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意大利新冠疫情期间血液学患者保护:一项全国性护理调查

Hematology Patient Protection During the COVID-19 Pandemic in Italy: A Nationwide Nursing Survey.

作者信息

Botti Stefano, Serra Nicola, Castagnetti Fausto, Chiaretti Sabina, Mordini Nicola, Gargiulo Gianpaolo, Orlando Laura

机构信息

Hematology Unit, Azienda USL-IRCCS Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.

Department of Molecular Medicine and Medical Biotechnology, University Federico II of Naples, via S. Pansini 80131 Naples, Italy.

出版信息

Mediterr J Hematol Infect Dis. 2021 Jan 1;13(1):e2021011. doi: 10.4084/MJHID.2021.011. eCollection 2021.

Abstract

BACKGROUND

Italy has been one of the first European countries hit by the COVID-19 pandemic, with many patients dying from severe respiratory issues, especially frail subjects. Hematology patients are generally thought to be at high risk of developing severe COVID-19-associated complications. The aim of this work was to describe the infection control measures adopted in Italian hematology settings to protect patients and health-care professionals.

MATERIALS AND METHODS

On behalf of the Nursing Campus in Hematology Group, a nationwide nursing survey was conducted. Questionnaire items included general information, infection control measures, patient and health-care professional protection, information management, and participants' opinion on critical issues. Data have been analyzed by center location (Northern, Central, or Southern Italy) and by patient age (adult vs pediatric).

RESULTS

Forty-four Italian hematology centers participated, representing 52.4% of those invited. Patients underwent nasopharyngeal swabs (93.2%) generally the day before admission (43.2%), though less frequently in Southern centers (p = 0.0377). Visitor restrictions were implemented in all centers: 65.9% barred all visitors, while 25.0% allowed visitors only for patients with specific conditions, especially in Central Italy. Deficiency of personal protective equipment, including masks (45.5%) and gloves (22.7%), was reported, although the nurses' opinion was that the emergency was nevertheless well managed to protect patients and professionals. Almost all health-care institutions (97.7%) provided recommendations on emergency management. No significant differences were found between adult and pediatric centers in terms of infection prevention and control.

DISCUSSION

Low variability in patient protection strategies was observed, meaning that national recommendations were effective. However, some critical issues emerged regarding the management of infected health-care professionals and their contacts.

摘要

背景

意大利是最早受到新冠疫情冲击的欧洲国家之一,许多患者死于严重的呼吸道问题,尤其是体弱的患者。血液学患者通常被认为极易出现与新冠相关的严重并发症。本研究旨在描述意大利血液学机构为保护患者和医护人员所采取的感染控制措施。

材料与方法

代表血液学护理校园小组开展了一项全国性的护理调查。问卷项目包括一般信息、感染控制措施、患者及医护人员保护、信息管理以及参与者对关键问题的看法。数据按中心所在地(意大利北部、中部或南部)和患者年龄(成人与儿童)进行了分析。

结果

44家意大利血液学中心参与了调查,占受邀中心的52.4%。患者通常在入院前一天接受鼻咽拭子检测(93.2%),其中43.2%的患者接受检测,但在南部中心接受检测的频率较低(p = 0.0377)。所有中心均实施了访客限制:65.9%的中心禁止所有访客,而25.0%的中心仅允许特定情况下的患者访客,尤其是在意大利中部。报告称个人防护设备存在短缺,包括口罩(45.5%)和手套(22.7%),尽管护士们认为在保护患者和专业人员方面,紧急情况仍得到了妥善管理。几乎所有医疗机构(97.7%)都提供了应急管理建议。在感染预防和控制方面,成人中心和儿童中心之间未发现显著差异。

讨论

观察到患者保护策略的差异较小,这意味着国家建议是有效的。然而,在感染医护人员及其接触者的管理方面出现了一些关键问题。

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