de 90% de conformidade na mediana dos hospitais. A maior dispersão dos resultados de conformidade entre os hospitais estudados foi referente ao indicador de Vigilância Epidemiológica.

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“…26 The availability of hand hygiene resources is indispensable for healthcare workers and patient's adherence. 23,32 Physical infrastructure to admit patients and inadequate spaces in the laboratory poses a challenge. Strict adherence to contact precautions is crucial to avoid nosocomial transmission and prevent the development of DR-TB.…”

Section: Barriers and Enablers For Tb Ipc Implementationmentioning

confidence: 99%

“…Thus, adequate physical infrastructure and guidelines are essential. 32 Improved communication, coordination and collaboration, sensitization and re-training can enhance adherence and improve implementation. However, behavioural and attitudinal changes remain challenging.…”

Section: Barriers and Enablers For Tb Ipc Implementationmentioning

confidence: 99%

Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method study

Gyem

Ahmad

Mahendradhata

2020

Journal of Global Health Reports

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Background Background The rise in multi-drug resistant tuberculosis (MDR-TB) cases indicates that it is being transmitted as a primary infection in the general population and has been linked to the health care environment. Studies in resource-limited countries have shown that even simple control measures to prevent TB (tuberculosis) infection appear to be inadequately implemented. This study aimed to assess implementation fidelity with a major focus on adherence, knowledge, and responsiveness to TB infection and prevention control (IPC) practices by exploring its barriers and enablers. Methods Methods This research was an implementation research using a mixed-method explanatory sequential design. We conducted a descriptive cross-sectional study of health care workers (HCWs) working in TB and TB patients enrolled in the three hospitals with the highest notified TB cases in Bhutan from May to August 2019 to assess the implementation fidelity of TB IPC practices. Structured questionnaires and a non-participatory observation checklist were used to assess adherence, knowledge, and responsiveness of the participants. We carried out descriptive statistical analysis for quantitative data and thematic analysis for qualitative data. Results Results The overall adherence proportion of the participants was poor, with a poor adherence score of 82.6% by the healthcare workers and 93.1% by the patients. HCWs were judged to have overall good knowledge. Most patients strongly agree to the perceptions about TB transmissible through air and visitors wearing masks when they visit the facility; however, the overall response rate score was only 33%. Two overarching themes, "poor administrative policy" and "behavior and attitude" are identified as key barriers and enablers to the implementation of the TB IPC. Conclusions Conclusions There was inadequate IPC practice among healthcare workers and patients. The overall good knowledge of the HCWs did not appear to have a positive influence on adherence. Hence, there is a need for continuous improvement and mandatory training, surveillance, awareness, and sensitization. Gyem K, Ahmad RA, Mahendradhata Y. Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method study.

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

Cited by 7 publications

References 24 publications

A surveillance program for long-term central venous access–associated infections in outpatient chemotherapy services

A surveillance program for long-term central venous access–associated infections in outpatient chemotherapy services

Desempenho dos programas de prevenção e controle de infecções em pequenos hospitais

Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method study

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