Evaluation of the appropriateness of control measures related to nosocomial transmission of multidrug-resistant microorganisms within the SS Multipurpose Intensive Care Unit: observational study

Abstract

Background: Healthcare-Associated Infections (HAIs), by definition, occur 48 hours or more after admission or within 30 days after discharge or surgical procedure; they represent a significant challenge for the healthcare system due to their prevalence in Italy and the involvement of multi-drug resistance. Intensive Care Units (ICU) exhibit the highest prevalence of such infections due to lapses in adherence to safety protocols. The primary cause of hospital-acquired infections is poor adherence to guidelines for the prevention and control of these infections. This study aims to evaluate infection control measures in a mixed ICU. Materials and Methods: a cross-sectional observational single-center study was conducted in the Mixed ICU at the University Hospital of Alessandria. The study used an assessment tool based on the DVA 91 rev 03 issued on 07/22/22. This tool provides guidance on isolation type (airborne, contact, droplet), patient accommodation, care measures, cleaning and disinfection protocols, patient transportation, and visitor management. Results: overall, 220 observations were included, primarily involving nurses (75.4%) and female personnel (65.9%), with a mean age of 35.8 years and a median length of service of 36 months in the Mixed ICU. Notably, all observations were made on patients in contact isolation. In 199 observations (92.6%), healthcare providers performed hand hygiene immediately after glove removal. Conclusions: the findings highlight a strong adherence to infection control protocols at Alessandria Hospital-University. These efforts promote a safety culture among healthcare providers, ensuring the effective implementation of preventive measures.