Infection control in a Brazilian regional multihospital system

Objective: This study describes the organization of infection control commi ttees 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 intervie wed the chairs and the nurses of the infection control committees and visit ed the main areas to observe infection control in a multihospital system wi th 3146 beds. For analysis of the results, we performed a standardization p rocess, establishing a score for each hospital by using infection control o rganization as a surrogate marker for quality outcome. The mean hospital sc ores for infection control, existence of policies, and infrastructure at ea ch hospital were compared by using different stratification and multivariat e analysis. Results: Statistically significant differences were found among surveyed ho spitals by using stratification by size, funding status, and presence of te aching 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 epi demiologic indicators and the surveillance and control system proposed by t he Brazilian Ministry of Health and based on the Centers for Disease Contro l and Prevention model showed poor suitability.