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Sartelli M, Bartoli S, Borghi F, Busani S, Carsetti A, Catena F, Cillara N, Coccolini F, Cortegiani A, Cortese F, Fabbri E, Foghetti D, Forfori F, Giarratano A, Labricciosa FM, Marini P, Mastroianni C, Pan A, Pasero D, Scatizzi M, Viaggi B, Moro ML. Implementation Strategies for Preventing Healthcare-Associated Infections across the Surgical Pathway: An Italian Multisociety Document. Antibiotics (Basel) 2023; 12:antibiotics12030521. [PMID: 36978388 PMCID: PMC10044660 DOI: 10.3390/antibiotics12030521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Healthcare-associated infections (HAIs) result in significant patient morbidity and can prolong the duration of the hospital stay, causing high supplementary costs in addition to those already sustained due to the patient’s underlying disease. Moreover, bacteria are becoming increasingly resistant to antibiotics, making HAI prevention even more important nowadays. The public health consequences of antimicrobial resistance should be constrained by prevention and control actions, which must be a priority for all health systems of the world at all levels of care. As many HAIs are preventable, they may be considered an important indicator of the quality of patient care and represent an important patient safety issue in healthcare. To share implementation strategies for preventing HAIs in the surgical setting and in all healthcare facilities, an Italian multi-society document was published online in November 2022. This article represents an evidence-based summary of the document.
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Affiliation(s)
- Massimo Sartelli
- Department of Surgery, Macerata Hospital, 62100 Macerata, Italy
- Correspondence:
| | - Stefano Bartoli
- Vascular Surgery Unit, S. Eugenio Hospital, 00100 Roma, Italy
| | - Felice Borghi
- Oncologic Surgery Unit, Candiolo Cancer Institute FPO–IRCCS, 10060 Torino, Italy
| | - Stefano Busani
- Anaesthesia and Intensive Care Unit, University Hospital of Modena, 41124 Modena, Italy
| | - Andrea Carsetti
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria delle Marche, 60100 Ancona, Italy
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60100 Ancona, Italy
| | - Fausto Catena
- General and Emergency Surgery Unit, “Bufalini” Hospital, 47521 Cesena, Italy
| | - Nicola Cillara
- General Surgery Unit, Santissima Trinità Hospital, 09121 Cagliari, Italy
| | - Federico Coccolini
- General and Emergency Surgery Unit, Trauma Center, New Santa Chiara Hospital, University of Pisa, 56100 Pisa, Italy
| | - Andrea Cortegiani
- Department of Surgical Oncological and Oral Science, University of Palermo, 90134 Palermo, Italy
- Department of Anesthesia Intensive Care and Emergency, University Hospital “Policlinico Paolo Giaccone”, 90134 Palermo, Italy
| | - Francesco Cortese
- Emergency Surgery Unit, San Filippo Neri Hospital, 00135 Roma, Italy
| | - Elisa Fabbri
- Health and Social Services, Emilia-Romagna Region, 40127 Bologna, Italy
| | | | - Francesco Forfori
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Antonino Giarratano
- Department of Surgical Oncological and Oral Science, University of Palermo, 90134 Palermo, Italy
- Department of Anesthesia Intensive Care and Emergency, University Hospital “Policlinico Paolo Giaccone”, 90134 Palermo, Italy
| | | | - Pierluigi Marini
- General and Emergency Surgery Unit, S. Camillo-Forlanini Hospital, 00152 Roma, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy
| | - Angelo Pan
- Unit of Infectious Diseases, ASST Cremona, 26100 Cremona, Italy
| | - Daniela Pasero
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Department of Emergency, Anaesthesia and Intensive Care Unit, AOU Sassari, 07100 Sassari, Italy
| | - Marco Scatizzi
- General Surgery Unit, Santa Maria Annunziata Hospital, 50012 Firenze, Italy
| | - Bruno Viaggi
- Neuro-Intensive Care Unit, Department of Anesthesiology, Careggi University Hospital, 50139 Florence, Italy
| | - Maria Luisa Moro
- Italian Multidisciplinary Society for the Prevention of Healthcare-Associated Infections, 20159 Milano, Italy
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Hernández-Borges AA, Pérez-Estévez E, Jiménez-Sosa A, Concha-Torre A, Ordóñez-Sáez O, Sánchez-Galindo AC, Murga-Herrera V, Balaguer-Gargallo M, Nieto-Moro M, Pujol-Jover M, Aleo-Luján E. Set of Quality Indicators of Pediatric Intensive Care in Spain: Delphi Method Selection. Pediatr Qual Saf 2017; 2:e009. [PMID: 30229149 PMCID: PMC6132791 DOI: 10.1097/pq9.0000000000000009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 11/23/2016] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION This study objective was to identify, select, and define a basic set of quality indicators for pediatric intensive care in Spain. METHODS (1) Review of the literature to identify quality indicators and their defining elements and (2) selection of indicators by consensus of a group of experts using basic Delphi methodology (2 rounds) and forms distributed by email among experts from the Spanish society of pediatric intensive care. RESULTS We selected quality indicators according to their relevance and feasibility and the experts' agreement on their incorporation in the final set. We included only those indicators whose assessment was within the highest tertile and greater than or equal to 70% evaluator agreement in the final selection. Starting from an initially proposed set of 136 indicators, 31 experts first selected 43 indicators for inclusion in the second round. Twenty indicators were selected for the final set. This "top 20" set comprised 9 process indicators, 9 of results (especially treatment-associated adverse effects), and 2 indicators of structure. Several of them are classical indicators in intensive care medicine (rates of hospital-acquired infections, pressure ulcers, etc.), whereas others are specifically pediatric (eg, unrestricted parent visitation or training the parents of technology-dependent children). CONCLUSIONS We reached a consensus on a set of 20 essential quality indicators for pediatric intensive care in Spain. A significant subset reflects the peculiarities of pediatric care. We consider this subset as a starting point for future projects of network collaboration between pediatric intensive care units in Spain.
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Affiliation(s)
- Angel A. Hernández-Borges
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Elena Pérez-Estévez
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Alejandro Jiménez-Sosa
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Andrés Concha-Torre
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Olga Ordóñez-Sáez
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Amelia C. Sánchez-Galindo
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Vega Murga-Herrera
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Mónica Balaguer-Gargallo
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Montserrat Nieto-Moro
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Montserrat Pujol-Jover
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Esther Aleo-Luján
- From the Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d’Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain
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