RESUMO
Objetivo: avaliar criticamente Programas de Controle de Infecções Relacionadas à Assistência à Saúde (PCIRAS) em hospitais de médio-extra portes, quanto ao cumprimento dos critérios sanitários nacionais. Métodos: estudo transversal realizado em 18 hospitais com Comissões de Controle de Infecções Relacionadas à Assistência à Saúde (CCIRAS) dos estados de Goiás e São Paulo, Brasil. Para coleta de dados aplicou-se formulário online fundamentado nos itens de avaliação preconizados pela Resolução de Diretoria Colegiada (RDC) Nº 48/2000 - ANVISA. Para análise estatística utilizou-se exame da frequência e distribuição das variáveis (média e desvio padrão - DP). Resultados: as CCIRAS atenderam 100% dos itens imprescindíveis, 93,0% (DP = 5,8) dos necessários e 64,8% (DP = 32,5) dos recomendados. Os Serviços de Controle de IRAS atenderam 90,2% (DP = 16,1) dos itens necessários, e 77,8% (DP = 19,2) dos recomendáveis. Conclusão: itens imprescindíveis foram cumpridos, porém os necessários e recomendados apresentam diferentes graus de inconformidades, podendo comprometer a prevenção e controle de IRAS. A aplicação de roteiro baseado na RDC N° 48/2000 contribui para conhecer a realidade dos PCIRAS dos hospitais, contudo, essa normativa não estabelece percentual mínimo de conformidade, dificultando a interpretação dos resultados. Há necessidade de atualizá-la para instrumentalizar os órgãos fiscalizadores.
Objective: to critically evaluate Healthcare-Associated Infection Control Programs (HAICP) in medium to extra-large hospitals, as to compliance with national health criteria. Methods: cross-sectional study conducted in 18 hospitals with Healthcare-Associated Infection Control Committees (HAICC) in the states of Goiás and São Paulo, Brazil. Data were collected using online form based on the evaluation items from Directors' Collegiate Resolution (RDC) Nº 48/2000 ANVISA. For statistical analysis, frequency, and distribution of variables (mean; standard deviation - SD) were examined. Results:HAICC met 100% of the indispensable items, 93.0% (SD = 5.8) of the required, and 64.8% (SD = 32.5) of the recommended. Healthcare-Associated Infection Control Services complied with 90.2% (SD = 16.1) of the necessary items, and 77.8% (SD = 19.2) of those recommended. Conclusion: indispensable items were met, but the necessary and recommended ones present different degrees of noncompliance, which may compromise the prevention and control of healthcare-associated infections. The application of a script based on the RDC Nº 48/2000 contributes to identify the reality of the hospitals' HAICP, however, this normative does not establish a minimum percentage of compliance, making it difficult to interpret the results. It is necessary to update it in order to provide tools to surveillance agencies.
Objetivo: evaluar críticamente los Programas de Control de Infecciones Relacionadas con la Atención de Salud (PCIRAA) en hospitales medianos y grandes para determinar si cumplen con los criterios nacionales de salud. Métodos: estudio transversal realizado en 18 hospitales con Comisiones de Control de las Infecciones Asociadas a la Atención de Salud (CCIAAS) en los estados de Goiás y São Paulo, Brasil. Para la recolección de datos se aplicó un formulario online, desarrollado con base en los ítems de evaluación recomendados por la Resolución Directiva Colegiada (RDC) Nº 48/2000 de la ANVISA. Para el análisis estadístico, se utilizó el examen de la frecuencia y distribución de las variables (media y desvío estándar - DE). Resultados:las CCIAAS cumplieron en promedio el 100% de los ítems indispensables, el 93,0% (DE = 5,8) de los necesarios y el 64,8% (DE = 32,5) de los recomendados. Los Servicios de Control de las Infecciones Asociadas a la Atención de Salud cumplieron en promedio el 90,2% (DE = 16,1) de los ítems necesarios y el 77,8% (DE = 19,2) de los recomendados. Conclusión: se cumplieron los ítems imprescindibles, pero los necesarios y los recomendados presentan diferentes grados de disconformidad, que pueden comprometer la prevención y el control de las infecciones asociadas a la atención de salud. La aplicación de la rutina basada en la RDC Nº 48/2000 contribuyó a conocer la realidad de los PCIRAA en los hospitales, pero esta normativa no establece un porcentaje mínimo de conformidad, lo que dificulta la interpretación de los resultados. Se hace necesario actualizarla para dotar de herramientas a los organismos supervisores
Assuntos
Humanos , Infecção Hospitalar , Monitoramento Epidemiológico , Qualidade da Assistência à Saúde , Programa de Controle de Infecção HospitalarRESUMO
BACKGROUND: The COVID-19 pandemic has presented high morbidity and mortality, with associated high socioeconomic costs. Brazil ranks third in the number of COVID-19 cases, behind only India and the United States. OBJECTIVE: To analyze risk factors for mortality in adults hospitalized with COVID-19 in Brazil. METHODS: Observational retrospective cohort study including data from all Brazilian states and regions. The study included information from 468,226 in-hospital patients from all regions of Brazil from 1 January 2021 to 31 July 2021. Data from the influenza epidemiological surveillance system were used. The participants were adults hospitalized with COVID-19. A Cox regression model was used to analyze factors associated with mortality in adults with COVID-19. RESULTS: The in-hospital mortality lethality was 37.5%. The risk factors associated with COVID-19 mortality were older age, with a linear increase with increments in age, male sex, black or mixed race, low education level, comorbidities, use of ventilatory support, and living in the southeast, north, or northeast regions of the country. CONCLUSIONS: Our results illustrate the severity of the COVID-19 pandemic in Brazil and reinforce that policies and practices to deal with this disease should focus on groups and regions with higher risk, whereas public policies should promote nonpharmacological measures and vaccination in the Brazilian population.
