Major articleStructure for prevention of health care–associated infections in Brazilian hospitals: A countrywide study
Section snippets
Design and settings
A cross-sectional study was carried out from August 2011-August 2013. Hospitals located in the 5 Brazilian regions were evaluated.
Sampling
A list of all acute care hospitals in the country was obtained from the free-access national database of health care facilities (CNES: http://cnes.datasus.gov.br/). The sample size included 10 out of 26 Brazilian states (Ceará, Goiás, Minas Gerais, Pará, Paraná, Paraíba, Pernambuco, Rio Grande do Sul, Rio de Janeiro, and São Paulo). These states were selected by
Results
The distribution of the number of hospitals and beds among the sample is shown in Table 1. The intended sample was 270 hospitals (6.8% of all hospitals in the studied states; 4.3% of the total number in Brazil). However, there was sample loss for the following reasons: (1) relevant incongruity between CNES (official registry) data and actual hospital data (type of health care facility did not fit the inclusion criteria; inexistence of health care facility, lack of inpatient units, or other);
Discussion
Brazil is a highly populated country (192 million) with approximately 6,266 hospitals (2012 data) spread in a large territory, posing a challenge to countrywide studies aiming at driving governmental strategies for prevention and control of HAI.6 To our knowledge, this study presents the first scaled evaluation of structure for HAI prevention in the country.
Despite being mandatory by law since 1997,7 the HAIPCC is still not fully compliant with all legal and recommended issues. This is
Conclusions
The findings from this study have major implications in national policies in promoting patient safety. A national plan should be driven to strengthen the main structures in HAI prevention, HAIPCC, SS, and laboratories of microbiology, giving high priority for the Midwest, North, and Northeast regions.
Acknowledgments
The Research Group of the Project IRAS-BRASIL acknowledges the efforts from nurses that contributed with data collection and thank the cooperation of the health care team in the visited hospitals.
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Funding/Support: Supported by the National Council for Scientific and Technological Development (CNPq: 563225/2010-6) in partnership with the Ministry of Health of Brazil, under the call MCT/CNPq/CT-Saúde/MS/SCTIE/DECIT N° 40/2010.
Conflicts of interest: None to report.