Preventability of percutaneous injuries in healthcare workers: a year-long survey in Italy

The aim of the study was to examine the preventability of percutaneous injuries either through the adoption of correct behaviour or by the use of needles with safety features. We analysed the report forms of occupational needlestick or sharps injuries in a sample of healthcare workers exposed to the risk of percutaneous injuries in the period between 1 June 2000 and 31 May 2001; the forms were returned to the regional SIROH (Italian Study on Occupational Exposure to HIV) centre in which all hospitals of the Piemonte region (Italy) participate. Percutaneous injuries caused by needles (injection, phlebotomy, infusion), suture needles and scalpels were analysed; three samples were extracted according to the type of device that caused the injury. In the sample of 439 needlestick-related percutaneous injuries, 74% were caused by incorrect health worker behaviour and 26% were unpreventable, seventy-nine percent of accidents caused by incorrect behaviour and 24% of accidents could have been prevented by using needles with safety features. In the sample of 221 suture needle and 114 scalpel injuries, incorrect health worker behaviour was identified in 26.2% and 14%, respectively, and unpreventable causes in 73.8% and 50.9%, respectively. A high rate of percutaneous injuries, especially those involving needles for injection, phlebotomy, infusion, and scalpels, could be prevented by adopting safe work behaviour practices and using personal protection equipment. The introduction of devices with safety features could lead to a significant reduction in the number of injuries from needles.     

Qualities of enduring cross-sector partnerships in public health

The social, economic and political challenges accompanying our rapidly transforming global health environments have created unique social challenges that demand cross-sector solutions. Four cross-sector partnerships are reviewed with a special focus on sector roles, change management, phases of partnership development, and key factors for success.     

国际旅行卫生保健中心工作人员职业安全的思考

目的提高国际旅行卫生保健中心工作人员的职业安全防护意识，做好保健中心的职业安全防护工作。方法分析国际旅行卫生保健中心日常工作中职业安全方面潜在的危险因素，提出防护对策、具体措施。结果保健中心工作人员职业安全防护意识及措施相对薄弱，应制定完善的职业安全防护制度及操作规程等。结论加强管理与相关知识技能培训是职业安全防护的关键。     

The impact of home hospitalization on healthcare costs of exacerbations in COPD patients

Home-hospitalization (HH) improves clinical outcomes in selected patients with chronic obstructive pulmonary disease (COPD) admitted at the emergency room due to an exacerbation, but its effects on healthcare costs are poorly known. The current analysis examines the impact of HH on direct healthcare costs, compared to conventional hospitalizations (CH). A randomized controlled trial was performed in two tertiary hospitals in Barcelona (Spain). A total of 180 exacerbated COPD patients (HH 103 and CH 77) admitted at the emergency room were studied. In the HH group, a specialized respiratory nurse delivered integrated care at home. The average direct cost per patient was significantly lower for HH than for CH, with a difference of 810€ (95% CI, 418–1,169€) in the mean cost per patient. The magnitude of monetary savings attributed to HH increased with the severity of the patients considered eligible for the intervention. This study was funded by Grants AATM 8/02/99 from the Agencia d’Avaluació de Tecnología Mèdica (Barcelona, Spain); FIS 98/0052-01 from the Fondo de Investigaciones Sanitarias (Spain); SEPAR 1998 (Spain); CHRONIC project (IST-1999/12158) from the European Union (DG XIII); Comissionat per a Universitats i Recerca de la Generalitat de Catalunya (1999-SGR-00228); Fundación Mapfre Medicina (Spain); Red Respira—ISCIII—RTIC-03/11 and Red Telemedicina ISCIII—RTIC—03/117. Alejandro Casas was pre-doctoral research fellow supported by CHRONIC (IST-1999/12158) from the European Union (DG XIII).     

城市最低生活保障人口的医疗保障体制

本文主要探讨了城市人口的医疗保障体制，尤其探讨了城市最低生活保障人口的医疗保障体制。阐明了低保人口生活保障津贴没有包含看病的费用；社会医疗保险和商业医疗保险对低保人口进行了制度上的排斥。虽然，随着我国社会保障体系的连立和不断完善，城市低保人口的基本生活得到了初步保障，但低保人口的医疗仍面临很大的困难。     

The laboratory and the general practitioner

Clinical laboratories provide vital services for primary care and such work will inevitably increase with the moves to increase the extent to which patients are treated in the primary care setting, an increase in day-case surgery and shorter in-patient stay. The relationship between clinical laboratories and general practitioners should be a partnership with both the parties communicating efficiently in the interest of the patient. In particular, a close relationship between general practitioners and specialists in laboratory medicine is mandatory for handling the increasing number and complexity of laboratory tests, assuring the appropriateness of their request and utilization. In addition, the enormous increase in near-patient testing procedures claims for joint efforts to assure the quality of laboratory results. The General Practitioner always has the responsibility to understand the relevance of a test result and, where appropriate, to investigate further or to refer, irrespective of where the test has been done, but laboratory consultation can assure a better utilization of laboratory services for improving patient outcomes.     

Variations in nursing baccalaureate education and 30-day inpatient surgical mortality

BackgroundIn 2010, the IOM recommended an increase in the proportion of bachelor's-prepared (BSN) nurses to 80% by 2020. This goal was largely based on evidence linking hospitals with higher proportions of BSN nurses to better patient outcomes. Though, evidence is lacking on whether outcomes differ by a hospital's composition of initial BSN and transitional RN-to-BSN nurses.PurposeThe purpose of this study is to determine whether risk-adjusted odds of surgical mortality are associated with a hospital's proportion of initial BSN and transitional RN-to-BSN nurses.MethodsLogistic regression models were used to analyze cross-sectional data of general surgical patients, nurses, and hospitals in four large states in 2015 to 2016.FindingsHigher hospital proportions of BSN nurses, regardless of educational pathway, are associated with lower odds of 30-day inpatient surgical mortality.DiscussionFindings support promoting multiple BSN educational pathways to reach the IOM's recommendation of at least an 80% BSN workforce.     

The meaning of caring touch for healthcare professionals in an intensive care unit: A qualitative interview study

BackgroundThe way health care professionals touch patients and relatives in the intensive care unit plays a significant role. A negative feeling can be caused by being touched in the wrong way, this is why a holistic approach with respect for the patient is important for the ability to make the patient and their relatives feel secure, avoiding unnecessary suffering.AimThe aim of the study was to describe the meaning of caring touch that is given in the ICU from the health care professionals perspective.MethodQualitative interview study with health care professionals in the intensive care unit, analysed using inductive content analysis, resulting in two themes and four main categories.FindingsTwo themes emerged: Imperative touch and emotional touch and four main categories: touch as a natural tool, create a prerequisite for touch, empathetic touch and conversant touch.ConclusionCaring touch can be used as a natural tool in the daily work in order to bring comfort and calm to the patient in the intensive care unit.     

心脏康复推荐量表的汉化及信效度检验

目的 对心脏康复推荐量表（the Recommending Cardiac Rehabilitation Scale,ReCaRe）进行翻译及文化调试,并分析其信效度。方法 依据Brislin经典回译模型对ReCaRe进行正译、回译,经文化调试及预调查后形成中文版ReCaRe。2021年7月—8月选取324名湖南省心血管内外科医护人员进行线上调查,评价量表的信效度。结果 中文版ReCaRe共16个条目,条目水平的内容效度指数为0.833~1.000,全体一致量表水平的内容效度指数为0.875,平均量表水平的内容效度指数为0.979,探索性因子分析共提取3个公因子,即感知到益处和障碍、感知到严重性和易感性、感知到服务可用性,累计方差贡献率为67.858%。总量表的Cronbach’s α系数为0.867,各维度的Cronbach’s α系数为0.881~0.908;总量表的分半信度为0.759,各维度的分半信度为0.837~0.864。结论 中文版ReCaRe具有良好的信效度,可为评价医护人员心脏康复推荐信念提供可靠工具。