ABSTRACT
INTRODUCTION: The reduction of tuberculosis reported in admitted patients in a community hospital in La Habana (Cuba) was identified as a quality gap and priority for action. The objective was to increase by 50% the number of bacilloscopies and smear-positive tuberculosis confirmed by December 2017. PATIENTS AND METHODS: A quality improvement initiative was conducted from January 2017 to December 2017 in a 300-bed secondary care teaching hospital. The improvement project was addressed to patients admitted with respiratory infections (upper or lower). The baseline was considered the period from January to December 2016. The intervention period was from January 2017 to June 2018. The intervention includes training activities for medical staff, monthly monitoring of bacilloscopies performed and feedback and analysis with leaders and departments. RESULTS: During the baseline period seven patients were confirmed with pulmonary tuberculosis and 160 bacilloscopies were performed (mean 40 bacilloscopies/quarter). During the intervention period were confirmed 22 cases of tuberculosis and 577 bacilloscopies were performed (mean 96 bacilloscopies/quarter). CONCLUSIONS: The number of bacilloscopies and sputum smear tuberculosis was successfully increased in admitted patients using the staff education, monitoring, and feedback as intervention measures. The next steps of the project will be focused in achieve the sustainability of the intervention, evaluation of educational needs of medical staff and design training activities accordingly and, screening of latent tuberculosis infections using of tuberculin skin test in selected high risk admitted patients.
Subject(s)
Mass Screening/standards , Quality Improvement , Tuberculosis, Pulmonary/diagnosis , Cuba , Hospitals, Teaching , Humans , Mass Screening/methods , Patient Admission , Secondary Care Centers , Tuberculosis, Pulmonary/prevention & controlABSTRACT
OBJECTIVE: Determine nosocomial infection (NI) prevalence in seven University Hospitals of Havana. METHOD: A cross sectional survey was carry out in university hospital with more than 100 beds. Presence of NI was determined by an active screening procedure in all patients admitted in hospitals. Technical statistics of frequency distribution was used. Rates of NI were estimated for each hospital and in the special case of procedure, Odds Ratio and its confidence interval at 95 % were calculated (CI 95 %). RESULTS: Prevalence of NI was 9.2 %. The most frequent localization were: cardiovascular system (55 patients), surgical site (50 patients) and urinary tract (42 patients ). The 19.7 % of studied patient showed intravascular device. All patients showed NI associated with procedures, the highest intensity was association with an endotracheal tube (OR 7.83, IC 95 % 3.32-11.52). CONCLUSION: Nosocomial infections in this hospital is a serious health problem; it is necessary to focus our medical work in this regard for the prevention and control of NI.
Subject(s)
Cross Infection/epidemiology , Cross-Sectional Studies , Cuba/epidemiology , Hospital Bed Capacity , Hospitals, University/statistics & numerical data , Humans , Prevalence , Risk FactorsABSTRACT
Objetivo: Determinar la prevalencia de infección nosocomial (IN) en siete Hospitales Clínico Quirúrgicos de Ciudad de La Habana. Método: Realizamos un estudio descriptivo de corte transversal de los hospitales universitarios con número de camas superior a 100. La presencia de IN, se determinó mediante la realización de pesquizaje activo en la totalidad de los pacientes ingresados. Se utilizó la técnica estadística de análisis de distribución de frecuencias. Fueron calculadas tasas de IN, por hospital y servicio de atención. También se calculó Odds Ratio puntual y por intervalos. Resultados: La prevalencia global de IN resultó ser de 9,2 por cada 100 pacientes. Las localizaciones más frecuentes correspondieron a: el sistema cardiovascular (55 casos), el sitio quirúrgico (50 casos) y el tracto urinario (42 casos). El 19,7 % de los pacientes estudiados, tenían algún dispositivo intravascular colocado. Todos ellos fueron encontrados asociados a la presencia de infección nosocomial. La mayor intensidad resultó ser con la entubación endotraqueal (OR 7.83 IC 95 % 3,32-11,52). Conclusión: La prevalencia de infecciones nosocomiales en los Hospitales Clínico Quirúrgicos de Ciudad de la Habana hacen necesario fortalecer las actividades de prevención y control, con especial énfasis en su vigilancia
Objective: Determine nosocomial infection (NI) prevalence in seven University Hospitals of Havana. Method: A cross sectional survey was carry out in university hospital with more than 100 beds. Presence of NI was determined by an active screening procedure in all patients admited in hospitals. Technical statistics of frequency distribution was used. Rates of NI were estimated for each hospital and in the special case of procedure, Odds Ratio and its confidence interval at 95 % were calculated (CI 95 %). Results: Prevalence of NI was 9.2 %. The most frequent localization were: cardiovascular system (55 patients), surgical site (50 patients) and urinary tract (42 patients ). The 19.7 % of studied patient showed intravascular device. All patients showed NI associated with procedures, the highest intensity was association with an endotracheal tube (OR 7.83, IC 95 % 3.32-11.52). Conclusion: Nosocomial infections in this hospital is a serious health problem; it is necessary to focus our medical work in this regard for the prevention and control of NI
Subject(s)
Humans , Cross Infection/epidemiology , Cross-Sectional Studies , Cuba/epidemiology , Hospital Bed Capacity , Hospitals, University/statistics & numerical data , Prevalence , Risk FactorsABSTRACT
Los ancianos constituyen una proporción importante de los pacientes atendidos en instituciones de salud, y constituyen un grupo altamente susceptible de adquirir infecciones nosocomiales. Con el objetivo de describir el comportamiento de las infecciones nosocomiales en el servicio de geriatría del Hospital "Joaquín Albarrán" en el periodo de 1990 al 2001, realizamos un estudio observacional descriptivo. Se analizó la tendencia secular de la infección nosocomial mediante el método gráfico de suavizamiento de datos mediante medianas móviles y la localización y la etiología de las infecciones nosocomiales mediante la técnica estadística de análisis de distribución de frecuencias. En el Servicio de Geriatría se observó decremento marcado en la tasa de infección nosocomial a partir del año 1995, que se mantuvo hasta 1997, un predominio de las infecciones venosas (58,9 por ciento) sobre el resto de las localizaciones (tracto urinario (19,2 por ciento) y las del tracto respiratorio bajo (15,1 por ciento).Los principales gérmenes aislados resultaron ser: Klebsiella spp (34 por ciento), Pseudomona spp (23 por ciento), y con frecuencias bastante similares, Estafilococo spp (18,5 por ciento) y Proteus spp (17 por ciento). Se constata la magnitud e importancia que tienen las infecciones nosocomiales como problema de salud en los ancianos atendidos en el servicio de geriatría, y la necesidad de aplicar enfoques adecuados dirigidos a la prevención y control de estas infecciones (AU)