[The result of application's monitoring of NEWS score in a surgery unit of a North Italy hospital]. / Risultati del monitoraggio dell'applicazione dello score National Early Warning Score in area chirurgica di un ospedale del Nord Italia.

INTRODUCTION: In a hospital in Northern Italy was decided to experiment a new standardized methodology for detection and evaluation of vital parameters and effective communication between healthcare professionals, with the applications of NEWS score. Then it was necessary to evaluate the application and usefulness of the score in the specific contest. The aim of this project was adopting a validated and standardized methodology for detecting vital parameters to identificate early the signs and symptoms of a possible clinical deterioration and to create an effective communication between professionals. In the end it was necessary to monitor the correct application of the NEWS score to evaluate the usefulness of extending the score in surgical units. METHODS: The indicators were identified and monitored, consulting a sample of medical Gynecologic records of the 2019. The sample size useful for having a confidence level of 95% was identified, which, according to the Sample Size Calculator, known the population of 865 patients, corresponds to 160 sample units. An ad hoc data set was then developed for data collection. RESULTS: The correctness of the execution of clinical monitoring according to the parameters provided by the score is 75%, while the completeness of score's recording is 99% of the sample analyzed. The days of hospitalization in which there is a score≥5 are 10, equal to 1.5%. An in-depth study of cases with a score ≥5 showed that in 9 out of 10 cases the doctor was alerted. DISCUSSION: The NEWS score is useful in the early identification of risk situations, in rapid and objective communication and in the timely activation of interventions to prevent complications. Furthermore, the application of the score does not involve a waste of time than that used for the collection of vital parameters.

Long-term effectiveness evaluation of an action-research intervention to improve hand hygiene in an intensive care unit.

OBJECTIVES: To evaluate the long-term effectiveness of an action research intervention aimed at improving hand hygiene in an intensive care unit of a public hospital in Italy. METHODS: An observational, prospective before-after study was carried out.Compliance with hand hygiene was estimated by measuring the utilization of hand hygiene products before the intervention and four years after the end of the project. Products used were the following: detergent liquid soap, antiseptic liquid soap and alcohol-based hand gel. Endpoints were quantity consumed (in grams) for each product category. Quantitative consumptions per workshift were compared. RESULTS: In 2017 the median consumption of antiseptic liquid soap and alcohol-based hand gel per workshift was significantly higher than in 2012 (111.5 g vs 72.5 g, p = 0.014, and 18.0 g vs 5.0 g, p < 0.001). Odds in favour of a higher value in 2017 were 1.99:1 (CI95%: 1.19:1 to 3.73:1) for antiseptic solution, and 5.39:1 (CI95%: 3.09:1 to 13.61:1) for antiseptic gel. Covariates were not associated with consumption of products, and this made it possible to compare the measurements in the two data collections. CONCLUSIONS: Results of this study support the long-term effectiveness of the action research intervention to improve practices of hand hygiene in an intensive care setting.