Essential strategies in HAI prevention and control: performance assessment through the implementation of the HAI-CoSIP tool of the GISIO-SItI group. A pilot study in a sample of Italian Organizations.

Autor:	Tardivo S; Department of Diagnostics and Public Health, University of Verona, Verona, Italy., Moretti F; Department of Diagnostics and Public Health, University of Verona, Verona, Italy., Agodi A; Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy., Appignanesi R; Management Department, Asur Zt 12, San Benedetto del Tronto, Italy., Baldovin T; Department of Molecular Medicine, Section of Public Health, University of Padova, Padova, Italy., Barchitta M; Department of Molecular Medicine, Section of Public Health, University of Padova, Padova, Italy., Brusaferro S; Department of Medical and Biological Sciences, University of Udine, Udine, Italy., Canino R; Medical Direction Department, Oglio-Po Hospital, Vicomoscano - Casalmaggiore, Cremona, Italy., Carli A; Department of Diagnostics and Public Health, University of Verona, Verona, Italy., D'Errico MM; Department of Biomedical Science and Public Health, Polytechnic University of Marche, Torrette di Ancona, Ancona, Italy., Giuliani G; Medical Direction Department, Infections Control Committee, G.Salvini Hospital, Garbagnate Milanese, Milan, Italy., Moro M; Medical Direction Department, Infections Control Committee, IRCCS San Raffaele Scientific Institute, Milan, Italy., Mura I; Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy., Nobile M; Management Department, G. Pini Orthopedic Institute, University of Milan, Milan, Italy., Novati R; Medical Direction Department, Aosta Regional Hospital, Aosta, Italy., Pasquarella C; Department of Hygiene and Public Health, University of Parma, Parma, Italy., Privitera G; Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy., Rossini A; Medical Direction Department, IRCCS Santa Lucia Scientific Institute, Rome, Italy., Sodano L; Medical Direction Department San Camillo Forlanini Hospital, Rome, Italy., Torregrossa MV; Department of Sciences for Health Promotion 'G. D'Alessandro', Hygiene Section, University of Palermo, Palermo, ItalY., Torri E; Department of Health and Social Policy, P.A. Trento, Trento, Italy., Auxilia F; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
Jazyk:	angličtina
Zdroj:	Annali di igiene : medicina preventiva e di comunita [Ann Ig] 2018 Sep-Oct; Vol. 30 (5 Supple 2), pp. 70-85.
DOI:	10.7416/ai.2018.225
Abstrakt:	Background: Healthcare-Associated Infections are a great concern for worldwide healthcare systems and represent a considerable threat to patient safety, leading to adverse clinical outcomes. A defined panel of indicators represents a key element to guide Healthcare Organizations towards identification of main gaps, implementation of effective actions and continuous improvements on Healthcare-Associated Infections prevention and control activities. A review on accreditation systems conducted by the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene Preventive Medicine and Public Health revealed a substantial heterogeneity of implemented standards and led to the development of a core set of indicators and requirements for Healthcare-Associated Infections' prevention and control within the hospital setting. The main aim of the study was to test the feasibility of the Healthcare-Associated Infections' prevention and control within the hospital setting tool to calculate performance scores on a sample of Italian Healthcare Organizations and to identify major critical issues. The potential benefits of the possibility of future implementation of the tool within Institutional Accreditation Programs is discussed. Study Design: Cross sectional pilot survey. Methods: The Healthcare-Associated Infections' prevention and control within the hospital setting included 96 criteria and 20 key areas including an area for outcomes indicators. For applicable criteria, standards fulfilment was evaluated according to a 4 point Likert scale. A composite score was calculated for each Healthcare Organization and five performance levels were identified. Data were further analysed by computing performance scores at the level of each area and requirement. Results: 20 Healthcare Organizations agreed to take part in this pilot study including two rehabilitative Healthcare Organizations. Among the whole sample a mean of 12.20% of requirements resulted not fulfilled, leaving space for further improvements. Critical areas were easily identified and the instrument was able to capture substantial differences between Healthcare Organizations. Only a few number of standards resulted "Not Applicable" (Mean = 4.71%) and most of them regarded Rehabilitative Healthcare Organizations. Mean composite performance index resulted 74.06% (SD = 16.96, range 36.30 - 94.27%); area of outcome indicators obtained a mean score of 56.17. Conclusion: The Healthcare-Associated Infections' prevention and control within the hospital setting resulted an useful tool to assess Healthcare Organizations' performance in the field of Healthcare-Associated Infections prevention and control and to identify necessary actions for further improvements. The distribution of total scores by Healthcare Organizations showed a high heterogeneity. Implementation of the Healthcare-Associated Infections' prevention and control within the hospital setting tool as an institutional accreditation tool may help to drive the required harmonization at a national level of Healthcare-Associated Infections management and control strategies and overcome current substantial regional differences.
Databáze:	MEDLINE
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