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PURPOSE: A rise in affective and anxiety disorders and in antidepressant (AD) treatment during the COVID-19 pandemic has been extensively described, but few studies were provided at the individual level, further considering COVID-19 severity and vaccination status. METHODS: Case-control study evaluating the association between the new use of ADs and a previous COVID-19 infection, in Friuli Venezia Giulia Region, Italy, from March 1, 2020, to July 19, 2022. Multiple conditional logistic regressions assess the association between a new AD use and a COVID-19 infection previous to the index date, stratified by gender, age and anti-COVID-19 vaccination status. Odds Ratios (OR) and 95% confidence intervals were reported. RESULTS: COVID-19 was associated with AD treatment after the infection. The disease severity was positively associated with a growing risk of being dispensed an AD, with the highest risk in unvaccinated subjects previously hospitalised in ICU (OR = 28.77). The risk of using ADs after COVID-19 infection was higher in unvaccinated subjects aged 65 years and older, both females and males. The association between COVID-19 infection and AD dispensation in vaccinated subjects was not significant, with the exception of females aged 65 years and over. CONCLUSIONS: Anti-COVID-19 vaccination, especially among the elderly, might prevent post-COVID AD treatment. Clinicians should be aware that COVID-19 patients requiring hospitalisation are more likely to experience these symptoms, given their higher risk of being dispensed ADs. Future studies may benefit by analysing the incidence of both mental disorders and psychotropic treatment in post-COVID patients, considering socioeconomic factors and vaccination status.
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Perovskite solar cells promise to be part of the future portfolio of photovoltaic technologies, but their instability is slow down their commercialization. Major stability assessments have been recently achieved but reliable accelerated ageing tests on beyond small-area cells are still poor. Here, we report an industrial encapsulation process based on the lamination of highly viscoelastic semi-solid/highly viscous liquid adhesive atop the perovskite solar cells and modules. Our encapsulant reduces the thermomechanical stresses at the encapsulant/rear electrode interface. The addition of thermally conductive two-dimensional hexagonal boron nitride into the polymeric matrix improves the barrier and thermal management properties of the encapsulant. Without any edge sealant, encapsulated devices withstood multifaceted accelerated ageing tests, retaining >80% of their initial efficiency. Our encapsulation is applicable to the most established cell configurations (direct/inverted, mesoscopic/planar), even with temperature-sensitive materials, and extended to semi-transparent cells for building-integrated photovoltaics and Internet of Things systems.
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Perovskite solar cells (PSCs) offer impressive performance and flexibility, thanks to their simple, low-temperature deposition methods. Their band gap tunability allows for a wide range of applications, transitioning from opaque to transparent devices. This study introduces the first flexible, bifacial PSCs using the FAPbBr3 perovskite. We investigated the impact of optimizing electron and hole transport layers on the cells' bifaciality, transparency, and stability. PSCs achieved a maximum power conversion efficiency (PCE) of 6.8 and 18.7% under 1 sun and indoor light conditions (1200 lx), respectively, showing up to 98% bifaciality factor and an average visible transmittance (AVT) of 55%. Additionally, a P1-P2-P3 laser ablation scheme has been developed on the flexible poly(ethylene terephthalate) (PET) substrate for perovskite solar modules showing a PCE of 4.8% and high geometrical fill factor (97.8%). These findings highlight the potential of flexible, bifacial PSCs for diverse applications such as building-integrated photovoltaics (BIPV), agrivoltaics, automotive technology, wearable sensors, and Internet of things (IoT).
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BACKGROUND: A significant proportion of individuals reports persistent clinical manifestations following SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) acute infection. Nevertheless, knowledge of the burden of this condition-often referred to as 'Long COVID'-on the health care system remains limited. This study aimed to evaluate healthcare utilization potentially related to Long COVID. METHODS: Population-based, retrospective, multi-center cohort study that analyzed hospital admissions and utilization of outpatient visits and diagnostic tests between adults aged 40 years and older recovered from SARS-CoV-2 infection occurred between February 2020 and December 2021 and matched unexposed individuals during a 6-month observation period. Healthcare utilization was analyzed by considering the setting of care for acute SARS-CoV-2 infection [non-hospitalized, hospitalized and intensive care unit (ICU)-admitted] as a proxy for the severity of acute infection and epidemic phases characterized by different SARS-CoV-2 variants. Data were retrieved from regional health administrative databases of three Italian Regions. RESULTS: The final cohort consisted of 307 994 previously SARS-CoV-2 infected matched with 307 994 uninfected individuals. Among exposed individuals, 92.2% were not hospitalized during the acute infection, 7.3% were hospitalized in a non-ICU ward and 0.5% were admitted to ICU. Individuals previously infected with SARS-CoV-2 (vs. unexposed), especially those hospitalized or admitted to ICU, reported higher utilization of outpatient visits (range of pooled Incidence Rate Ratios across phases; non-hospitalized: 1.11-1.33, hospitalized: 1.93-2.19, ICU-admitted: 3.01-3.40), diagnostic tests (non-hospitalized: 1.35-1.84, hospitalized: 2.86-3.43, ICU-admitted: 4.72-7.03) and hospitalizations (non-hospitalized: 1.00-1.52, hospitalized: 1.87-2.36, ICU-admitted: 4.69-5.38). CONCLUSIONS: This study found that SARS-CoV-2 infection was associated with increased use of health care in the 6 months following infection, and association was mainly driven by acute infection severity.
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COVID-19 , Hospitalización , Aceptación de la Atención de Salud , SARS-CoV-2 , Humanos , COVID-19/epidemiología , Masculino , Estudios Retrospectivos , Femenino , Persona de Mediana Edad , Anciano , Adulto , Hospitalización/estadística & datos numéricos , Italia/epidemiología , Aceptación de la Atención de Salud/estadística & datos numéricos , Síndrome Post Agudo de COVID-19 , Estudios de Cohortes , Recursos en Salud/estadística & datos numéricos , Unidades de Cuidados Intensivos/estadística & datos numéricosRESUMEN
BACKGROUND AND OBJECTIVE: The second victim (SV) phenomenon concerns health care workers (HCWs) whose involvement in a medical error, as well as non-error patient safety events, has affected their well-being. Its prevalence ranges from 10% to 75% and can predispose HCWs to burnout, increasing the probability of committing errors. The primary aim of our study was to determine the prevalence of HCWs involved in an adverse patient safety event in Friuli Venezia Giulia Region (Italy). The secondary aims were to use latent profile analysis to identify profiles of SVs and factors influencing profile membership, and to evaluate the relationship between the severity of symptoms and desired support options. METHODS: A cross-sectional survey through the Italian version of the Second Victim Experience and Support Tool tool was conducted in 5 local health authorities. Descriptive statistics were conducted for all variables. Associations and correlations were assessed with statistical tests, as appropriate. Latent profile analysis was based on the scores of dimensions measuring SVs' symptoms. Factors affecting profile membership were assessed through multinomial logistic regression. RESULTS: A total of 733 HCWs participated. Of them, 305 (41.6%) experienced at least 1 adverse event. Among dimensions measuring SVs' symptoms, psychological distress had the highest percentage of agreement (30.2%). Three latent profiles were identified: mild (58.7%), moderate (24.3%), and severe (17.0%) symptoms. Severe symptoms profile was positively associated with the agreement for extraoccupational support and negatively associated with the agreement for organizational support. A respected colleague with whom to discuss the details of the incident (78.7%) and free counseling outside of work (71.2%) were the support options most desired by HCWs. The severity of symptoms was directly associated with the desire for support strategies. CONCLUSIONS: The prevalence of HCWs involved in adverse events is consistent with the literature. Three latent profiles have been identified according to SV symptoms, and the higher the severity of symptoms, the greater the reliance on extraoccupational support.
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Personal de Salud , Humanos , Estudios Transversales , Personal de Salud/psicología , Italia/epidemiologíaRESUMEN
BACKGROUND: Vaccine effectiveness (VE) studies consolidate knowledge of real-world effectiveness in different contexts. However, methodological issues may undermine their conclusions: to assess the VE against COVID-19 within the Italian population, a specific threat to validity is related to the consequences of divergent compliance to the Green Pass policy. METHODS: To address this challenge we conducted a test negative case-control (TNCC) study and multiple sensitivity analysis among residents aged ≥ 12 in Friuli Venezia Giulia Region (FVG), North-east Italy, from February 1, 2021 to March 31, 2022. Information regarding 211,437 cases of COVID-19 infection and 845,748 matched controls was obtained from the regional computerized health database. The investigation considered: COVID-19 infection, hospitalization, and death. Multiple conditional logistic regressions adjusted for covariates were performed and VE was estimated as (1-OR COVID-19vaccinated vs. unvaccinated)x100. Mediation analyses were carried out to offset potential collider variables, particularly, the number of swabs performed after the introduction of pandemic restrictions. RESULTS: Full-cycle VE against infection decreased from 96% (95% CI: 96, 97) in the Alpha period to 43% (95% CI: 42, 45) in the Omicron period. Booster dose raised the protection in Omicron period to 67% (95% CI: 66, 67). Against the evasive Omicron variant, the protection of the booster dose was 87% (95% CI: 83, 90) for hospitalization and 90% (95% CI: 82, 95) for death. The number of swabs performed was included as a covariate in the adjustments, and the mediation analysis confirmed that it was a strong mediator between vaccination and COVID-19-related outcomes. CONCLUSIONS: The study suggests that, under similar TNCC settings, mediation analysis and adjustment for number of diagnostic tests should be included, as an effective approach to the challenge of differential testing behavior that may determine substantial selection bias. This correction allowed us to align with results from other studies that show how full-cycle VE against infection was initially high but decreased over time by variant circulation, counterbalanced by booster dose that raised protection across variants and outcome severity.
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Vacunas contra la COVID-19 , COVID-19 , Humanos , Estudios de Casos y Controles , COVID-19/epidemiología , COVID-19/prevención & control , SARS-CoV-2 , PolíticasRESUMEN
Recent studies estimated that about 20-30% of visits in a paediatric emergency department (PED) are inappropriate. Nonurgent visits have been negatively associated with crowding and costs, causing longer waiting and dissatisfaction among both parents and health workers. We aimed to analyze possible factors conditioning inappropriate visits and misuse in a PED. We performed a cross-sectional study enrolling children accessing an Italian PED from June 2022 to September 2022 who received a nonurgent code. The appropriateness of visits, as measured by the "Mattoni SSN" Project, comprises combination of the assigned triage code, the adopted diagnostic resources, and outcomes. A validated questionnaire was also administered to parents/caregivers of included children to correlate their perceptions with the risk of inappropriate visit. Data were analyzed using independent-samples t-tests, Wilcoxon-Mann-Whitney tests, chi-square tests, and Fisher's exact tests. The factors that were found to be associated with inappropriate visits to the PED were further evaluated by univariable and multivariable logistic regression analyses. Almost half (44.8%) of nonurgent visits resulted inappropriate. Main reasons for parents/caregivers to take their children to PED were (1) the perceived need to receive immediate care (31.5%), (2) the chance to immediately perform exams (26.7%), and (3) the reported difficulty in contacting family paediatrician (26.3%). Inappropriateness was directly related to child's age, male gender, acute illness occurred in the previous month, and skin rash or abdominal pain as complaining symptoms. Conclusion: This study highlights the urgent need to finalize initiatives to reduce misuse in accessing PED. Empowering parents' awareness and education in the management of the most frequent health problems in paediatric age may help to achieve this goal. What is Known: ⢠About 20-30% of pediatric urgent visits are estimated as inappropriate. ⢠Several factors may be associated with this improper use of the emergency department, such as the misperception of parents who tend to overrate their children's health conditions or dissatisfaction with primary care services. What is New: ⢠This study evaluated almost half of pediatric emergency department visits as inappropriate adopting objective criteria. ⢠Inappropriateness was directly related to the child's age, male gender, acute illness that occurred in the previous month, and skin rash or abdominal pain as complaining symptoms. Educational interventions for parents aimed at improving healthcare resource utilization should be prioritized.
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Servicio de Urgencia en Hospital , Exantema , Niño , Humanos , Masculino , Estudios Transversales , Enfermedad Aguda , Padres/educación , Dolor AbdominalRESUMEN
BACKGROUND: Prepectoral direct-to-implant reconstruction with acellular dermal matrix (ADM) represents a safe, fast, and successful option in breast reconstruction in a selected cohort of patients. Nowadays, this procedure is considered challenging in thin. Meanwhile, his cohort has not been accurately analyzed yet. METHODS: A single institution retrospective cohort study was performed between January 2019 and March 2023 in all women who underwent mastectomy. Biometrical and clinical data were recorded. Also, surgical technique, operating room (OR) time, mastectomy weights, implant choice, and acellular dermal matrix (ADM) types were properly noted. Postoperative complications represented the main topic: these were classified into early and late ones based on onset time. At least 12-month follow-up was required. A comparison between thin and ideal body mass index (BMI) populations was performed. RESULTS: Early complications did not seem to differ between the 2 groups with 37.8% and 38.9% of women having at least 1 early complication in thin and ideal-weight women, respectively (P = .919). In univariable regression analysis, compared with women with a BMI of 22.1 to 25.0, women with a BMI ≤ 22.0 were associated with an increased risk of late complications of 2.84 (1.13-7.14). Specifically, thin women appeared to have a 3-fold increased risk (OR = 2.97, 95% CI 1.08-8.18) of ripples/wrinkles compared with women with ideal weight. CONCLUSIONS: Prepectoral reconstruction with ADM in thin patients may be considered as safe as in standard BMI patients. Rippling may be more frequent, but, whenever needed, easy to correct with a few sessions of lipo-grafts. LEVEL OF EVIDENCE: III.
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Dermis Acelular , Implantación de Mama , Implantes de Mama , Neoplasias de la Mama , Mamoplastia , Humanos , Femenino , Mastectomía/efectos adversos , Mastectomía/métodos , Implantación de Mama/efectos adversos , Implantación de Mama/métodos , Estudios Retrospectivos , Dermis Acelular/efectos adversos , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/etiología , Mamoplastia/efectos adversos , Mamoplastia/métodos , Implantes de Mama/efectos adversosRESUMEN
BACKGROUND: Two-stages pre-pectoral breast reconstruction may confer advantages over direct to implant (DTI) and subpectoral reconstruction in selected patients who have no indication for autologous reconstruction. The primary endpoint of the study was to evaluate and compare the incidence of capsular contracture in the pre-pectoral two-stages technique versus the direct to implant technique. Complications related to the two surgical techniques and patient satisfaction were also evaluated. METHODS: A retrospective review of 45 two stages and 45 Direct-to-implant, DTI patients was completed. Acellular dermal matrix was used in all patients. An evaluation of anthropometric and clinical parameters, surgical procedures and complications was conducted. Minimum follow-up was 12 months after placement of the definitive implant. RESULTS: There was no statistically significant difference in the rate of capsular contracture in the two groups. Rippling occurred more in DTI reconstruction. In the two-stages reconstruction, lipofilling was applied more often and there was a higher incidence of seroma. Patient satisfaction extrapolated from the Breast Q questionnaire was better for patients submitted to two-stage implant-based breast reconstruction. CONCLUSION: Dual-stage pre-pectoral reconstruction with acellular dermal matrix appears to be a good reconstructive solution in patients with relative contraindications for one-stage heterologous reconstruction with definitive prosthesis and no desire for autologous reconstruction.
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The commercialization of perovskite solar cells (PSCs) requires the development of long-term, highly operational-stable devices. An efficient barrier layer plays a key role in improving the device stability of planar PSCs. Here, we focus on the use of sputtered indium tin oxide (ITO) as a barrier layer to stop major degradations. To mitigate efficiency losses of cells with the ITO barrier, we optimized various sputtering process parameters such as ITO layer thickness, target power density, and working pressure. The fabricated planar inverted PSCs based on the novel ITO barrier optimization demonstrate a power conversion efficiency (PCE) of 19.05% on a cell area of 0.09 cm2. The encapsulated cells retained >80% of their initial efficiency after 1400 h of continuous illumination at 55 °C and 94.5% of their initial PCE after 1500 h stored in air. Employing such a holistic stabilization approach, the PSC minimodules without encapsulation achieved an efficiency of 16.4% with a designated area of 2.28 cm2 and retained approximately 80% of the initial performance after thermal stress at 85 °C for 350 h under ambient conditions.
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The impact of socio-economic status on the risk of allergy in African children is not clear.This was a cross sectional study including children aged 6-14 years from urban and rural settings in north-central Nigeria. Participants underwent skin prick tests to house dust mite (HDM) and an interview investigating socio-economic status through the Family Affluence Scale (FAS) based on a score of 0-6.A total of 346 children were enrolled (52.8% boys; mean age ± SD 9.6 ± 2.0 years), including 142 (41% of total) rural and 204 (59% of total) urban pupils. Prevalence of HDM sensitivity was 2.8% (4/142) in the rural setting and 15.6% (32/204) in the urban setting (P < 0.001). Among urban children, frequency of HDM sensitization was 8.6% (7/81) in the lowest socio-economic group (FAS 0-1), 13.1% (8/61) in the intermediate one (FAS 2-3) and 27.4% (17/62) in the highest one (FAS ≥ 4).Urbanization and increasing wealth are associated with a higher frequency of sensitization to HDM in Nigerian children.
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Pyroglyphidae , Urbanización , Alérgenos , Animales , Niño , Estudios Transversales , Polvo/análisis , Femenino , Humanos , Masculino , Nigeria/epidemiología , Pruebas CutáneasRESUMEN
Rationale: Chronic lung injury is common in sickle cell anemia (SCA) and worsens outcomes. Sensitive lung function tests might predict reversible disease that might benefit from therapeutic interventions. Objectives: To evaluate whether lung clearance index (LCI) (measuring global ventilation inhomogeneity), intraacinar ventilation inhomogeneity (Sacin), and conductive ventilation inhomogeneity (Scond) are more frequently abnormal than lung volumes in young people with SCA. Methods: Nitrogen multiple-breath washout, spirometry, and body plethysmography were cross-sectionally evaluated at steady state in subjects with SCA (hemoglobin SS) and healthy control subjects aged 8-21 years from London, United Kingdom. Results: Thirty-five patients (51% boys, mean ± SD age, 16.4 ± 3.5 yr) and 31 control subjects (48% boys; 16.2 ± 3.2 yr) were tested. There were significant differences between the study and control groups in mean LCI (mean difference, 0.42 units; 95% confidence interval [CI], 0.22 to 0.63; P = 0.0001), Sacin (mean difference, 0.014 units; 95% CI, 0.001 to 0.026; P = 0.04), forced expiratory volume in 1 second (FEV1) (mean difference, -0.79 z-scores; 95% CI, -1.28 to -0.30; P = 0.002), forced vital capacity (FVC) (mean difference, -0.80 z-scores; 95% CI, -1.28 to -0.31, P = 0.002), and total lung capacity (mean difference, -0.76 z-scores; 95% CI, -1.25 to -0.29, P = 0.002), but not in Scond and FEV1-to-FVC ratio. Whereas 29% (10 of 35) of patients had LCI > 95th percentile of control subjects, 23% (8 of 35) had abnormal FEV1 (<5th percentile of the reference population). Conclusions: LCI detected slightly more abnormalities than lung volumes in young people with SCA. Significant differences from control subjects in LCI and Sacin but not in Scond and FEV1-to-FVC ratio suggest that the lung function changes were most likely owing to patchy peripheral lung disease.
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Anemia de Células Falciformes , Enfermedades Pulmonares , Adolescente , Adulto , Anemia de Células Falciformes/complicaciones , Anemia de Células Falciformes/diagnóstico , Niño , Femenino , Volumen Espiratorio Forzado , Humanos , Pulmón , Masculino , Pruebas de Función Respiratoria , Espirometría , Adulto JovenRESUMEN
Cost management and toxic waste generation are two key issues that must be addressed before the commercialization of perovskite optoelectronic devices. We report a groundbreaking strategy for eco-friendly and cost-effective fabrication of highly efficient perovskite solar cells. This strategy involves the usage of a high volatility co-solvent, which dilutes perovskite precursors to a lower concentration (<0.5 M) while retaining similar film quality and device performance as a high concentration (>1.4 M) solution. More than 70% of toxic waste and material cost can be reduced. Mechanistic insights reveal ultra-rapid evaporation of the co-solvent together with beneficial alteration of the precursor colloidal chemistry upon dilution with co-solvent, which in-situ studies and theoretical simulations confirm. The co-solvent tuned precursor colloidal properties also contribute to the enhancement of the stability of precursor solution, which extends its processing window thus minimizing the waste. This strategy is universally successful across different perovskite compositions, and scales from small devices to large-scale modules using industrial spin-coating, potentially easing the lab-to-fab translation of perovskite technologies.
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BACKGROUND: The use of physical restraints (PRs) varies across countries and clinical settings, with intensive care units having the highest frequency. Although many investigations on the use of PRs have been conducted worldwide, few studies are reported in the Italian context. OBJECTIVES: The aims of this study were to describe PR rates and types and to observe the factors associated with PR use. METHODS: In this observational study, 2 methods were used to collect data: direct observation and review of patients' documentations. RESULTS: We performed 328 observations on 146 critically ill patients. Physical restraints were applied in 56.7% (n = 186) of these observations. Bilateral wrist ties were used for most PR episodes (n = 135, 72.6%), followed by unilateral wrist ties (12.9%). The most documented reasons were preventing patients from self-extubation (n = 93, 50.0%) and preserving indwelling lines and tubes (n = 60, 32.2%). In the multivariate logistic regression analysis, patients who were cared for during the night shift were almost 4 times more likely to be restrained than patients in the morning shifts (odds ratio, 3.84; P = .001) and patients with endotracheal tube were 3.5 times more likely to be restricted than spontaneously breathing patients (odds ratio, 3.59; P < .001). DISCUSSIONS: Physical restraints are commonly used among critically ill patients in Italian intensive care units. There is a need to share the metrics for an efficient and accurate measurement of PR usage and trends and to document the reason for restraints, type of restraints, timeframe, and decision-making criteria.
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Unidades de Cuidados Intensivos , Restricción Física , Enfermedad Crítica , Documentación , Humanos , Intubación IntratraquealRESUMEN
OBJECTIVE: Second victims are defined as healthcare workers involved in an unanticipated adverse patient event, who experienced professional and psychological distress. The Second Victim Experience and Support Tool (SVEST) is a survey developed and validated in the United States, which describes the experience of second victims. This study aims to perform the cross-cultural adaptation of the SVEST and to evaluate its psychometric characteristics in the Italian context. METHODS: Translation and cross-cultural adaptation process was performed according to the World Health Organization guidelines. Then, 349 healthcare workers, including nurses, doctors, residents, and technicians, involved in direct patient care-a potential second victim-completed the Italian version of SVEST in a validation survey at the Academic Hospital of Udine. The SVEST consists of 29 items, divided into 7 dimensions, 2 outcome variables, and 7 support options. The Italian version was assessed for internal consistency through Cronbach α, for content validity with content validity index for scales and for item and for construct validity with Confirmatory Factor Analysis. RESULTS: The internal consistency of the instrument was adequate in its overall evaluation with Cronbach α value of 0.88 (95% confidence interval = 0.86). The content validity index for scales was 0.94 and that for item was 0.70. The confirmatory factor analysis results showed a good model fit for the 9-factor structure (χ2 = 676.18, df = 327, P < 0.001). Root mean squared error of approximation, Akaike information criterion, and comparative fix index Tucker-Lewis index values also suggested a good fit to the data. CONCLUSIONS: The Italian version of the SVEST can be used to evaluate second victim experiences, demonstrating adequate validity, reliability, and good psychometric properties.
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Comparación Transcultural , Análisis Factorial , Humanos , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Clinical record (CR) is the primary tool used by healthcare workers (HCWs) to record clinical information and its completeness can help achieve safer practices. CR is the most appropriate source in order to measure and evaluate the quality of care. In order to achieve a safety climate is fundamental to involve a responsive healthcare workforce thorough peer-review and feedbacks. This study aims to develop a peer-review tool for clinical records quality assurance, presenting the seven-year experience in the evolution of it; secondary aims are to describe the CR completeness and HCWs' diligence toward recording information in it. METHODS: To assess the completeness of CRs a peer-review tool was developed in a large Academic Hospital of Northern Italy. This tool included measurable items that examined different themes, moments and levels of the clinical process. Data were collected every three months between 2010 and 2016 by appointed and trained HCWs from 42 Units; the hospital Quality Unit was responsible for of processing and validating them. Variations in the proportion of CR completeness were assessed using Cochran-Armitage test for trends. RESULTS: A total of 9,408 CRs were evaluated. Overall CR completeness improved significantly from 79.6% in 2010 to 86.5% in 2016 (p<0.001). Doctors' attitude showed a trend similar to the overall completeness, while nurses improved more consistently (p<0.001). Most items exploring themes, moments and levels registered a significant improvement in the early years, then flattened in last years. Results of the validation process were always above the cut-off of 75%. CONCLUSIONS: This peer-review tool enabled the Quality Unit and hospital leadership to obtain a reliable picture of CRs completeness, while involving the HCWs in the quality evaluation. The completeness of CR showed an overall positive and significant trend during these seven years.
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Centros Médicos Académicos/normas , Documentación/normas , Registros Electrónicos de Salud/normas , Sistemas de Información en Hospital/normas , Manejo del Dolor/normas , Garantía de la Calidad de Atención de Salud/normas , Mejoramiento de la Calidad/normas , Anestesia/normas , HumanosRESUMEN
Medical students and residents play an important role in patient care and ward activities, thus they should follow hospital procedures and ensure best practices and patient safety. A survey concerning staff on training was conducted to assess the perceived quality of healthcare from healthcare workers (HCWs), residents, medical students and patients in Udine Academic Hospital, Italy. Between December, 2018 and March, 2019, a 5-point Likert-scale questionnaire was administered in 21 units, covering four thematic areas: patients and medical staff satisfaction with the quality of care provided by residents and students, patient privacy, clinical risk management, patient perception of staff on training. Data analysis included descriptive analysis and ordered logistic regressions. A total of 596/1,863 questionnaires were collected from: HCWs (165/772), residents (110/355), students (121/389), and patients (200/347). Residents were rated high both by patients (median = 5, IQR = 4-5, OR 0.49, 95%CI 0.26-0.93) and HCWs (median = 4, IQR = 3-5, OR 0.14, 95%CI 0.08-0.26), with a lower score for medical students on the same topic, both by patients (median = 4, IQR = 3-5, OR 2.94, 95%CI 1.49-5.78) and HCWs (median = 3, IQR = 2-3, OR 0.41, 95%CI 0.25-0.67). Therefore, the role of staff on training in quality and safety of healthcare deserves integrated regular evaluation, since direct interaction with patients contributes to patients' perception of healthcare.