Barriers to investigating and reporting nosocomial outbreaks to health authorities in São Paulo, Brazil: a mixed methods approach.
BACKGROUND
Not all nosocomial outbreaks (NOs) are reported to health authorities (HAs).


AIM
To identify barriers to investigating and reporting NOs to HAs.


METHODS
A mixed methods approach was performed with a convergent parallel design. The quantitative and qualitative branches of the study were a statewide (electronic) survey and focus groups (FGs), respectively. Infection control practitioners (ICPs) working in the State of São Paulo, Brazil were recruited.


FINDINGS
Eighty-five ICPs were enrolled in the survey and 22 ICPs were enrolled in the FGs. Barriers to investigating and reporting NOs included: (i) difficulty in translating outbreak investigation knowledge into practice; (ii) weak planning in outbreak investigation process; (iii) organizational culture and context; (iv) lack of awareness about reporting; and (v) lack of autonomy of ICPs to report outbreaks to HAs.


CONCLUSION
HAs could overcome these barriers by revising their strategies to work with healthcare services, as well as delivering translational educational programmes to support improvement in knowledge and skills for NO investigation.
['Maciel|A L P|AL|', 'de Carvalho|B A|BA|', 'Timmons|S|S|', 'Padoveze|M C|MC|']
D001291:Attitude of Health Personnel D001938:Brazil D003428:Cross Infection D018563:Disease Notification D004196:Disease Outbreaks D006801:Humans D016357:Infection Control Practitioners D057184:Practice Patterns, Nurses' D010818:Practice Patterns, Physicians' D011795:Surveys and Questionnaires
Investigation Mixed methods Infection control practitioners Cross-infection Disease outbreak