[Exposure to biologic hazards in rehabilitation: analysis of the perceived risk and of the educational needs of nurses and physiotherapists]. / Il rischio biologico in riabilitazione: analisi della percezione del rischio e del bisogno formativo negli infermieri e nei fisioterapisti.

Nurses and physiotherapists who work in a Rehabilitation Centre are exposed to biologic hazards due to the close physical contact they have with their patients, who are often affected by contagious infectious diseases. The perceived risk amongst these workers is a significant element in establishing an effective prevention plan and in evaluating educational needs and was therefore investigated in this survey. An anonymous self-administered questionnaire, structured in four subsections for a total of twenty four multiple-choice questions was used. The evaluated variables included knowledge of pathogen transmission pathways, modes of exposure to such pathogens, knowledge of universal precautions and of ways in which to deal with known exposure. Physiotherapists, more so than nurses, have a partial and insufficient knowledge of biologic hazards. The main reason for this gap can be found in the school curriculum for such professionals, in which, in comparison to other graduate degree courses (medicine, nursing) a much smaller amount of course time is allotted to the topic of biologic hazards and risk prevention. In order to practice effective risk management it is therefore necessary for the employer to commit to providing specific on-site education and training to its workers. For this purpose, our centre has developed specific educational activities and internal procedures which can be shared on the topic of biologic hazards and risk management.

[Critical aspects of the management of "hazardous" health care workers. Consensus document]. / Aspetti critici della gestione dei "lavoratori rischiosi" nei servizi sanitari. Documento di consenso.

BACKGROUND: A worker is considered to be hazardous to others when, in the course of performing a specific work task, his/her health problems (e.g., substance dependence, emotional disorders, physical disability, transmissible diseases) pose a risk for other workers' or the public's health and safety, or begins to interfere with ability to function in profession life. The presence of certain illnesses or the fact that a health care worker is impaired because of them do not necessarily imply that he, or she, is hazardous for others. Working in health care increases the probability that an impaired worker being hazardous for others. Management of hazardous workers requires new techniques and procedures, and specific policies. OBJECTIVE AND METHODS: An interdisciplinary group of experts from medical, bioethical, legal and administrative disciplines, together with trade union and employers' representatives, is currently attempting to define a way to put prevention measures into practice in accordance with state laws and individual rights. RESULTS: A consensus document is presented, covering critical aspects such as: social responsibility of the employer, risk management, informed consent, non compliance, confidentiality, responsibility of workers, disclosure of risk to patients, non-discrimination, counselling and recovery of impaired workers, effectiveness of international guidelines. CONCLUSIONS: Occupational health professionals are obliged to adhere to ethical principles in the management of "hazardous" workers; the assessment of ethical costs and benefits for the stakeholders is the basis for appropriate decisions.