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

Year: 2024

Type: article

Abstract: Healthcare-associated infections (HAI) represent a major challenge in patient safety that affect services disproportionally. This paper aimed to assess how HAI prevalence varies between hospital services, and what contextual characteristics may explain such variance. A cross-sectional study was conducted on adult patients in Portuguese hospitals, using data from the European point prevalence survey (PPS) of HAI prevalence. Study variables included patient, structural and process variables. Variables were tested in a univariate logistic regression as risk factors, with patients clustered in hospitals. Variables with a p-value ≤0.2 were tested in a multivariable model. A total 736 patients from 56 intensive care units (ICU), 3160 from 72 surgical departments and 8081 from 90 medical departments were included. HAI prevalence was 7.9%, 5.9% and 1.7%, respectively. In ICU, only the number of devices was associated with HAI prevalence. In surgical departments, age, comorbidities, being a specialized hospital and a higher ratio of infection prevention and control (IPC) personnel were associated with higher SSI. Safety climate was associated with lower SSI. In Medicine departments, age and devices were positively associated, whereas a larger ratio of IPC nurses was negatively associated. These results may help implement targeted interventions to achieve optimal results in each department.

Source: Microorganisms

DOI: 10.3390/microorganisms12122522