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UN REPARTO DI MEDICINA INTERNA SOVRAFFOLLATO E’ MENO SICURO ? Giuseppe Civardi

UN REPARTO DI MEDICINA INTERNA SOVRAFFOLLATO E’ MENO SICURO ? Giuseppe Civardi Direttore U. O. C. di Medicina Interna P.O. della val d’Arda. ?. …MA IL SOVRAFFOLLAMENTO INCIDE SUL RISCHIO CLNICO ?.

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UN REPARTO DI MEDICINA INTERNA SOVRAFFOLLATO E’ MENO SICURO ? Giuseppe Civardi

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  1. UN REPARTO DI MEDICINA INTERNA SOVRAFFOLLATO E’ MENO SICURO ? Giuseppe Civardi Direttore U. O. C. di Medicina Interna P.O. della val d’Arda

  2. ? …MA IL SOVRAFFOLLAMENTO INCIDE SUL RISCHIO CLNICO ?

  3. methicillin-resistant Staphylococcus aureus (MRSA) incidence (black line) and corresponding rate of bed occupancy (gray line) in medical wards (2000-2006) Borg MA et al, Infect Control Hosp Epidemiol 2008; 29:496–502\

  4. Factors linked to transmission of MRSA in hospitals Clements A et al, Lancet Infect Dis 2008; 8: 427–34 HCW=health-care worker.

  5. High users of hospitals have overlap of physical and social vulnerabilities

  6. Seven-day survival after emergency admission stratified by H occupancy on the day of admission Adjusted for age, mode of transport, diagnosis (ICD-10-CM), triage urgency, referral source Sprivulis PC, MJA 2006

  7. SOVRAFFOLLAMENTO OSPEDALIERO VS. MORTALITA’ A 7 GG. P = 0.002

  8. HR for variables used in 7-day mortality Overcrowding Hazard Scale Sprivulis PC, MJA 2006

  9. Overcrowding Hazard Scale (ED Boarder occupancy at attendance) x (Hospital occupancy at midnight)

  10. STRATEGIE DI GESTIONE DEGLI INDICI DI OCCUPAZIONE PER UN OSPEDALE SICURO • Gli ospedali che operano con IO fra il 90 e il 100% dovrebbero rivedere la gestione complessiva dei flusso dei pazienti (in entrata e in uscita) allo scopo di perseguire le condizioni migliori per la sicurezza dei pazienti ricoverati • IO oltre il 100% sono un rischio per la sicurezza dei pazienti La prudenza suggerisce che gli ospedali dovrebbero operare con livelli non superiori al 90% di IO AcademyHealth Annual Meeting Boston, Massachusetts June 26, 2005 http://www.academyhealth.org/2005/sunday.htm Peter Sprivulis

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