Evaluation of Nosocomial Infection Control Programs in health services

this is a descriptive, exploratory and quantitative study conducted in 2013. The study population comprised 13 Nosocomial Infection Control Programs of health services in a Brazilian city of the state of São Paulo. Public domain instruments available in the Manual of Evaluation Indicators of Nosocomial Infection Control Practices were used.

RESULTS:

The indicators with the highest average compliance were "Evaluation of the Structure of the Nosocomial Infection Control Programs" (75%) and "Evaluation of the Epidemiological Surveillance System of Nosocomial Infection" (82%) and those with the lowest mean compliance scores were "Evaluation of Operational Guidelines" (58.97%) and "Evaluation of Activities of Control and Prevention of Nosocomial Infection" (60.29%).

CONCLUSION:

The use of indicators identified that, despite having produced knowledge about prevention and control of nosocomial infections, there is still a large gap between the practice and the recommendations.

Descriptors
Indicators of Health Services; Health Evaluation; Hospital Infection Control Program

Indicator 1		Compliance		Non-compliance		Partial compliance		Does not apply
Indicator 1		n	%	n	%	n	%	n
Component
	The Commission is represented, at least, by members of the medical service, nursing and administration.	12	92.31	1	7.69	0		0
	There is a charter that determines the functioning of the Commission.	12	92.31	0		1	7.69	0
	There are two health professionals with higher education performing actions of prevention and control of infection, for every 200 beds, one of whom is a nurse.	8	61.54	5	38.46	0		0
	The nurse acts exclusively dedicated to the service, at least 6 hours a day.	8	61.54	5	38.46	0		0
	There are other professionals, with higher education, who act exclusively dedicated to the service, at least 4 hours a day.	7	53.85	6	46.15	0		0
	The Commission holds regular meetings with participation of members and leaders.	10	76.92	1	7.69	2	15.39	0
	There is support of own or outsourced microbiology and pathology laboratories.	13	100.00	0		0		0
	There is physical space limited and exclusive for daily activities, archives etc. of the Commission.	8	61.54	4	30.77	1	7.69	0
	There is availability of computer resources for the activities of the Commission.	12	92.31	1	7.69	0		0
	The administration provides statistical data (number of admissions, discharges, deaths, patients-day etc.) to carry out the Commission’s reports.	10	76.92	3	23.08	0		0
Mean		75.38		20.00		4.62		-

Indicator 2		Compliance		Non-compliance		Partial compliance		Does not apply
Indicator 2		n	%	n	%	n	%	n
Component
	There is a recommendation for assessment and referral of injuries caused by sharps and biological material.	9	69.23	1	7.69	3	23.08	0
	There are recommendations for waste disposal.	8	61.54	0		5	38.46	0
	There are recommendations for control and prevention of respiratory infections.	7	58.33		33.33	1	8.34	1
	There are recommendations for control and prevention of urinary tract infections.	7	58.33	3	25	2	16.67	1
	There are recommendations for control and prevention of bloodstream infections.	8	61.54	5	38.46	0		0
	There are recommendations for control and prevention of surgical site infections.	8	61.54	4	30.77	1	7.69	0
	There are recommendations for isolation of patients with infectious and contagious diseases.	8	66.67	3	25	1	8.33	1
	There is recommendation for the use of prophylactic antibiotics.	9	69.24	2	15.38	2	15.38	0
	There is standardization of germicidal and antiseptic solutions.	7	53.85	6	46.15	0		0
	There is a recommendation for cleaning, disinfection and sterilization techniques of materials.	8	61.54	3	23.08	2	15.38	0
	There is a recommendation for hand hygiene technique.	9	69.24	2	15.38	2	15.38	0
	There is a recommendation for cleaning and disinfecting surfaces.	9	69.23	3	23.08	1	7.69	0
	There is a recommendation for washing and sanitizing clothes used in the institution.	4	30.77	5	38.46	4	30.77	0
	There is a technical recommendation for collecting material to perform cultures.	6	46.16	5	38.46	2	15.38	0
	There is a recommendation for bandage techniques and frequency of their change.	7	53.85	4	30.77	2	15.38	0
Mean		59.40		26.07		14.53		-

Indicator 3		Compliance		Non- compliance		Partial Compliance		Does not apply
Indicator 3		n	%	n	%	N	%	n
Component
	Conducts epidemiological surveillance at fixed intervals.	12	92.31	1	7.69	0		0
	Conducts surveillance of nosocomial infection through active case search.	12	92.31	1	7.69	0		0
	Conducts active search of nosocomial infection in high-risk units.	8	100	0.00		0		5
	Monitors with regular intervals and records the microbiological culture results, which identify resistant microorganism’s strains or species.	10	83.33	2	16.67	0		1
	There are predetermined criteria for diagnosis of nosocomial infection.	8	61.54	3	23.08	2	15.38	0
	Produces periodic report of results of epidemiological surveillance.	12	92.31	1	7.69	0		0
	The reports examine and report changes in the epidemiological profile.	12	92.31	1	7.69	0		0
	The reports correlate results with control and prevention strategies adopted.	6	46.15	6	46.16	1	7.69	0
	The reports are regularly available to sectors and leaders.	10	76.92	3	23.08	0		0
	The reports are regularly available to public bodies.	100	100	0		0		0
	Mean	83.72		13.97		2.31		-

Indicator 4		Compliance		Non- compliance		Partial compliance		Non- compliance
Indicator 4		n	%	n	%	n	%	n
Component
	Dialysis unit	4	66.68	1	16.66	1	16.66	7
	Blood bank	1	20	3	60.00	1	20	8
	Clinical analysis laboratory	0		5	83.33	1	16.67	7
	Pathological anatomy laboratory	0		4	80	1	20	8
	Inpatient units	12	92.31	1	7.69	0		0
	Intensive care units	8	100.00	0		0		5
	Baby nursery	5	100.00	0		0		8
	Center of material and sterilization	10	76.93	1	7.69	2	15.38	0
	Surgical center	10	76.93	1	7.69	2	15.38	0
	Emergency room	3	50	2	33.33	1	16.67	7
	Ambulatory	5	55.56	1	11.11	3	33.33	4
	Nutrition and dietetics service	8	61.54	3	23.08	2	15.38	0
	Participates in the technical decisions for product specification and purchase	5	38.46	8	61.54	0		0
Mean		56.80		30.16		13.04		-

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Ana Maria Laus Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto Departamento de Enfermagem Geral e Especializada Av. Bandeirantes, 3900 Bairro: Monte Alegre CEP: 14040-902, Ribeirão Preto, SP, Brasil E-mail: analaus@eerp.usp.br