Impact of a National Nosocomial Infection Program in Changing Practices

BACKGROUND: Ministry of Health developed a nosocomial infection (NI) program in 1982. In 1998 and 2003 hospitals were surveyed regarding implementation of effective practices. Results of these surveys are presented. METHOD: Questionnaires sent to all hospitals throughout the country in 1998 asked for implementation of evidence-based practices to prevent wound infection (WI), urinary tract infection (UTI), bacteremia (BAC), and pneumonia (NEU). WI evaluated practices were: avoidance of shaving, antimicrobial prophylaxis, and post-discharge surveillance. For UTI and BAC: aseptic technique, medical criteria for catheterization, radiographic control. NEU: aseptic suction technique and sterilization of ventilation items. In 2003 the same survey was sent to same hospitals. A response of 100% was obtained among all high-complexity public hospitals (27). The percentage of hospitals adhering to each practice is shown for each period and compared by correlation coefficient r. RESULTS: Comparing both surveys, all aspects under evaluation improved: avoiding shaving from 4.3% to 100% (r2= 0,8789), antimicrobial prophylaxis from 0% to 100% (r2= 0.8918), post-discharge surveillance from 4.3% to 76% (r2= 0,8571), aseptic technique in urinary catheterization from 4.3% to 100% (r2= 0.9139), medical criteria from 0% to 96% (r2= 0,8782), aseptic technique for vascular catheterization from 4.3% to 95.7% (r2= 0.8641), medical criteria involved from 0% to 69.6% (r2= 0.7676), radiographic control from 0% to 47.8% (r2= 0,786), aseptic suction technique from 4.3% to 91.3% (r2= 0.8873), and sterilization of ventilation items from 8.7% to 100% (r2= 0.9176), . CONCLUSIONS: Very few studies have evaluated the impact of national NI program in changing practices. We demonstrate that it shows to be effective.