S Tardivo1, F Moretti1, M Nobile2, A Agodi3, R Appignanesi4, C Arrigoni5, T Baldovin6, S Brusaferro7, R Canino8, A Carli1, R Chiesa9, D D'Alessandro10, M M D'Errico11, G Giuliani12, M T Montagna13, M Moro14, I I Mura15, R Novati16, G B Orsi17, C Pasquarella18, G Privitera19, G Ripabelli20, A Rossini21, M Saia22, L Sodano23, M V Torregrossa24, E Torri25, R Zarrilli26, F Auxilia27, Gisio SItI28. 1. Department of Diagnostics and Public Health, University of Verona, Verona, Italy. 2. Management Department, G. Pini Orthopedic Institute, University of Milan, Milan, Italy. 3. Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy. 4. Management Department, Asur Zt 12, San Benedetto del Tronto, Italy. 5. Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy. 6. Department of Molecular Medicine, Section of Public Health, University of Padova, Padova, Italy. 7. Department of Medical and Biological Sciences, University of Udine, Udine, Italy. 8. Medical Direction Department, Oglio-Po Hospital, Vicomoscano - Casalmaggiore, Cremona, Italy. 9. Programming Acquisition and Control Department, Asl Brescia, Brescia, Italy. 10. Department of Civil Building and Environmental Engineering, Sapienza University of Rome, Rome, Italy. 11. Department of Biomedical Science and Public Health, Polytechnic University of Marche, Torrette di Ancona, Ancona, Italy. 12. Department of Medical Direction, Infections Control Committee, G. Salvini Hospital, Garbagnate Milanese, Milan, Italy. 13. Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy. 14. Department of Medical Direction, Infections Control Committee, IRCCS San Raffaele Scientific Institute, Milan, Italy. 15. Department of Biomedical Sciences, Hygiene Unit, University of Sassari, Sassari, Italy. 16. Medical Direction, Aosta Regional Hospital, Aosta, Italy. 17. Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy. 18. Department of Hygiene and Public Health, University of Parma, Parma, Italy. 19. Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy. 20. Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy. 21. Department of Medical Direction, IRCCS Santa Lucia Scientific Institute, Rome, Italy. 22. Veneto Region Health Directorate, Palazzo Molin San Polo Venice, Italy. 23. Department of Medical Direction, San Camillo Forlanini Hospital, Rome, Italy. 24. Department of Sciences for Health Promotion "G. D'Alessandro" - Hygiene Section, University of Palermo, Palermo, Italy. 25. Department of Health and Social Policy, Trento, Italy. 26. Department of Public Health, University of Naples "Federico II", Naples, Italy. 27. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. 28. Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy.
Abstract
BACKGROUND: Healthcare-associated infections (HAIs) are an important issue in terms of quality of care. HAIs impact patient safety by contributing to higher rates of preventable mortality and prolonged hospitalizations. In Italy, analysis of the currently available accreditation systems shows a substantial heterogeneity of approaches for the prevention and surveillance of HAIs in hospitals. The aim of the present study is to develop and propose the use of a synthetic assessment tool that could be implemented homogenously throughout the nation. METHODS: An analysis of nine international and of the 21 Italian regional accreditation systems was conducted in order to identify requirements and indicators implemented for HAI prevention and control. Two relevant reviews on this topic were further analyzed to identify additional evidence-based criteria. The project team evaluated all the requirements and indicators with consensus meeting methodology, then those applicable to the Italian context were grouped into a set of "focus areas". RESULTS: The analysis of international systems and Italian regional accreditation manuals led to the identification respectively of 19 and 14 main requirements, with relevant heterogeneity in their application. Additional evidence-based criteria were included from the reviews analysis. From the consensus among the project team members all the standards were compared and 20 different thematic areas were identified, with a total of 96 requirements and indicators for preventing and monitoring HAIs. CONCLUSIONS: The study reveals a great heterogeneity in the definition of accreditation criteria between the Italian regions. The introduction of a uniform, synthetic assessment instrument, based on the review of national and international standards, may serve as a self-assessment tool to evaluate the achievement of a minimum standards set for HAIs prevention and control in healthcare facilities. This may be used as an assessment tool by the Italian institutional accreditation system, also useful to reduce regional disparities.
BACKGROUND: Healthcare-associated infections (HAIs) are an important issue in terms of quality of care. HAIs impact patient safety by contributing to higher rates of preventable mortality and prolonged hospitalizations. In Italy, analysis of the currently available accreditation systems shows a substantial heterogeneity of approaches for the prevention and surveillance of HAIs in hospitals. The aim of the present study is to develop and propose the use of a synthetic assessment tool that could be implemented homogenously throughout the nation. METHODS: An analysis of nine international and of the 21 Italian regional accreditation systems was conducted in order to identify requirements and indicators implemented for HAI prevention and control. Two relevant reviews on this topic were further analyzed to identify additional evidence-based criteria. The project team evaluated all the requirements and indicators with consensus meeting methodology, then those applicable to the Italian context were grouped into a set of "focus areas". RESULTS: The analysis of international systems and Italian regional accreditation manuals led to the identification respectively of 19 and 14 main requirements, with relevant heterogeneity in their application. Additional evidence-based criteria were included from the reviews analysis. From the consensus among the project team members all the standards were compared and 20 different thematic areas were identified, with a total of 96 requirements and indicators for preventing and monitoring HAIs. CONCLUSIONS: The study reveals a great heterogeneity in the definition of accreditation criteria between the Italian regions. The introduction of a uniform, synthetic assessment instrument, based on the review of national and international standards, may serve as a self-assessment tool to evaluate the achievement of a minimum standards set for HAIs prevention and control in healthcare facilities. This may be used as an assessment tool by the Italian institutional accreditation system, also useful to reduce regional disparities.
Authors: Martina Barchitta; Andrea Maugeri; Maria Clara La Rosa; Claudia La Mastra; Giuseppe Murolo; Antonella Agodi Journal: Antibiotics (Basel) Date: 2020-12-22