Infection control in a Brazilian regional multihospital system

Objective: This study describes the organization of infection control committees in a Brazilian multihospital system, identifying their major problems. Our goal is to discuss the main deficiencies in infection control and to target some interventions that can improve the efficiency of these actions in Brazilian hospitals. Design and setting: We used a descriptive epidemiologic design. We interviewed the chairs and the nurses of the infection control committees and visited the main areas to observe infection control in a multihospital system with 3146 beds. For analysis of the results, we performed a standardization process, establishing a score for each hospital by using infection control organization as a surrogate marker for quality outcome. The mean hospital scores for infection control, existence of policies, and infrastructure at each hospital were compared by using different stratification and multivariate analysis. Results: Statistically significant differences were found among surveyed hospitals by using stratification by size, funding status, and presence of teaching activities. Conclusions: Diverse patterns of infection control organization were found among surveyed hospitals. Small hospitals represented the major problem in providing effective infection control. Chiefly for these hospitals, the epidemiologic indicators and the surveillance and control system proposed by the Brazilian Ministry of Health and based on the Centers for Disease Control and Prevention model showed poor suitability.