isolation precautions: measurement of compliance by process indicators

Background: the centers for disease control’s guideline for isolation precautions in hospitals (2007), recommends its implementation and monitoring by a group of nosocomial infection control. this study aimed to evaluate the real condition of this practice on the health service through the use of process indicators and establish an education link with healthcare workers.

Objective: apply process indicators of isolation precautions for assessing compliance of this practice.

Methods: the study was developed at a medium general hospital, in são paulo city, brazil, jan-oct/2009. all beds in isolations were assessed according to a "check-list" prepared to assess compliance by the group of nosocomial infection control, consisting: patient complete identification  and record of compliance, characterized by: type of isolation precaution indicated; surveillance cultures; garment out of the room, provision of individual protective equipment (ipe), availability of alcohol gel at the bedroom door; individual materials and infectious trash inside the room, the nameplate of the isolation precautions and patient and family orientation. the total compliance was calculated when the process contemplated all the recommendations. seventeen visits were conducted on different dates. the instrument was applied directly, with subsequent calculation of compliance. at each visit, a report was prepared with the main non-conformities found which were distributed to the unit leaders. the data were analyzed with descriptive statistics.

Results: the compliance of the type of isolation precaution indicated was on average 96%, the compliance of surveillance cultures and the nameplate for isolation precautions was 99%, the patient and family orientation was 94%.  the compliance of the garment out of the room, the provision of ipe and provision of alcohol gel ranged from 60% to 100%, but with trend curves on the rise. the compliance of individual materials and infectious trash inside the room varied irregularly during the period (72% to 100%). the ratio of total compliance ranged from 30% (at the beginning) to 93%, with the regularity of evaluations, with an average of 71%.

Conclusions: the surveillance process is a feasible reality; it produces good results in the control and prevention of cross infection, which should involve local leaders in monitoring and reorientation of good practice.