Programa de Controle de Infecção Hospitalar: Avaliação dos Indicadores de Estrutura e Processo

Abstract

Healthcare-Associated Infections (HAIs) are considered a public health problem and impact Patient Safety (PS), since they can lead to increased length of hospital stay, hospital costs, and morbidity and mortality rates. In this context, the Hospital Infection Control Program (HICP) plays an important role in the prevention and control of these infections, as it ensures the implementation of guidelines and monitoring practices. Therefore, evaluating the structure and processes of these programs is essential to ensure the effectiveness of prevention actions, optimize resources, reduce infections, and improve PS. This study sought to analyze the structure and process indicators of the HICPs of hospitals in the cities of Três Lagoas/MS and Dracena/SP. This is a multicenter, cross-sectional study with a quantitative approach, carried out in the cities of Três Lagoas, in the state of Mato Grosso do Sul, and Dracena, in the state of São Paulo. Data were collected from March to April 2023, through interviews and documentary analysis with the Hospital Infection Control Committees (CCIH) of the participating institutions. Indicators validated in the scientific literature available in the Manual of Indicators for the Assessment of Hospital Infection Control Practices were used. Three (33%) hospitals that provide generalist care participated in the research, one (67%) medium-sized and two (33%) large, two located in the municipality of Três Lagoas/MS and one in Dracena/SP. Only one (33%) institution has accreditation certification by the National Accreditation Organization and all three (100%) had consolidated CCIHs, with 10 years or more of existence and have an Adult Intensive Care Unit (100%). The analysis of the indicators identified that the three (100%) hospitals achieved full compliance (100%) in the items related to the operational guidelines and the epidemiological surveillance system, suggesting that the institutions are well organized in terms of developing standards, protocols, and active and effective monitoring of Hospital Infections (HI). Regarding the technicaloperational structure, there was an overall compliance of 86.7%, with two (67%) institutions achieving 90% compliance and one (33%) achieving 80% compliance, which demonstrates the need for investments in the construction of exclusive physical spaces for the CCIHs. The indicator that deals with the activities of control and prevention of HI was the one that presented the lowest compliance (69.2%) among those analyzed, with significant variation between the institutions, between 57% and 86%, demonstrating deficiencies in the execution of practical activities of infection control, such as inspections, training, and protocol evaluations. It is observed that the PCIH analyzed have a good structure and well-established guidelines, but face challenges in the execution of practical activities of prevention and control. The study reinforces the importance of ongoing training and engagement of healthcare teams, as well as the need for regular monitoring of control practices to achieve full compliance with the indicators. Finally, it is recommended that future research expand the analysis to a larger number of institutions and explore the relationship between compliance with the indicators and clinical outcomes of patients. Keywords: Hospital Infection. Infection Control. Quality Indicators. Patient Safety.