Biomedical subjects

S Brusaferro

Publications and source records attributed to S Brusaferro.

At least 19 recordsLinked to original sources

PubMed2006

Incidence of hospital-acquired infections in Italian long-term-care facilities: a prospective six-month surveillance.

This study presents results from a six-month prospective surveillance of hospital-acquired infections in four Italian long-term-care facilities (LTCFs). Eight hundred and fifty-nine patients were enrolled and 21 503 person-days were observed. Two hundred and fifty-four hospital-acquired infections (HAIs) occurred in 188 patients. The overall infection rate was 11.8 per 1000 person-days. The most frequent infections were urinary tract infections (3.2 per 1000 person-days), lower respiratory tract infections (2.7 per 1000 person-days) and skin infections (2.5 per 1000 person-days). Risks related to HAI in a multi-variate regression model were: length of stay >or=28 days [odds ratio (OR) 3.5, 95% confidence intervals (CI) 2.4-5.0]; presence of a device (OR 2.0, 95%CI 1.3-3.0); Norton scale <12 (OR 1.8, 95%CI 1.2-2.6); and being bedridden (OR 1.7, 95%CI 1.08-2.6). The presence of HAI increased the median length of stay (31 days vs 20 days, P<0.01) without a significant influence on fatal outcome (OR 1.4, 95%CI 0.7-2.7).

Aged↗

PubMed2006

Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes.

AIM: To examine the effectiveness of reflexology foot massage in hospitalized cancer patients undergoing second or third chemotherapy cycles. BACKGROUND: Since the late-1970s, studies have been conducted to assess the efficacy of behavioural and relaxation approaches in controlling nausea/vomiting, anxiety and other side-effects associated with chemotherapy. METHODS: The study consisted of 30 patients being admitted to the oncology unit at a Scientific Research Hospital in Italy. Only 15 of the 30 participants received therapeutic massage. The subjects' self-reports of anxiety (measured by the Spielberger State-Trait Anxiety Inventory) were recorded before, after and 24 hours after the intervention. RESULTS: There was an average decrease of 7.9 points on the state-anxiety scale in the treatment group and of 0.8 points in the control group (P < 0.0001). CONCLUSIONS: Reflexology foot massage can be considered a support treatment used in combination with traditional medical treatments and executed by an expert, qualified person to help cancer patients receiving chemotherapy feel better and also cope better with their disease.

Adolescent↗

PubMed2005

Medical errors and clinical risk management: state of the art.

Medical errors represent a serious public health problem and pose a threat to patient safety. All patients are potentially vulnerable, therefore medical errors are costly from a human, economic, and social viewpoint. The present report aims not only to provide an overview of the problem on the basis of the published literature, but also to stress the importance of adopting standard terminology and classifications, fundamental tools for researchers to obtain valid and reliable methods for error identification and reporting. In fact, agreement on standard definitions allows comparison of data in different contexts. Errors can be classified according to their outcome, the setting where they take place (inpatient, outpatient), the kind of procedure involved (medication, surgery, etc.) or the probability of occurring (high, low). Error categories are analysed taking into consideration their prevalence, avoidance and associated factors as well as the different strategies for detecting medical errors. Incident reporting and documentation of near-misses are described as useful sources of information, and Healthcare Failure Mode Effect Analysis (HFMEA) and Root Cause Analysis (RCA) are seen as powerful methods for process analysis. Furthermore, means to increase patient safety are considered in the broader context of clinical risk management. New approaches in the field of medical errors are aimed at minimizing the recurrence of avoidable patterns associated with higher error rate. A system approach and a blame-free environment, aimed at better organizational performances, lead to much better results than focusing on individuals. Furthermore, use of technology, information accessibility, communication, patient collaboration and multi-professional team-work are successful strategies to reach the goal of patient safety within healthcare organizations.

Humans↗

PubMed2004

Infection Control Nurse: a national survey.

AIM: To study presence and activity of Infection Control Nurses (ICN) in Italian National Health System (NHS) hospitals. BACKGROUND: Infection Control Nurses play an essential and evidence-based role for optimal infrastructure and essential activities of infection control and epidemiology programmes in hospitals. METHODS: A survey of all Italian NHS hospitals (N = 529). Hospital health directors were asked to complete a questionnaire with a specific section on ICN presence, activities and roles played. Response rate was 87.5% (463 of 529). RESULTS: More than 50% of hospitals (250 of 463) have an ICN: 25% (116 of 463) have at least one part-time employed ICN and 23.3% (108 of 250) have at least one ICN employed full-time. Infection Control Nurses are more common in hospitals with >250 beds (P < 0.01). Infection Control Nurses working in hospitals with >250 beds are highly active in surveillance activities, personnel education and management of study groups (P < 0.01). CONCLUSIONS: In Italian NHS hospitals ICNs have yet to become pillar figures in hospital infection control.

Attitude of Health Personnel↗

PubMed2003

Factors influencing hospital infection control policies in Italian hospitals.

A study was undertaken to determine the resources available in Italian hospitals for the control of nosocomial infections and the factors favouring a successful approach. During January-May 2000 a questionnaire about infection control was sent to the hospital health director of all Italian National Health System hospitals treating acute patients and with more than 3500 admissions in 1999. An active programme was defined as a hospital infection control committee (HICC) meeting at least four times in 1999, the presence of a doctor with infection control responsibilities, a nurse employed in infection control and at least one surveillance activity and one infection control guideline issued or updated in the past two years. There was a response rate of 87.5% (463/529). Almost fifteen percent (69/463) of hospitals had an active programme for Infection Control and 76.2% (353/463) had a HICC. Seventy-one percent (330/463) of the hospitals had a hospital infection control physician and 53% (250/463) had infection control nurses. Fifty-two percent (242/463) reported at least one surveillance activity and 70.8% (328/463) had issued or updated at least one guidance document in the last two years. The presence of regional policies [odds ratio (OR) 8.7], operative groups (OR 4.2), at least one full-time nurse (OR 4.6) and a hospital annual plan which specified infection control (OR 2.1) were statistically associated with an active programme in the multivariate analysis.

Cross Infection↗

PubMed2001

Protocol implementation in hospital infection control practice: an Italian experience of preoperative antibiotic prophylaxis.

This study evaluates the effectiveness of a protocol implemented to induce behavioural modifications in healthcare workers (HCWs). A preoperative antibiotic prophylaxis protocol for surgical procedures in clean and clean-contaminated wounds was used. The study was conducted in a 300-bed Italian university hospital between 1998 and 1999. The protocol's impact was analysed by retrospective examination of the clinical records for selected common surgical procedures. The study also investigated the reasons for the low compliance with the protocol through a focus group methodology. We examined 723 surgical procedures and the overall compliance was 30.8% (56/182) before the implementation of the protocol and 45.2% (76/168) after 1 year (P< or = 0.01). During the same period compliance with the use of antibiotics increased when antibiotics were recommended by the protocol (5/115 vs. 19/109, P< or = 0.01) and use decreased when they were not (51/67 vs. 57/59, P< or = 0.01). As reported in the focus groups, reasons for low compliance included hospital policy weaknesses in protocol definition and implementation and the cultural behaviour of HCWs. Our results reinforce previous findings that monitoring the effectiveness of protocol implementation in the medical care setting is essential. Critical points that might increase the effectiveness of protocol implementation have also been identified.

Anti-Bacterial Agents↗

PubMed2001

A case-crossover study of sleep and childhood injury.

OBJECTIVE: To evaluate the association between sleep and wakefulness duration and childhood unintentional injury. Study Design. Case-crossover study. METHODS: Two hundred ninety-two injured children who presented at the Children's Emergency Center of Udine, Italy, or their parents were interviewed after a structured questionnaire. Information was collected concerning sociodemographic variables, participant's habits, and injury characteristics, including a brief description of the accident dynamics. Sleep or wakefulness status of the child was assessed retrospectively for each of the 48 hours before injury. For each child, we compared the 24 hours immediately before the injury (hours 1-24; case period) with hours 25 to 48 (control period). Nonparametric tests were conducted to compare the difference of sleep duration between case and control periods. In addition, we conducted intrapersonal conditional logistic regression analyses and estimated relative risks (RRs) and 95% confidence intervals (CIs). RESULTS: Overall, more children had longer hours of sleep during the control period than during the case period. However, this difference was significant for boys only. A direct association between injury risk and sleeping <10 hours was found among boys (RR: 2.33; 95% CI: 1.07-5.09) but not among girls (RR: 1.00; 95% CI:.29-3.45). This association was particularly strong among boys attending nursery school. We also found a direct association between injury occurring between 4 PM and midnight, and being awake for at least 8 hours before injury occurred (both sexes, RR: 4.00; 95% CI: 1.13-14.17). CONCLUSIONS: Our findings show that inadequate sleep duration and lack of daytime naps are transient exposures that may increase the risk of injury among children. These results suggest new prospects for injury prevention in childhood. children, injury, sleep, case-crossover, epidemiology.

Accidents↗

PubMed1999

A study on the role of the family and other risk factors in HCV transmission.

BACKGROUND/AIMS: To understand the intrafamilial transmission and the existing risk factors related to HCV infection in subjects confirmed anti-HCV positive, their sexual partners and household contacts in Friuli, North-East Italy. METHODS: We enrolled all the subjects that were consecutively identified as HCV positive during routine laboratory testing in six health districts and their household contacts. From each subject we obtained a blood sample, demographic data and a medical history including the existence of risk factors for HCV. Antibodies to HCV were detected employing a commercially available second-generation enzyme immunoassay (EIA); positive serum specimens were retested using a second-generation recombinant immunoblot assay (RIBA-2). RESULTS: We recruited 743 subjects, 229 first subjects identified as HCV positive and 514 household contacts. There were no statistically significant differences in positivity among household contacts. Analysing intracouple transmission we found no significant differences by gender in couples both with and without parenteral risk factors. We found, both with univariate and multivariate analysis, as statistically significant risk factors in all the subjects: age older than 60, blood transfusions (particularly those performed before 1984), surgical procedures such as abortion and/or uterine curettage, history of HBV infection, intravenous drug use, and tattooing. CONCLUSIONS: Our results stress the low relevance of sexual transmission in the intrafamilial context, the importance of abortion and/or uterine curettage, the important role of blood transfusions in the past, a higher prevalence of HCV infection within a household of a HCV positive member compared to all other existing data in the area.

Abortion, Induced↗

PubMed1999

Preliminary study on relevant data for health management in hospitals.

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.

Data Collection↗

PubMedDate not supplied