Background The COVID-19 pandemic highlighted the need to redefine the healthcare workforce (HCW) ... more Background The COVID-19 pandemic highlighted the need to redefine the healthcare workforce (HCW) competencies to face future emergencies linked to emerging infectious diseases, environmental, climate and social crises. As recently stated by WHO, there is a need to identify standards for education and competencies training for HCW in emergency and preparedness (E&P). The Italian National Institute of Health, in agreement with the deliberation of the G20 Health Ministers under the Italian Presidency, is developing an educational program named “Laboratorium” which includes a free access digital repository aimed to share selected documents and tools at the International Public HCW (PHCW) to increase the competencies in E&P response. Objectives A range of web domains selected according to their reliability was monitored using a keyword search tool for any relevant material published from February 14th up to April 28th, 2022. We included any publications, training materials, epidemiologic...
The SARS-CoV-2 variant of concern Omicron was first detected in Italy in November 2021. Data from... more The SARS-CoV-2 variant of concern Omicron was first detected in Italy in November 2021. Data from three genomic surveys conducted in Italy between December 2021 and January 2022 suggest that Omicron became dominant in less than one month (prevalence on January 3: 78.6%-83.8%) with a doubling time of 2.7–3.1 days. The mean net reproduction number rose from about 1.15 in absence of Omicron to a peak of 1.83 for symptomatic cases and 1.33 for hospitalized cases, while it remained stable for critical cases.
betico, la tubercolosi polmonare, le infezioni post-chirurgiche e le ectoparassitosi (scabbia) so... more betico, la tubercolosi polmonare, le infezioni post-chirurgiche e le ectoparassitosi (scabbia) sono le malattie prevalenti che si riscontrano nelle strutture per anziani con una frequenza che raggiunge anche l’11% ed oltre secondo recenti lavori. Inoltre, i residenti nelle LTCF sono spesso colonizzati da microrganismi antibiotico-resistenti come gli MRSA, i VRE, gli pneumococci penicillino-resistenti, le ESBL, i gram negativi resistenti ai fluorochinolonici ed il C. difficile. E pertanto fondamentale, nella gestione del rischio di infezione nell’anziano, intervenire sul cambiamento struttura/paziente attuando delle procedure di controllo, sorveglianza e prevenzione sia attiva che passiva limitando, nel contempo, la diffusione delle resistenze: in tal senso potrebbero essere utili i tests di screening al momento dell’accesso (tampone nasale per MRSA, urocoltura, tampone rettale per ESBL) che permettono di mettere in atto misure di isolamento preventivo (da contatto, da coorte o strut...
Annali di igiene : medicina preventiva e di comunita, 2018
BACKGROUND Despite the expansion of the HPH approach and its application in several countries of ... more BACKGROUND Despite the expansion of the HPH approach and its application in several countries of the world, the conception is still not ascertained in Iran. The main purpose of this study was to investigate the Iranian health professionals' ideas on applicability of the HPH standards in day-to-day practices of the Iranian hospitals. STUDY DESIGN A cross-sectional study. METHODS The study respondents were 354 physicians, nurses and general managers working in the ten educational hospitals affiliated to the Tabriz University of Medical Sciences in Tabriz the capital city of the East Azarbaijan province, North West of Iran. A validated self-assessment tool was used for data collection about adaptability of the HPH standards i.e. management policy, patient assessment, patient information, healthy workplace promotion and inter-sectional cooperation from September to November 2016. RESULTS The mean adaptability score of the HPH standards (60.0, SD: 13.0, range: 0- 136) represents ambi...
Background In literature, few studies evaluated Mediterranean diet (MD) adherence in pregnant wom... more Background In literature, few studies evaluated Mediterranean diet (MD) adherence in pregnant women, so we decided to conduct a survey to analyze MD and healthy habits in pregnant women living in North East of Italy, in 2018. Methods In our monocentric observational study, we enrolled >18 years pregnant women (2nd-3rd trimester) to evaluate MD adherence through “PREDIMED” validated questionnaire. Based on previous studies on MD score, women were classified into High-MD adherence (score >8; range 0-14) and low-MD adherence group (score ≤ 8). Comparisons between groups were performed using a t-test, Wilcoxon-Mann-Whitney test, chi square test and regression models as appropriate. We also investigated BMI (body mass index) and healthy habits before and during pregnancy. Results We analyzed 113 questionnaires and MD score, ranging from 3 to 13, had a mean value of 8.04 (SD 1.95), with low MD adherence in 63% (71) of our sample. Women (mean age 32 years; min 22- max 43; SD 1.95) we...
Issue/problem The classification of Public Health services (PHS) and related healthcare informati... more Issue/problem The classification of Public Health services (PHS) and related healthcare information systems (HIS) in Friuli Venezia Giulia, Italy, are complex and non-homogeneous. Since 2017 the Region has been realigning HIS according to the new Final Products (FP) System to classify PHS. The aim is to implement an integrated FP-based HIS, easing data transmission and improving the quality of planning, scheduling and expense reporting activities. Description of the problem From June 2017 to October 2018 68 Public Health professionals (PHP) from 10 Public Health areas outlined 102 PF from HIS through flowcharts and technical dossiers. Afterwards (10/5th-10/29th 2018) they assessed HIS through a questionnaire of 24 items. Statistical analysis was performed with Fisher’s Exact Test, stratifying 4 categories (physician, veterinarian, prevention technician, other professional). In June-July 2019, through a matrix-based assessment, PHP of regional PHS were invited to weight each FP activ...
Background Socioeconomic status (SES) has been proposed as an important determinant of oral healt... more Background Socioeconomic status (SES) has been proposed as an important determinant of oral health outcomes. The aim of this project is to assess the association between nationality, parents’ educational level and oral health in a sample of children in Udine, Italy. Methods Between February and May 2018, in the context of a screening programme carried out to evaluate the oral health status in 6-year-old children, parents filled out a questionnaire investigating behavioural, socioeconomic and demographical factors. For each child the number of decayed, missing and filled deciduous teeth (dmft) and caries prevalence (CP) were assessed. Results The screening was conducted on 976 children, 705 (72%) Italian (I) and 271 (28%) foreign residents (F). Not-Italian nationality significantly increased the CP (F: 59.32%; I: 32.74%; RR: 1.81 [95% CI: 1.57-2.10]; Risk Difference: 26.59 [95% CI: 19.98-33.19]) and dmft median value (F: 2±5; I:0±1; p < 0.0001). Stratified by level of education, t...
The European Food Safety Authority (EFSA) has identified some risk factors for the occurrence of ... more The European Food Safety Authority (EFSA) has identified some risk factors for the occurrence of side effects linked to energy drinks (EDs) consumption by young people. Tachycardia, sleeplessness, caffeine addiction may be caused by excessive consumption of EDs during parties, sport matches, ect. EDs consumption has been evaluated in a sample of students in Italy together with some aspects of their lifestyle. The survey was performed in two high schools from September 2014 to June 2015. 583 students between 14 to 18 years were recruited and a standard questionnaire (EFSA checklist) was used to collect information on responders characteristics, beverages consumption, EDs with alcohol, and EDs and sports. 350 out of 583 responders (60%) consumed EDs and 146 out of 583 responders (25%) reported an occasional alcohol consumption. Despite 82 out of 146 alcoholic drinkers (56%) were EDs-alcohol consumers, only 70 out of 583 adolescents (12%) reported habitual EDs consumption. Moreover, 38...
Background The promotion of safety culture in hospital care is a requisite to reduce errors and t... more Background The promotion of safety culture in hospital care is a requisite to reduce errors and to continuously improve the quality of care. Alongside patient safety programs, a quantitative evaluation of the safety culture in hospitals is essential to understand strengths and weaknesses of the system and to set up future investments. Therefore, Udine Academic Hospital (UAH) joined the Patient Safety Collaborative Alliance (PaSCAl) national survey in order to assess safety climate and evaluate the impact on it of the Joint Commission International (JCI) accreditation process. Methods The PaSCAl survey is based on a questionnaire made by the Agency for Healthcare Research and Quality (AHRQ), made by 52 items grouped in 12 areas. Sampled wards (medical, surgical and diagnostic) could differ between years. The survey was done in 2009 and 2015 with a sampled workforce of 793 and 587 respectively. The delivery was both electronic and paper based. The surveys were set before and after the first JCI accreditation (2010) and the second round (2014). Results Response rates increased from 16.6% (132/793) to 21.9% (129/587). 10 areas out of 12 had better scores. A significant (p < 0.05) increase of favorable opinions after the accreditation was found in the perception of patient safety (+16.1%); feedback and communication (+12.0%); adverse event reporting (+23.6%); teamwork between units (+12.7%). In 2015 no area was statistically far from the national benchmark, while previously patient safety (-11.1%) and teamwork between units (-14.7%) were significantly worse. Conclusions The questionnaire inquired the trust put by workforce in the hospital management and their wards. Before accreditation, key weaknesses were shown. Significant improvements on reporting culture were achieved. Education, followed by standardization of procedures and communication were the main efforts by our management. A \u201csilos\u201d mindset and a blaming attitude towards errors are still open challenges. Key messages: The analysis of patient safety culture is a useful tool to monitor the effects of patient safety programs on workforce attitudes Among other strategies, accreditation for excellence can help increase patient safety culture in the context of public hospital
Data and information are nowadays keys of success. We experienced the building of an hospital Inf... more Data and information are nowadays keys of success. We experienced the building of an hospital Information System (IS) selecting data from those already routinely produced and sharing them with health care units and general management. IS should be shaped to accomplish mission, vision and strategic direction of the hospital and in this direction our efforts are oriented.
Abstract: This review focuses on the present state of the art in the prevention and control of he... more Abstract: This review focuses on the present state of the art in the prevention and control of healthcare-associated infections (HAI) in Europe and discusses both the European Union (EU) recommendations and laws and European Centre for Disease Prevention and Control (ECDC) programmes. The standards for countries and organizations to recommended effective control and prevention of HAI are also discussed. These standards have evolved from a range of activities (e.g. scientific and professional societies, national and regional authorities, and voluntary accreditation bodies). Finally competencies for infection control/hospital hygiene (IC/HH) professionals, agreed at the European level, are summarized according to different professional responsibilities and compared with standards developed outside Europe. Training of healthcare workers in IC/HH is recognized as a fundamental requirement to achieving a safer delivery of healthcare.
Annali di igiene : medicina preventiva e di comunità
The Euroaction project, promoted by European Society of Cardiology, aims to determine whether a n... more The Euroaction project, promoted by European Society of Cardiology, aims to determine whether a nurse co-ordinated, multidisciplinary, family based preventive cardiology programme could help more patients and their families achieve the recommended European lifestyle, risk factor and therapeutic goals for cardiovascular disease prevention. EUROACTION was evaluated in a paired cluster randomized controlled trial, and the primary care branch included 6 European countries. Consecutive patients > 50 years and < 80 years, with no history of cardiovascular disease, were prospectively identified by the general practitioners with one of the following: (i) high total cardiovascular risk (HeartScore > or = 5% over 10 years, either now or when projected to age 60 years) and on no medical treatment for blood pressure, lipids or diabetes; (ii) on treatment with anti-hypertensive and/or lipid-lowering drug therapies started in the last year but with no diabetes; (iii) diagnosed with diabe...
Annali di igiene : medicina preventiva e di comunità
The study examines the implication of an institution-wide programme on pain management in reducin... more The study examines the implication of an institution-wide programme on pain management in reducing the patients' perception of the pain carried out in a university hospital by comparing the results of two surveys conducted in 2002 (prior to the programme) and in 2003 (during the course of the programme). The study was conducted in November 2003 and it consisted in a priority survey on the patients' pain perception using a questionnaire which was distributed to all the patients admitted in a highly specialised hospital and interviewed by trained interviewers. Later on the data were compared to the results obtained with a similar survey carried out in November 2002 in the same hospital. In 2002 the percentage of patients reporting pain at the moment of the interview was 43.4% (82/145), in the year 2003 it was 35.3% (49/139) [OR = 2.4, CI (95%) = 1.4-4.0, p < 0.001]. With regards to the pain reported in the previous 24 hrs, there was a reduction in the percentage of patients...
Background The COVID-19 pandemic highlighted the need to redefine the healthcare workforce (HCW) ... more Background The COVID-19 pandemic highlighted the need to redefine the healthcare workforce (HCW) competencies to face future emergencies linked to emerging infectious diseases, environmental, climate and social crises. As recently stated by WHO, there is a need to identify standards for education and competencies training for HCW in emergency and preparedness (E&P). The Italian National Institute of Health, in agreement with the deliberation of the G20 Health Ministers under the Italian Presidency, is developing an educational program named “Laboratorium” which includes a free access digital repository aimed to share selected documents and tools at the International Public HCW (PHCW) to increase the competencies in E&P response. Objectives A range of web domains selected according to their reliability was monitored using a keyword search tool for any relevant material published from February 14th up to April 28th, 2022. We included any publications, training materials, epidemiologic...
The SARS-CoV-2 variant of concern Omicron was first detected in Italy in November 2021. Data from... more The SARS-CoV-2 variant of concern Omicron was first detected in Italy in November 2021. Data from three genomic surveys conducted in Italy between December 2021 and January 2022 suggest that Omicron became dominant in less than one month (prevalence on January 3: 78.6%-83.8%) with a doubling time of 2.7–3.1 days. The mean net reproduction number rose from about 1.15 in absence of Omicron to a peak of 1.83 for symptomatic cases and 1.33 for hospitalized cases, while it remained stable for critical cases.
betico, la tubercolosi polmonare, le infezioni post-chirurgiche e le ectoparassitosi (scabbia) so... more betico, la tubercolosi polmonare, le infezioni post-chirurgiche e le ectoparassitosi (scabbia) sono le malattie prevalenti che si riscontrano nelle strutture per anziani con una frequenza che raggiunge anche l’11% ed oltre secondo recenti lavori. Inoltre, i residenti nelle LTCF sono spesso colonizzati da microrganismi antibiotico-resistenti come gli MRSA, i VRE, gli pneumococci penicillino-resistenti, le ESBL, i gram negativi resistenti ai fluorochinolonici ed il C. difficile. E pertanto fondamentale, nella gestione del rischio di infezione nell’anziano, intervenire sul cambiamento struttura/paziente attuando delle procedure di controllo, sorveglianza e prevenzione sia attiva che passiva limitando, nel contempo, la diffusione delle resistenze: in tal senso potrebbero essere utili i tests di screening al momento dell’accesso (tampone nasale per MRSA, urocoltura, tampone rettale per ESBL) che permettono di mettere in atto misure di isolamento preventivo (da contatto, da coorte o strut...
Annali di igiene : medicina preventiva e di comunita, 2018
BACKGROUND Despite the expansion of the HPH approach and its application in several countries of ... more BACKGROUND Despite the expansion of the HPH approach and its application in several countries of the world, the conception is still not ascertained in Iran. The main purpose of this study was to investigate the Iranian health professionals' ideas on applicability of the HPH standards in day-to-day practices of the Iranian hospitals. STUDY DESIGN A cross-sectional study. METHODS The study respondents were 354 physicians, nurses and general managers working in the ten educational hospitals affiliated to the Tabriz University of Medical Sciences in Tabriz the capital city of the East Azarbaijan province, North West of Iran. A validated self-assessment tool was used for data collection about adaptability of the HPH standards i.e. management policy, patient assessment, patient information, healthy workplace promotion and inter-sectional cooperation from September to November 2016. RESULTS The mean adaptability score of the HPH standards (60.0, SD: 13.0, range: 0- 136) represents ambi...
Background In literature, few studies evaluated Mediterranean diet (MD) adherence in pregnant wom... more Background In literature, few studies evaluated Mediterranean diet (MD) adherence in pregnant women, so we decided to conduct a survey to analyze MD and healthy habits in pregnant women living in North East of Italy, in 2018. Methods In our monocentric observational study, we enrolled >18 years pregnant women (2nd-3rd trimester) to evaluate MD adherence through “PREDIMED” validated questionnaire. Based on previous studies on MD score, women were classified into High-MD adherence (score >8; range 0-14) and low-MD adherence group (score ≤ 8). Comparisons between groups were performed using a t-test, Wilcoxon-Mann-Whitney test, chi square test and regression models as appropriate. We also investigated BMI (body mass index) and healthy habits before and during pregnancy. Results We analyzed 113 questionnaires and MD score, ranging from 3 to 13, had a mean value of 8.04 (SD 1.95), with low MD adherence in 63% (71) of our sample. Women (mean age 32 years; min 22- max 43; SD 1.95) we...
Issue/problem The classification of Public Health services (PHS) and related healthcare informati... more Issue/problem The classification of Public Health services (PHS) and related healthcare information systems (HIS) in Friuli Venezia Giulia, Italy, are complex and non-homogeneous. Since 2017 the Region has been realigning HIS according to the new Final Products (FP) System to classify PHS. The aim is to implement an integrated FP-based HIS, easing data transmission and improving the quality of planning, scheduling and expense reporting activities. Description of the problem From June 2017 to October 2018 68 Public Health professionals (PHP) from 10 Public Health areas outlined 102 PF from HIS through flowcharts and technical dossiers. Afterwards (10/5th-10/29th 2018) they assessed HIS through a questionnaire of 24 items. Statistical analysis was performed with Fisher’s Exact Test, stratifying 4 categories (physician, veterinarian, prevention technician, other professional). In June-July 2019, through a matrix-based assessment, PHP of regional PHS were invited to weight each FP activ...
Background Socioeconomic status (SES) has been proposed as an important determinant of oral healt... more Background Socioeconomic status (SES) has been proposed as an important determinant of oral health outcomes. The aim of this project is to assess the association between nationality, parents’ educational level and oral health in a sample of children in Udine, Italy. Methods Between February and May 2018, in the context of a screening programme carried out to evaluate the oral health status in 6-year-old children, parents filled out a questionnaire investigating behavioural, socioeconomic and demographical factors. For each child the number of decayed, missing and filled deciduous teeth (dmft) and caries prevalence (CP) were assessed. Results The screening was conducted on 976 children, 705 (72%) Italian (I) and 271 (28%) foreign residents (F). Not-Italian nationality significantly increased the CP (F: 59.32%; I: 32.74%; RR: 1.81 [95% CI: 1.57-2.10]; Risk Difference: 26.59 [95% CI: 19.98-33.19]) and dmft median value (F: 2±5; I:0±1; p < 0.0001). Stratified by level of education, t...
The European Food Safety Authority (EFSA) has identified some risk factors for the occurrence of ... more The European Food Safety Authority (EFSA) has identified some risk factors for the occurrence of side effects linked to energy drinks (EDs) consumption by young people. Tachycardia, sleeplessness, caffeine addiction may be caused by excessive consumption of EDs during parties, sport matches, ect. EDs consumption has been evaluated in a sample of students in Italy together with some aspects of their lifestyle. The survey was performed in two high schools from September 2014 to June 2015. 583 students between 14 to 18 years were recruited and a standard questionnaire (EFSA checklist) was used to collect information on responders characteristics, beverages consumption, EDs with alcohol, and EDs and sports. 350 out of 583 responders (60%) consumed EDs and 146 out of 583 responders (25%) reported an occasional alcohol consumption. Despite 82 out of 146 alcoholic drinkers (56%) were EDs-alcohol consumers, only 70 out of 583 adolescents (12%) reported habitual EDs consumption. Moreover, 38...
Background The promotion of safety culture in hospital care is a requisite to reduce errors and t... more Background The promotion of safety culture in hospital care is a requisite to reduce errors and to continuously improve the quality of care. Alongside patient safety programs, a quantitative evaluation of the safety culture in hospitals is essential to understand strengths and weaknesses of the system and to set up future investments. Therefore, Udine Academic Hospital (UAH) joined the Patient Safety Collaborative Alliance (PaSCAl) national survey in order to assess safety climate and evaluate the impact on it of the Joint Commission International (JCI) accreditation process. Methods The PaSCAl survey is based on a questionnaire made by the Agency for Healthcare Research and Quality (AHRQ), made by 52 items grouped in 12 areas. Sampled wards (medical, surgical and diagnostic) could differ between years. The survey was done in 2009 and 2015 with a sampled workforce of 793 and 587 respectively. The delivery was both electronic and paper based. The surveys were set before and after the first JCI accreditation (2010) and the second round (2014). Results Response rates increased from 16.6% (132/793) to 21.9% (129/587). 10 areas out of 12 had better scores. A significant (p < 0.05) increase of favorable opinions after the accreditation was found in the perception of patient safety (+16.1%); feedback and communication (+12.0%); adverse event reporting (+23.6%); teamwork between units (+12.7%). In 2015 no area was statistically far from the national benchmark, while previously patient safety (-11.1%) and teamwork between units (-14.7%) were significantly worse. Conclusions The questionnaire inquired the trust put by workforce in the hospital management and their wards. Before accreditation, key weaknesses were shown. Significant improvements on reporting culture were achieved. Education, followed by standardization of procedures and communication were the main efforts by our management. A \u201csilos\u201d mindset and a blaming attitude towards errors are still open challenges. Key messages: The analysis of patient safety culture is a useful tool to monitor the effects of patient safety programs on workforce attitudes Among other strategies, accreditation for excellence can help increase patient safety culture in the context of public hospital
Data and information are nowadays keys of success. We experienced the building of an hospital Inf... more Data and information are nowadays keys of success. We experienced the building of an hospital Information System (IS) selecting data from those already routinely produced and sharing them with health care units and general management. IS should be shaped to accomplish mission, vision and strategic direction of the hospital and in this direction our efforts are oriented.
Abstract: This review focuses on the present state of the art in the prevention and control of he... more Abstract: This review focuses on the present state of the art in the prevention and control of healthcare-associated infections (HAI) in Europe and discusses both the European Union (EU) recommendations and laws and European Centre for Disease Prevention and Control (ECDC) programmes. The standards for countries and organizations to recommended effective control and prevention of HAI are also discussed. These standards have evolved from a range of activities (e.g. scientific and professional societies, national and regional authorities, and voluntary accreditation bodies). Finally competencies for infection control/hospital hygiene (IC/HH) professionals, agreed at the European level, are summarized according to different professional responsibilities and compared with standards developed outside Europe. Training of healthcare workers in IC/HH is recognized as a fundamental requirement to achieving a safer delivery of healthcare.
Annali di igiene : medicina preventiva e di comunità
The Euroaction project, promoted by European Society of Cardiology, aims to determine whether a n... more The Euroaction project, promoted by European Society of Cardiology, aims to determine whether a nurse co-ordinated, multidisciplinary, family based preventive cardiology programme could help more patients and their families achieve the recommended European lifestyle, risk factor and therapeutic goals for cardiovascular disease prevention. EUROACTION was evaluated in a paired cluster randomized controlled trial, and the primary care branch included 6 European countries. Consecutive patients > 50 years and < 80 years, with no history of cardiovascular disease, were prospectively identified by the general practitioners with one of the following: (i) high total cardiovascular risk (HeartScore > or = 5% over 10 years, either now or when projected to age 60 years) and on no medical treatment for blood pressure, lipids or diabetes; (ii) on treatment with anti-hypertensive and/or lipid-lowering drug therapies started in the last year but with no diabetes; (iii) diagnosed with diabe...
Annali di igiene : medicina preventiva e di comunità
The study examines the implication of an institution-wide programme on pain management in reducin... more The study examines the implication of an institution-wide programme on pain management in reducing the patients' perception of the pain carried out in a university hospital by comparing the results of two surveys conducted in 2002 (prior to the programme) and in 2003 (during the course of the programme). The study was conducted in November 2003 and it consisted in a priority survey on the patients' pain perception using a questionnaire which was distributed to all the patients admitted in a highly specialised hospital and interviewed by trained interviewers. Later on the data were compared to the results obtained with a similar survey carried out in November 2002 in the same hospital. In 2002 the percentage of patients reporting pain at the moment of the interview was 43.4% (82/145), in the year 2003 it was 35.3% (49/139) [OR = 2.4, CI (95%) = 1.4-4.0, p < 0.001]. With regards to the pain reported in the previous 24 hrs, there was a reduction in the percentage of patients...
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