Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
Department of Anesthesia and Critical Care Medicine, Sapienza University of Rome, and Policlinico Umberto I Hospital, Rome, Italy.
Ann Ig. 2021 Nov-Dec;33(6):628-643. doi: 10.7416/ai.2021.2461. Epub 2021 Jul 6.
A questionnaire of 36 questions was developed and administered to assess socio-occupational characteristics, knowledge of Healthcare-associated infections, attitudes and barriers encountered in compliance with hygiene standards, self-analysis of professional behaviour, and proposals for new interventions. Variables were evaluated by univariate analysis, and multivariable logistic regression models were constructed to identify predictors of adequate knowledge, positive attitude and appropriate professional behaviour.
Healthcare-associated infections are the main complications of hospitalization. A bottom-up approach, where the Healthcare workers involved play a key role, can be adopted to limit the Healthcare-associated infections burden. To this end, a survey was conducted in the main intensive care unit of Umberto I Teaching Hospital of Rome, where an active surveillance system has been in place since April 2016.
Overall, 79/89 Healthcare workers completed the questionnaire. Multivariate analysis showed that Healthcare workers, who participated in ward meetings to share active surveillance reports, were more likely to have adequate knowledge (aOR=4.21, 95% CI: 1.36-13.07). Only job type seemed to be a predictor of adequate behaviour, since nurses and physicians were more likely to show adequate behaviour than residents in training (aOR=0.21, 95% CI: 0.06-0.74). Direct observation of compliance with standard hygiene precautions and the identification of 'local champions' to manage Healthcare-associated infections' issues were the most requested interventions.
Our study suggests that the training of healthcare professionals is a key factor in preventing and containing the spreading of Healthcare-associated infections. Moreover, by encouraging greater Healthcare workers' involvement, we conclude that a bottom-up approach is likely to improve Healthcare-associated infections' prevention and management.
编制并实施了一份包含 36 个问题的问卷，用于评估社会职业特征、医院感染相关知识、遵守卫生标准时的态度和遇到的障碍、自我分析职业行为，以及提出新的干预措施。通过单变量分析评估变量，并构建多变量逻辑回归模型，以确定充足知识、积极态度和适当职业行为的预测因素。
医院获得性感染是住院的主要并发症。可以采取自下而上的方法，让相关医护人员发挥关键作用，以限制医院获得性感染的负担。为此，我们在罗马翁贝托一世教学医院的主要重症监护病房进行了一项调查，该病房自 2016 年 4 月以来一直采用主动监测系统。
共有 79/89 名医护人员完成了问卷。多变量分析表明，参加病房会议以分享主动监测报告的医护人员更有可能具有充足的知识（优势比=4.21，95%可信区间：1.36-13.07）。只有工作类型似乎是适当行为的预测因素，因为护士和医生比住院医师更有可能表现出适当的行为（优势比=0.21，95%可信区间：0.06-0.74）。直接观察遵守标准卫生预防措施的情况以及确定“当地冠军”来管理医院获得性感染问题是最需要的干预措施。
我们的研究表明，培训医护人员是预防和控制医院获得性感染传播的关键因素。此外，通过鼓励更多医护人员的参与，我们得出结论，自下而上的方法可能会改善医院获得性感染的预防和管理。
