Analysis of workload generated in the two years following first consultation by each new cancer patient: studying the past to plan the future of cancer care.

INTRODUCTION: Prevalence of cancer patients is dramatically increasing. We aimed at quantifying the oncology workload generated by each new cancer patient in the two years following first consultation. METHODS: In this record-based retrospective study, we retrieved data of all newly diagnosed patients treated at the Oncology Department of Udine Academic Hospital between 01.01.2012 and 31.12.2017. We calculated mean number and standard deviation of the activity type generated by each new cancer patient during the following 2 years. RESULTS: Seven thousand four hundred fifty-two cancer patients generated a total of 85,338 clinical episodes. The two-years mean number of oncology episodes generated was 11.31 (i.e., for every 1,000 new cancer patients, 11,310 oncology activities are generated overall in the following two-year lapse). Patients with advanced disease generated the highest workload (24.3; SD 18.8) with a statistically significant difference compared to adjuvant and follow-up patients (p < 0.001). The workload generated in the period 0-6 and 0-12 months was significantly higher than in the following months (p < 0.001) and it was also higher for patients initially designated to treatment (p < 0.001). CONCLUSION: This is the first study reporting on the mean oncology workload generated during the 2 years following first consultation. Workload is the highest for patient with advanced disease, especially in the first months and in patients in active treatment. A detailed analysis of workloads in oncology is feasible and could be crucial for planning a sustainable framework for cancer care in the next future.

[Hospital clinical records accuracy in traceability of healthcare associated infections]. / Accuratezza della documentazione clinica ospedaliera nella tracciabilità delle infezioni correlate alle pratiche assistenziali.

We conducted a retrospective analysis on health care records in order to validate its accuracy in the reporting of healthcare associated infections (HAIs) for the purpose of supporting epidemiological surveillance and nursing-sensitive patient outcomes studies. The health care records have been selected on the basis of the database of alert microorganisms in a teaching Hospital of North-Eastern of Italy, for the years 2005-2006-2007 in three wards (Hematology, ICU and Surgical ward). In 80/107 (74.8%) cases of alert microorganisms a written record was found in the patient's health care records, most frequently in the nursing records (64/80, 80%). In the health care records have been reported 21 diagnosis of infection (21/107, 19.6%). The presence of written symptoms was heterogeneous among the different sources considered (medical and nursing records, vital parameters and therapy sheets). The results are not completely satisfactory from the point of view of the information accuracy. The promotion of integrated clinical health care record systems (doctors/nurses), also electronics, a more accurate compilation and periodical supervision would be needed.

Incidence of hospital-acquired infections in Italian long-term-care facilities: a prospective six-month surveillance.

This study presents results from a six-month prospective surveillance of hospital-acquired infections in four Italian long-term-care facilities (LTCFs). Eight hundred and fifty-nine patients were enrolled and 21 503 person-days were observed. Two hundred and fifty-four hospital-acquired infections (HAIs) occurred in 188 patients. The overall infection rate was 11.8 per 1000 person-days. The most frequent infections were urinary tract infections (3.2 per 1000 person-days), lower respiratory tract infections (2.7 per 1000 person-days) and skin infections (2.5 per 1000 person-days). Risks related to HAI in a multi-variate regression model were: length of stay >or=28 days [odds ratio (OR) 3.5, 95% confidence intervals (CI) 2.4-5.0]; presence of a device (OR 2.0, 95%CI 1.3-3.0); Norton scale <12 (OR 1.8, 95%CI 1.2-2.6); and being bedridden (OR 1.7, 95%CI 1.08-2.6). The presence of HAI increased the median length of stay (31 days vs 20 days, P<0.01) without a significant influence on fatal outcome (OR 1.4, 95%CI 0.7-2.7).