Scaling up improvement: the drive to reduce healthcare-associated infections in public Brazilian intensive care units across all patient ages
Year: 2026
Type: article
Abstract: BACKGROUND: Despite the availability of straightforward and economic interventions to prevent HAIs, these unintentional adverse events still pose a significant challenge to public health globally. We aimed to evaluate the outcomes of a nationwide project designed to mitigate HAI incidence in intensive care units (ICUs) using the Model of Improvement framework. METHODS: A Quality Improvement (QI) study assessing the outcomes of a two-year initiative in Brazilian ICUs from September 2021. A customized Collaborative methodology was applied to mentor and enhance the capabilities of healthcare workers, equipping them with evidence-based, structured, systematic, and auditable QI strategies (prevention bundles) to improve patient care outcomes. A one-year preintervention baseline incidence was established for the three critical HAIs: central line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infections (CAUTI), to compare with the intervention period. RESULTS: The initiative encompassed 188 ICUs (169 adults, 11 pediatric, and eight neonatal), recording substantial reductions in HAI incidence density: by 43% for CLABSI (from 5.5 to 3.2 per 1,000 catheter-day), by 51% for VAP (from 13.6 to 6.7 per 1,000 ventilator-day), and by 55% for CAUTI (from 3.2 to 1.4 per 1,000 catheter-day), irrespective of age. Implementing this QI strategy prevented an estimated 7,342 infections. CONCLUSION: Our initiative has been demonstrated to be a feasible and valuable strategy for preventing HAIs in critical care settings. The success of this approach emphasizes the potential for its broader application and reinforces the need for systematic, evidence-based interventions in healthcare settings.
Authors: Guilherme Cesar Silva Dias Santos, Andrea Keiko Fujinami Gushken, Karen Cristina da Conceição Dias Silva, Rafaela Moraes de Moura, Amanda Brassaroto Gimenes, Flavia Fernanda Franco, Maira Francisco Moya, Cristiana Martins Prandini, Bruno de Melo Tavares, Aline Brenner, Fernanda Pimentel Coelho, Roberta Gonçalves Marques, Livia Muller Bernz, Marianilza Lopes da Silva, Luciana Gouvea de Albuquerque Souza, Admilson Reis da Silva, Giselle Franco Santos, Priscila Martini Bernardi Garzella, Ademir Jose Petenate, Paulo Borem, Cristiane Maria Reis, Luciana Yumi Ue, Claudia Garcia de Barros, Sebastian Vernal
Language: English
Topic: Nosocomial Infections in ICU
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,550
OpenAlex ID: W7161587980