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Hospital Context Determinants of Variability in Healthcare-Associated Infection Prevalence: Multi-Level Analysis.

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Healthcare-associated infections (HAIs) vary significantly across hospital services. Understanding patient, structural, and process factors is key to reducing infection prevalence and improving patient safety.

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Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Patient Safety

Background:

  • Healthcare-associated infections (HAIs) pose a significant threat to patient safety, with varying impact across different hospital services.
  • Understanding the drivers of HAI prevalence is crucial for developing targeted infection control strategies.

Purpose of the Study:

  • To assess the variation in HAI prevalence across different hospital services (intensive care units, surgical, and medical departments).
  • To identify patient, structural, and process-related factors associated with HAI prevalence in Portuguese hospitals.

Main Methods:

  • A cross-sectional study utilizing data from the European point prevalence survey of HAI prevalence.
  • Inclusion of 18,261 adult patients from 119 Portuguese hospitals across various departments.
  • Multivariable logistic regression analysis to identify risk factors for HAIs.

Main Results:

  • Overall HAI prevalence was 7.9% in ICUs, 5.9% in surgical departments, and 1.7% in medical departments.
  • In ICUs, the number of devices was associated with HAI prevalence. In surgical departments, age, comorbidities, hospital specialization, and IPC personnel ratio were associated with Surgical Site Infections (SSIs), while safety climate was associated with lower SSIs.
  • In medical departments, age and devices showed a positive association, whereas a higher ratio of IPC nurses was negatively associated with HAI prevalence.

Conclusions:

  • HAI prevalence differs significantly across hospital services, influenced by distinct factors.
  • Targeted interventions, considering service-specific characteristics like device use, staffing ratios, and safety climate, are essential for effective HAI reduction.
  • Findings provide a basis for optimizing infection prevention and control strategies tailored to individual hospital departments.