دورية أكاديمية
Results of a national system-wide quality improvement initiative for the implementation of evidence-based infection prevention practices in Brazilian hospitals.
| العنوان: | Results of a national system-wide quality improvement initiative for the implementation of evidence-based infection prevention practices in Brazilian hospitals. |
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| المؤلفون: | de Miranda Costa MM; Brazilian Health Regulatory Agency, Brasília, Brazil; Graduate Program in Quality Management in Health Services, Federal University of Rio Grande do Norte, Natal, Brazil., Santana HT; Brazilian Health Regulatory Agency, Brasília, Brazil., Saturno Hernandez PJ; National Institute of Public Health, Morelos, Mexico., Carvalho AA; Brazilian Health Regulatory Agency, Brasília, Brazil. Electronic address: Andre.Carvalho@anvisa.gov.br., da Silva Gama ZA; Graduate Program in Quality Management in Health Services, Federal University of Rio Grande do Norte, Natal, Brazil; Department of Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil. Electronic address: zasgama@gmail.com. |
| المصدر: | The Journal of hospital infection [J Hosp Infect] 2020 May; Vol. 105 (1), pp. 24-34. Date of Electronic Publication: 2020 Mar 06. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: W.B. Saunders For The Hospital Infection Society Country of Publication: England NLM ID: 8007166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2939 (Electronic) Linking ISSN: 01956701 NLM ISO Abbreviation: J Hosp Infect Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: London : W.B. Saunders For The Hospital Infection Society Original Publication: New York, Academic Press. |
| مواضيع طبية MeSH: | Health Plan Implementation*, Cross Infection/*prevention & control , Hospitals/*statistics & numerical data , Infection Control/*methods, Brazil ; Humans ; Infection Control/organization & administration ; National Health Programs ; Patient Safety ; Quality Improvement |
| مستخلص: | Background: Quality improvement (QI) methods are recommended to address healthcare-associated infections (HCAIs) in hospitals, but whereas internal initiatives have been widely studied, there is little evidence on the application and effect of a QI approach from an external system-wide perspective. Aim: To analyse the effect of a national system-wide QI initiative aimed at promoting HCAI prevention via regulatory interventions in Brazil. Methods: A QI cycle approach designed and assessed with a before-and-after quasi-experimental design was implemented by the Brazilian Health Regulatory Agency (ANVISA), targeting 1869 hospitals. Eleven evidence-based quality indicators related to HCAI prevention and a composite measure were assembled, shared, and assessed; the intervention to improve was then based on participatory multifaceted regulatory actions. Absolute and relative improvements were estimated after the intervention. Findings: In all, 563 hospitals (30.1% response) totalling 86,837 beds participated in the baseline assessment, and 681 hospitals (36.4% response) totalling 101,231 beds in the second. Ten of the 11 criteria improved (P < 0.05), as well as the composite indicator (P = 0.001) in all the regions of the country, particularly in the group of hospitals participating at baseline. 'Hand hygiene (HH) infrastructure' reached 100% (baseline: 97.9; P = 0.001), 'HH protocol' 96.9% (baseline: 92.9; P = 0.001), 'HH monitoring' 70% (baseline: 60.7; P < 0.001) and 'existence of antimicrobial prescription protocol' 80.7% (baseline: 73.2; P < 0.001), among others. The HCAI rates of the participating hospitals decreased after the intervention (P < 0.05). Conclusion: The QI cycle approach was useful in guiding system-wide interventions for patient safety. External regulation was feasible and effective in promoting internal HCAI prevention nationwide. (Copyright © 2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Health services research; Infection control; Patient safety; Quality improvement |
| تواريخ الأحداث: | Date Created: 20200311 Date Completed: 20210201 Latest Revision: 20210201 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.jhin.2020.03.005 |
| PMID: | 32151673 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1532-2939 |
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| DOI: | 10.1016/j.jhin.2020.03.005 |