Annali di igiene : medicina preventiva e di comunità
-
Comparative Study
Is an institution-wide programme able to reduce the in-patients' experiences of pain in a high specialization hospital?
The study examines the implication of an institution-wide programme on pain management in reducing the patients' perception of the pain carried out in a university hospital by comparing the results of two surveys conducted in 2002 (prior to the programme) and in 2003 (during the course of the programme). The study was conducted in November 2003 and it consisted in a priority survey on the patients' pain perception using a questionnaire which was distributed to all the patients admitted in a highly specialised hospital and interviewed by trained interviewers. ⋯ With regards to the pain reported in the previous 24 hrs, there was a reduction in the percentage of patients experiencing pain from 69.0% in 2002 (100/145) to 42.4% in 2003 (59/139) [OR = 3.0, CI (95%) = 1.8-5.0, p < 0.001]. Our hospital wide program succeeded in reducing pain in patients, improving professional quality and creating customer satisfaction in a hospital.
-
Repetitive work in occupational settings often requires a combination of mental and physical demands, but few studies were conducted concerning the relationship between attention and repetitive work. In attentive and cognitive tasks, it is common to observe effort and fatigue without the presence of those neuromuscular modifications that would justify the use of these terms. Therefore, we can talk about mental fatigue in those cases in which it is observed the exhaustion of the necessary resources for the execution of a job that doesn't demand the employment of neuromuscular apparatus. ⋯ The European Community has often emphasized the pathogenic value of stress and fatigue with their high social and individual costs. For this purpose, it is opportune to consider the norm UNI EN ISO 10075, which points out the necessity to consider the human component, in term of mental load which implies not only the cognitive component but also the whole psychical sphere of the subject. Training intended like a sort of learning of specific modalities, supplies workers with the necessary instruments for a correct and more aware management of the peculiarities of working activity, contributing to the reduction of fatigue and stress deriving from the job.
-
Meta Analysis
[Hospital at home: assessment of early discharge in terms of patients mortality and satisfaction].
New organizational models are essentials for European Hospitals because of restraining budget and ageing of population. Hospital at home is an alternative to inpatient care, effective both in clinical and economic ground. The aim of our study was to evaluate the impact of Hospital at Home in terms of decreased mortality and patient satisfaction. ⋯ The selected studies indicated a greater effect size of patient satisfaction in home patients than hospitalized ones (Odds Ratio: 1.58 95% CI: 1.25, 2.00) and showed no difference in terms of mortality (Risk Difference: -0.01 95% CI: -0.03, 0.02). Our results underline the effectiveness of this organizational model, as an alternative to continued care in an acute hospital. Further useful considerations could be drawn by economic evaluation studies carried out on field.
-
Surgical site infection (SSI) frequency is influenced by several risk factors, among which perioperative hair removal. Traditionally it is part of the procedures carried out on skin before surgery. Although preoperative shaving is widely used in many hospitals, its use should be re-evaluated. ⋯ We found first of all that preoperative shaving (razor) is associated with a significantly higher surgical site infection (SSI) risk. Second, when hair removal is considered necessary by the surgeon, it should be carried out by means of a clipper or depilatory cream. Furthermore hair removal should be performed immediately before surgery and not in advance, to avoid an increased risk of SSI.
-
The Italian National Health Service (S. S. N.), adopted in 1978 (Law n 833) and based on Beveridge's model, emphasises the citizens freedom to choose and the equal opportunity in accessing health care structures. ⋯ Following the Law 502/1992, the power of attraction of our hospital is increased. Nevertheless the flow of escape continued to increase. It appears that to discourage the attraction power means to promote the loss of perceived quality and that it is difficult to correct such effects.