Healthcare Workers In Italy Research Articles

Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic.

Italy is among the most severely hit nations in terms of hospital patients’ overload, and its healthcare workforce is struggling to cope with challenges that could threaten their own wellbeing. In this scenario, understanding the health-related consequences of COVID-19 outbreak on Italian frontline healthcare professionals is urgent. Our study provides a first account of the huge psycho-physical impact of COVID-19 outbreak for healthcare workers in Italy. Italian healthcare professionals reported relevant work-related psychological pressure, emotional burnout and somatic symptoms. This result requires attention as previous studies showed that emotional distress is associated with long-lasting effect on professionals’ health, including risk of post-traumatic stress disorder.

Impact of COVID-19 Outbreak on Healthcare Workers in Italy: Results from a National E-Survey

Italy has been the first-hit European country to face the outbreak of coronavirus disease 2019 (COVID-19). Aim of this survey was to assess in depth the impact of the outbreak on healthcare workers (HCW). A 40-item online survey was disseminated via social media inviting Italian HCW, with questions exploring demographics, health status and work environment of respondents. A total of 527 were invited to take part in March 2020, of whom 74% (n = 388) responded to the survey. Of these, 235 (61%) were women. HCW were mostly physicians (74%), from high-prevalence regions (52%). 25% experienced typical symptoms during the last 14 days prior to survey completion, with only 45% of them being tested for COVID-19. Among the tested population, 18 (18%) resulted positive for COVID-19, with 33% being asymptomatic. Only 22% of HCW considered personal protective equipment adequate for quality and quantity. Females and respondents working in high-risk sectors were more likely to rate psychological support as useful (OR, 1.78 [CI 95% 1.14–2.78] P = 0.012, and 2.02 [1.12–3.65] P = 0.020, respectively) and workload as increased (mean increase, 0.38 [0.06–0.69] P = 0.018; and 0.54 [0.16–0.92] P = 0.005, respectively). The insights from this survey may help authorities in countries where COVID-19 epidemic has not yet broken out. Management strategies should be promptly undertaken in order to enhance safety and optimise resource allocation.

Alcohol consumption in a sample of Italian healthcare workers: A cross-sectional study

ABSTRACTSince previous evidence suggested a risky alcohol consumption among healthcare workers (HCW), this study aimed to investigate the patterns of alcohol use in a sample of HCWs in Italy, through the Alcohol Use Disorders Identification Test Consumption (AUDIT-C). Overall, 639 HCWs participated in the study. 43.8% of them reported a score of 0 at AUDIT-C test. Drinkers were divided into “low-risk” and “at-/high-risk,” being respectively the 47.1% and 9.1% of the whole sample. There were significant differences between abstainers and drinkers, and between low-risk and at-/high-risk drinkers. In the multivariate logistic regression model, being younger, male, and physicians was associated with the profile of regular alcohol drinkers. A high risk AUDIT-C score was more likely in older and female HCWs. Briefly, this study confirmed the hypothesis of a risky level of drinking in HCWs. Educational preventive measures should be implemented to reduce alcohol consumption in this population.

Influenza vaccination of healthcare workers in Italy: could mandatory vaccination be a solution to protect patients?

Several studies have reported that influenza infections in healthcare workers (HCWs) can lead to nosocomial outbreaks. HCWs can potentially be infected with influenza every year, and may continue to work, encouraging the spread of the virus. Different strategies, such as informative interventions on influenza and influenza vaccination, 'onsite' vaccination weeks, communicative strategies through dedicated web and social media pages, and mandatory informed dissent form, were organized for HCWs working at the University Hospital of Palermo, during previous influenza seasons. However, the increased vaccination rates observed among HCWs still remain far from the 75% recommended by Public Health Authorities. The level of coverage observed in countries with mandatory vaccination policies for HCWs, couldsuggest the adoption of this strategyforincrease influenza vaccination adherence in Italy.

Susceptibility to vaccine-preventable diseases and vaccination adherence among healthcare workers in Italy: A cross-sectional survey at a regional acute-care university hospital and a systematic review

ABSTRACTHealthcare Workers (HCWs) have an increased risk both to acquire and to spread vaccine preventable diseases (VPDs) both to their colleagues and, especially, to vulnerable patients. The prevention of occupational hazards among HCWs is based on proper adoption of the standard and additional precautions, immunizations, and secondary preventive measures, such as post-exposure prophylaxis. Moreover, HCWs are often referred to as the most trusted source of vaccine-related information for their patients. In the present article, we report the findings of a cross-sectional study investigating the compliance to vaccinations among HCWs employed at the Obstetric Unit of a regional acute-care University Hospital in Northern Italy. Furthermore, a systematic review of the literature for some VPDs (i.e., HBV, measles, rubella, varicella and influenza) was performed, over a 17-year period, in order to update the socio-demographic and professional characteristics, the susceptibility status and the vaccination rates among HCWs in Italy.

Influenza vaccination among healthcare workers in Italy

Influenza vaccination is a fundamental tool for the prevention of influenza in healthcare settings and its administration to healthcare workers (HCWs) is recommended in more than 40 countries including United States of America and many countries of the European Union. Despite these recommendations, the compliance of HCWs to influenza vaccination is largely inadequate in Italy. Since 2005/06 season, a comprehensive multifaceted intervention project aimed at increasing the seasonal influenza vaccination coverage rates among HCWs was performed at the IRCCS AOU San Martino IST teaching hospital in Genoa, Italy, the regional tertiary adult acute-care reference center with a 1300 bed capacity. Despite almost a decade of efforts, the vaccination coverage rates registered at our hospital steadily remain unsatisfactory and very distant by the minimum objective of 75% defined by the Italian Ministry of Health. During the last influenza season (2013/14), vaccination coverage rates by occupation type resulted 30% among physicians, 11% among nurses and 9% among other clinical personnel. Further efforts are necessary to prevent the transmission of influenza to patient and novel strategies need to be identified and implemented in order to increase the compliance of HCWs, particularly nurses, with the seasonal influenza vaccination.

Acceptability of meningococcal serogroup B vaccine among parents and health care workers in Italy: A survey

A new meningococcal serogroup B vaccine (4CMenB) has recently been licensed. This study assessed the acceptability of 4CMenB vaccine among parents and healthcare workers (HCWs). From May to July 2013 in Milan, Italy, self-administered questionnaires were distributed to 2050 parents of infants presenting at immunization clinics for the mandatory hexavalent vaccination and submitted to 350 HCWs involved in immunization practices.1842 parents (89.1%) responded to the survey; 64.4% of parents wanted their child to receive the 4CMenB vaccine and 5.1% would not vaccinate their children. Multivariate analysis showed that recognition of the severity of meningitis [a life threatening vs a mild or unthreatening disease (Odds ratio (OR): 2.3; confidence interval (CI): 1.4–3.6], awareness of vaccination as a beneficial preventive measure (very beneficial vs not beneficial OR = 6.4; CI 3.0–13.7) and knowledge of the Meningococcal C vaccine (OR = 1.4; CI 1.1–1.8) were strongly associated to willingness to receive 4CMenB vaccine. On the contrary, level of education was associated with refusal of immunization (university vs education level lower than middle school OR = 0.68; CI 0.47–0.97). Among the parents who were willing to immunize their children, 66.9% would agree with three injections to be administered during the same visit. A total of 291 HCWs (83.1%) agreed to participate in the survey; 73% considered 4CMenB vaccine a priority in infants’ immunization schedule; 26.8% of HCWs suggested the concomitant administration with routine infant immunization.Parental and HCWs acceptability of 4CMenB vaccine was high. Increasing knowledge about meningitis and vaccine prevention might further increase the acceptability of this vaccine.

Determinants of influenza vaccination uptake among Italian healthcare workers

We analyzed seasonal influenza vaccination coverage among the Italian healthcare workers (HCW) in order to identify socio-demographic and clinical determinants of vaccination. We used data from the survey “Health and health care use in Italy,” which comprised interviews of 5,336 HCWs For each respondent, information on socioeconomic, health conditions, self-perceived health and smoking status were obtained. After bivariate analysis, we used multilevel regression models to assess determinants of immunization. Overall 20.8% of HCWs (95%CI 19.7–21.9) reported being vaccinated against seasonal influenza. After controlling for potential confounders, multilevel regression revealed that older workers have a higher likelihood of vaccine uptake (OR = 6.07; 95% CI 4.72–7.79). Conversely, higher education was associated with lower vaccine uptake (OR = 0.65; 95% IC 0.50–0.83). Those suffering from diabetes (OR = 2.07; 95% CI 1.19–1.69), COPD (OR = 1.95; 95% CI 1.31–2.89) and cardiovascular diseases (OR = 1.48 95% CI 1.11–1.96) were more likely to be vaccinated. Likewise, smokers, or former smokers receive more frequently the vaccination (OR = 1.40; 95% CI 1.15–1.70; OR = 1.54; 95% CI 1.24–1.91, respectively) compared with never-smokers as well as those HCWs reporting fair or poor perceived health status (ORs of 1.68, 95% CI 1.30–2.18). Vaccine coverage among HCWs in Italy remains low, especially among those with no comorbidities and being younger than 44 y old. This behavior not only raises questions regarding healthcare organization, infection control in healthcare settings and clinical costs, but also brings up ethical issues concerning physicians who seem not to be very concerned about the impact of the flu on themselves, as well as on their patients. Influenza vaccination campaigns will only be effective if HCWs understand their role in influenza transmission and prevention, and realize the importance of vaccination as a preventive measure

Knowledge of Oxygen Administration, Aerosol Medicine, and Chest Physiotherapy Among Pediatric Healthcare Workers in Italy

Oxygen administration, aerosol devices and drugs, or the use of chest physiotherapy are common practices in pediatrics; however, little is known about the knowledge of pediatric healthcare workers concerning the right utilization of these tools. The aim of this study was to fill this gap as a preliminary step in the implementation of appropriate educational programs. This cross-sectional survey of a nationally representative sample of Italian pediatricians and nurses was carried out between September 1 and October 8, 2008. A self-administered, anonymous questionnaire concerning the approach to respiratory disease in infants and children was distributed to all of the participants at the Annual Congress of the Italian Society of Pediatrics, together with a stamped envelope addressed to the trained study researchers. Of the 900 distributed questionnaires, 76.7% were completed and returned by 606 physicians (199 primary care pediatricians, 245 hospital pediatricians, and 162 pediatric residents) and 84 pediatric nurses. The vast majority of the respondents did not know the percentage of hemoglobin saturation indicating hypoxemia that requires oxygen administration. Most of the nurses admitted to overusing mucolytics and inhalatory corticosteroids, did not know the role of ipratropium bromide, were unable to indicate the first-line drug for respiratory distress, and did not know the correct dose of salbutamol. Only a minority of the respondents were able to specify the indications for chest physiotherapy. The nurses gave the fewest correct answers regardless of their age, gender, work setting, or the frequency with which they cared for children with respiratory distress in a year cared. The knowledge of primary care pediatricians, hospital pediatricians, and pediatric nurses in Italy concerning the use of pulse oximetry, aerosol devices and drugs, and chest physiotherapy is far from satisfactory and should be improved. Educational programs are therefore required for both nurses and pediatricians.

Increasing hepatitis B vaccination coverage among healthcare workers in Italy 10 years apart

Background In Italy, vaccination against hepatitis B virus infection was strongly recommended for healthcare workers since 1985. Update findings on vaccination coverage are lacking. Aim To assess current vaccination coverage against hepatitis B in this job category. Methods In 2006, 1632 healthcare workers randomly selected in 15 Italian public hospitals completed a self-administered precoded questionnaire. Results The overall vaccination coverage was 85.3%, a figure higher than the 64.5% observed in 1996. Vaccine coverage showed a significant downtrend ( p < 0.01) from the Northern (93.1%) to the Southern (77.7%) areas. Logistic regression analysis showed that residence in the North (Odds ratio 4.2; 95% confidence interval 2.6–6.7) and youngest age (Odds ratio 4.5; 95% confidence interval 2.6–7.8), both were independent predictors of vaccine acceptance. Conclusions Ten years apart, vaccine coverage has markedly increased, closely paralleling the downtrend in the incidence of acute B hepatitis among healthcare workers in Italy.

Incidence of Parenterally Transmitted Acute Viral Hepatitis Among Healthcare Workers in Italy

In Italy during 1995-2004, no significant difference was observed in the incidence rate of acute hepatitis B virus infection in the general population and in healthcare workers, with a downward trend noted in both groups. In contrast, the incidence rate of acute hepatitis C virus infection was significantly higher in healthcare workers than in the general population. In Italy, despite the strong recommendation since 1985 for healthcare workers (HCWs) to receive the hepatitis B virus (HBV) vaccine , the incidence of hepatitis B in HCWs continued to be higher than that in the general population during 1986-1991, likely reflecting poor vaccination coverage. Hepatitis C virus (HCV) is less infective than HBV. Studies published between 1992 and 2002 involving more than 11,000 HCV-exposed HCWs in 6 countries indicate that the average rate of HCV transmission after a single needlestick exposure is 0.5%. According to the Studio Italiano Rischio Occupazionale da HIV, a nationwide study on the occupational risk of acquiring human immunodeficiency virus (HIV) in Italy, the largest and most standardized study in the world, since 1995 there have been 3,795 exposures to anti-HCV–positive patients and a transmission rate as low as 0.4%. This rate increases to 0.9% in exposures with large inocula (eg, from hollow needles full of blood), whereas it is 0.3% for conjunctival exposure. Similar to hepatitis B, the incidence of acute hepatitis C in Italy during 1991-1994 was significantly higher in HCWs than in the general population. The Sistema Epidemiologico Integrato dell’Epatite Virale Acuta (SEIEVA) is Italy’s national surveillance system for acute viral hepatitis, which has been operating since 1985. Using SEIEVA data, we evaluated the incidence trends of acute hepatitis B and hepatitis C in HCWs and compared the incidence of these 2 infections in HCWs and members of the general population of the same age during 1995-2004. The SEIEVA data also served as the basis for the previously performed evaluations.

Hepatitis B vaccination coverage among healthcare workers in Italy.

In 1996, the vaccination coverage against hepatitis B virus among 3,157 healthcare workers in Italy was inversely related to the level of hepatitis B virus endemicity in the area of residence. Youngest age and lowest years of employment were independent predictors of the likelihood of vaccine acceptance.

Hepatitis B Vaccination Coverage among Healthcare Workers in Italy

Hepatitis B Vaccination Coverage among Healthcare Workers in Italy

Incidence of non-A, non-B and HCV positive hepatitis in healthcare workers in Italy

In Italy, using figures from a surveillance system for acute viral hepatitis, the incidence rate of acute non-A, non-B hepatitis (NANBH) and hepatitis C virus (HCV) hepatitis cases was evaluated in healthcare workers (HCWs) and the general population of the same age over the period 1988–1994. The NANBH incidence among the general population declined from 4·7 100 000 in 1988 to 2·1 100 000 in 1994; the corresponding figures among HCWs were 12·3 100 000 (RR 2·62; CI 95% = 1·66-4·15) in 1988 and 4·3 100000 (RR 2·05; CI 95% = 1·13-3·77) in 1994. Since 1991, NANBH cases have been tested for antibodies to HCV (anti-HCV). During the period 1991–1994 the proportion of NANBH cases tested for anti-HCV was 81% ( 38 47 ) in HCWs and 85% ( 1019 1193 ) in other NANBH cases. A similar proportion of NANBH cases in each group (74% and 70%) were shown to be due to HCV. The incidence rate of HCV positive cases among the general population was 1·3 100 000 in 1991 and 1·8 100000 in 1994; the corresponding figures among HCWs were 3·7 100 000 (RR 2·85; CI 95% = 1·42-5·92) in 1991 and 3·1 100 000 (RR 1·72; CI 95% = 0·88-3·59) in 1994. The proportion of cases with jaundice was 56·2% in HCWs and 63·7% in the general population. Needlestick injury without major risk factors such as blood transfusion, intravenous drug use or surgical intervention was reported by 12·0% of HCWs and by 0·1% of the general population. Lack of any risk factor was reported by 40·2% of HCWs. These findings strongly suggest that in Italy healthcare workers are at greater risk than the general population of acquiring NANBH, as well as HCV.