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Healthcare-related infections within nursing homes (NHS)
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Resumo(s)
Background: Infectious events, often related to healthcare practice, occur frequently within Nursing Homes (NHs), representing one of the main causes for morbidity, hospital admissions and mortality. The aims of this study are the analysis of care delivery problems and contributory factors of healthcare-related infections in a sample of NHs. This research could help identify organizational, technological and behavioural aspects, to implement improvement actions and reduce the impact of infections in long-term care. Methods: The study is a qualitative research with a systemic approach, based on the analysis of interactions in real practice between human factors, technologies and organizational structure and processes in 7 NHs in Tuscany (Italy), through extensive and structured observations of daily practices. The collected data were analyzed by applying clinical and ergonomic competences, comparing the data collected with established safe practices. The study was conducted by a nurse and a psychologist Results: From the data several problems related to infection control emerge. Buildings are often not suitable for confined spaces, room ventilation, natural light and rapid emergency response. Hand washing is not sufficient, use of antibiotics is usually not adequate. The microclimate is often not adequate, hygienic procedures are not always flawless. Staff members are in small numbers. Discussions: This study highlights high risk of contracting infections related to NHs. The study shows that dedicated infection prevention guidance are needed, to develop a local plan integrated with hospital setting, customized to needs of guests and characteristics of long-term care facilities, supported by a deep understanding of daily practices.
Descrição
Funding Information: I thank first of all my professors and co-authors of this article for all the teachings. I thank the working group “La Buona Cura” and Tuscany Region (Italy) that allowed the realization of the study. Finally, I thank Doctor Margherita D'ambrini and Doctor Riccardo Coletta for the revision of translation and Doctor Yari Longobucco for help in reviewing literature. The authors conducted the research with the support of a Regional funding from Tuscany Region (Italy) sanctioned in the resolution DGRT 1016 of 26-10-2015 and DRGT 953 of 06-09-2017.37,38 Tuscany Region has allocated through Formas (institution for training in healthcare companies) a total amount of €40,000.00 for carrying out the research-intervention. The funding was addressed to different entities including the regional clinical risk management center (GRC) of which Tommaso Bellandi and Giulia Lefosse were affiliated for the conduct of the research. The funding was used for the field observation phases. The rest of the work was conducted under the university system by the student Giulia Lefosse as part of the PhD in clinical sciences at the University of Florence, in collaboration with her PhD tutor Laura Rasero (associate professor at the University of Florence) and professor Paulo Sousa, head of the National Center for Public Health and Research in Lisbon (Portugal), for methodological support. The author(s) received no financial support for authorship, and/or publication of this article. Funding Information: The authors conducted the research with the support of a Regional funding from Tuscany Region (Italy) sanctioned in the resolution DGRT 1016 of 26-10-2015 and DRGT 953 of 06-09-2017. Tuscany Region has allocated through Formas (institution for training in healthcare companies) a total amount of €40,000.00 for carrying out the research-intervention. The funding was addressed to different entities including the regional clinical risk management center (GRC) of which Tommaso Bellandi and Giulia Lefosse were affiliated for the conduct of the research. The funding was used for the field observation phases. The rest of the work was conducted under the university system by the student Giulia Lefosse as part of the PhD in clinical sciences at the University of Florence, in collaboration with her PhD tutor Laura Rasero (associate professor at the University of Florence) and professor Paulo Sousa, head of the National Center for Public Health and Research in Lisbon (Portugal), for methodological support. The author(s) received no financial support for authorship, and/or publication of this article. , Publisher Copyright: © The Author(s) 2022.
Palavras-chave
human factors Infection control nursing homes patient safety risk management Leadership and Management Health(social science) Health Policy SDG 3 - Good Health and Well-being