Evidence-based health care for all: support from the Brazilian Ministry of Health.

As you well know, after Semmelweis made the fundamental discovery of the cause of puerperal infection (contamination from doctors’ hands), he died as a “madman” in a hospital, tormented by the lack of comprehension of his findings. His colleagues, who had been performing puerperal examinations without antiseptic procedures for so long, did not believe the new evidence. Even today, it is known that not washing hands, stethoscopes, etc, between examining one patient and the next is one of the most incontestable causes of hospital infections. Infections resulting from contamination with catheters in intensive care are common, potentially lethal and cause great human and financial losses. A study published in the New England Journal of Medicine showed that four simple evidence-based procedures reduced bloodstream infections due to catheters by 66%: 1. washing hands; 2. use of complete barriers when inserting central catheters; 3. asepsis with chlorhexidine instead of iodine, on the skin in the area to be punctured; 4. avoidance of the use of catheters in the femoral region and, whenever possible, removal of unnecessary catheters.