Prospective surveillance applying the national nosocomial infection surveillance methods in a Brazilian pediatric public hospital

Lopes, Julia M. Maluf; Tonelli, Euclide; Lamounier, Joel Alves; Couto, Bráulio Roberto Gonçalves Marinho; Siqueira, Arminda Lúcia; Komatsuzaki, Flávia; Champs, Ana Paula Silva; Starling, Carlos Ernesto Ferreira

doi:10.1067/mic.2002.117039

Cited by 34 publications

(26 citation statements)

References 10 publications

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“…There were 131,764 hospital patient-days and 14,892 discharges from January 1993 to December 1997. There were 1,174 nosocomial infections identified in 754 patients [8], who were admitted with the following diagnoses: meningitis (26%), pneumonia (11.5%), sepsis (11.3%), diarrhea (10.7%), malnutrition (7.8%), other infectious diseases (7.2%) and other problems, such as congenital abnormalities, syndromes, immune deficiencies (less than 7%).…”

Section: Methodsmentioning

confidence: 99%

“…Prospective cohort nosocomial infection surveillance was undertaken for all acute-care patients according to the hospitalwide and intensive care NNIS components [5,6], adapted for Brazilian hospitals [1,4,8,11], since January 1992. There were 131,764 hospital patient-days and 14,892 discharges from January 1993 to December 1997.…”

Section: Methodsmentioning

confidence: 99%

“…The services that were surveyed were: Unit IIcommunicable diseases, Unit III-acute and clinical, and the Pediatric Intensive Care Unit (PICU) [7,8].…”

Section: Methodsmentioning

confidence: 99%

“…Most of the pediatricians are professors and/or infectious disease specialists. All patients (there are no surgical patients) are also attended by pediatric and/or infectious disease medical residents [7,8].…”

Section: The Hospitalmentioning

confidence: 99%

“…The methodology reported in the medical literature [4][5][6] was adapted for our hospital; this program led to improvements in healthcare quality [7,8]. Nevertheless, few studies have analyzed mortality data [9,10], and this has not been done in Brazilian public pediatric hospitals.…”

mentioning

confidence: 99%

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Nosocomial infections in brazilian pediatric patients: using a decision tree to identify high mortality groups

Lopes

Goulart²,

Siqueira

et al. 2009

Braz J Infect Dis

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Nosocomial infections (NI) are frequent events with potentially lethal outcomes. We identified predictive factors for mortality related to NI and developed an algorithm for predicting that risk in order to improve hospital epidemiology and healthcare quality programs. We made a prospective cohort NI surveillance of all acute-care patients according to the National Nosocomial Infections Surveillance System guidelines since 1992, applying the Centers for Disease Control and Prevention 1988 definitions adapted to a Brazilian pediatric hospital. Thirty-eight deaths considered to be related to NI were analyzed as the outcome variable for 754 patients with NI, whose survival time was taken into consideration. The predictive factors for mortality related to NI (p < 0.05 in the Cox regression model) were: invasive procedures and use of two or more antibiotics. The mean survival time was significantly shorter (p < 0.05 with the Kaplan-Meier method) for patients who suffered invasive procedures and for those who received two or more antibiotics. Applying a tree-structured survival analysis (TSSA), two groups with high mortality rates were identified: one group with time from admission to the first NI less than 11 days, received two or more antibiotics and suffered invasive procedures; the other group had the first NI between 12 and 22 days after admission and was subjected to invasive procedures. The possible modifiable factors to prevent mortality involve invasive devices and antibiotics. The TSSA approach is helpful to identify combinations of predictors and to guide protective actions to be taken in continuous-quality-improvement programs.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The services that were surveyed were: Unit IIcommunicable diseases, Unit III-acute and clinical, and the Pediatric Intensive Care Unit (PICU) [7,8].…”

Section: Methodsmentioning

confidence: 99%

Section: The Hospitalmentioning

confidence: 99%

mentioning

confidence: 99%

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Nosocomial infections in brazilian pediatric patients: using a decision tree to identify high mortality groups

Lopes

Goulart²,

Siqueira

et al. 2009

Braz J Infect Dis

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An Evidence-Based Perspective on Greetings in Medical Encounters

Makoul¹,

Zick²,

Green³

2007

Arch Intern Med

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Background: Widely used models for teaching and assessing communication skills highlight the importance of greeting patients appropriately, but there is little evidence regarding what constitutes an appropriate greeting.Methods: To obtain data on patient expectations for greetings, we asked closed-ended questions about preferences for shaking hands, use of patient names, and use of physician names in a computer-assisted telephone survey of adults in the 48 contiguous United States. We also analyzed an existing sample of 123 videotaped new patient visits to characterize patterns of greeting behavior in everyday clinical practice.Results: Most (78.1%) of the 415 survey respondents reported that they want the physician to shake their hand, 50.4% want their first name to be used when physicians greet them, and 56.4% want physicians to introduce them-selves using their first and last names; these expectations vary somewhat with patient sex, age, and race. Videotapes revealed that physicians and patients shook hands in 82.9% of visits. In 50.4% of the initial encounters, physicians did not mention the patient's name at all. Physicians tended to use their first and last names when introducing themselves.Conclusions: Physicians should be encouraged to shake hands with patients but remain sensitive to nonverbal cues that might indicate whether patients are open to this behavior. Given the diversity of opinion regarding the use of names, coupled with national patient safety recommendations concerning patient identification, we suggest that physicians initially use patients' first and last names and introduce themselves using their own first and last names.

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Testing the Effectiveness of Disinfectants and Sanitizers

Maillard

2016

Handbook of Hygiene Control in the Food Industry

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Prospective surveillance applying the national nosocomial infection surveillance methods in a Brazilian pediatric public hospital

Cited by 34 publications

References 10 publications

Nosocomial infections in brazilian pediatric patients: using a decision tree to identify high mortality groups

Nosocomial infections in brazilian pediatric patients: using a decision tree to identify high mortality groups

An Evidence-Based Perspective on Greetings in Medical Encounters

Testing the Effectiveness of Disinfectants and Sanitizers

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