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Healthcare workers (HCWs) are on the frontline fight against the ongoing pandemic with an increased risk of infection from COVID-19. As of December 27, 2020, approximately 89,879 COVID-19 cases had been reported among HCWs in Italy. Vaccination plans recommend that initial supplies of COVID-19 vaccine be allocated to HCWs because their early protection is crucial to preserve capacity to care for patients. The aim of this study is threefold: to investigate the factors influencing the likelihood towards vaccination, to estimate the vaccine efficacy (VE) in a hospital setting and to assess the frequency of adverse reactions (AR). This retrospective study was conducted in an Italian teaching hospital from December 28, 2020 to March 31, 2021 (before the introduction of mandatory vaccination for HCWs). A total of 6,649 individuals was included. HCWs were divided into physicians, nurses and other HCWs. Univariate analyses and a multivariate logistic regression were run with an alpha of 0.05. VE was estimated as the proportionate reduction in disease attack rate between the unvaccinated and vaccinated. Out of 6,649 HCWs, 5,162 were fully vaccinated against COVID-19. Among the selected job categories, 82% of physicians, 79% of nurses and 68% of other HCWs were vaccinated. The findings of the logistic regression depicted that the 41-60 years old age class, compared with the youngest age class, was statistically significant (OR 1.17, 95% CI 1.03-1.33) in influencing vaccination, as well as being nurses (OR 0.80, 95% CI 0.69-0.92) or other HCWs (OR 0.45, 95% CI 0.39-0.52) in comparison with physicians. VE equaled 92.83% (p < 0.05). The frequency of serious and not serious AR was 0.03% and 2.9%, respectively. Sustaining and boosting COVID-19 vaccination campaigns is effective for preventing SARS-CoV-2 infection in real-world conditions. COVID-19 vaccination among HCWs is a critical public health measure to safeguard HCWs themselves, patients and the hospital community. Key messages In light of the encouraging efficacy and safety of COVID-19 vaccination, it represents an essential strategy to protect HCWs themselves, their patients and the hospital community. Despite the introduction of mandatory vaccination, policy-makers should set up tailored strategies of clear communication to reduce reluctancy to vaccination among HCWs.

Influenza is an acute viral respiratory infection that causes significant morbidity and mortality worldwide, with indirect costs considerably exceeding direct costs on patients and society. Flu vaccination is one of the major strategies for preventing it, especially among healthcare workers (HCWs), to avoid onward transmission to patients and colleagues. The aim of this research is to analyze the flu vaccination coverage rate among HCWs and to study which factors conditioned their adherence. The observational study was conducted in an Italian teaching hospital located in Rome (Italy) and data were collected from October to December 2020. A total of 6,568 HCWs was included considering physicians, nurses and other HCWs as job categories. Age class, gender and job category variables were analyzed. Statistically significant differences among groups were tested through χ2 test. Univariate analyses and a multivariate logistic regression (p < 0.05) were performed to assess differences in flu vaccination adherence. The flu vaccination coverage rate was 60.94%. Considering the job categories, physicians reached the highest coverage (76.09%) followed by others HCWs (64.25%) and nurses (49.09%). According to the logistic regression, belonging to 20-40 age class was significantly associated with higher flu vaccination adherence, as well as being nurses (OR 0.26, 95% CI 0.22-0.31) or other HCWs (OR 0.48, 95% CI 0.40-0.58). Findings showed an encouraging vaccination coverage rate among HCWs. Deeper knowledge of the value of vaccination among younger HCWs could be probably a reason for higher adherence as well as the wrong perception of being at low risk of illness or transmitting infections may explains job categories differences. Especially when considering the disrupting impact of the SARS-CoV-2 pandemic, an improved attitude towards flu vaccination would reduce stress on hospitals and preserve scarce medical resources. Key messages Reaching high coverage rates for flu vaccination could save healthcare resources. It is crucial to preserve this positive trend for the future years by spreading the message to all the involved stakeholders.

Computerized Clinical Decision Support Systems (CCDSS) are information technology-based systems that use specific patient characteristics and combine them with rule-based algorithms. The aim of this study is to conduct a survey to measure and assess the over-utilization rates of laboratory requests and to estimate the monthly cost of inappropriate requests in inpatients of the “Fondazione Policlinico Universitario A. Gemelli IRCCS” Care Units. This observational study is based on the count of rules violations for 43 different types of laboratory tests requested by the Hospital physicians, for a total of 5,716,370 requests, over a continuous period of 20 months (from 1 July 2016 to 28 February 2018). Requests from all the hospital internal departments (except for Emergency, Intensive Care Units and Urgent requests) were monitored. The software intercepted and counted, in silent mode for the operator, all requests and violations for each laboratory test among those identified. During the observation period a mean of 285,819 requests per month were analyzed and 40,462 violations were counted. The global rate of overuse was 15.2% ± 3.0%. The overall difference among sub-groups was significant (p This study reports rates (15.2%) similar to other works. The real impact of inappropriateness is difficult to assess, but the generated costs for patients, hospitals and health systems are certainly high and not negligible. Key messages It would be desirable for international medical communities to produce a complete panel of prescriptive rules for all the most common laboratory exam. That is useful not only to reduce costs, but also to ensure standardization and high-quality care.

In Europe flu vaccination among healthcare workers (HCWs) is strongly recommended even though not mandatory such as elsewhere (USA). Despite this, vaccination coverage in EU countries is usually low: 30.2% in 2016-17. In Italy, at the end of the same season it was 15.6%. Aim of this study is to describe and evaluate the new strategy adopted by Gemelli and Humanitas Research Hospitals, two Italian Teaching Hospitals (THs) part of the MIRO Public Health Center, to increase the vaccination coverage among their HCWs. Before the 2019-20 campaign, experts of the two THs met up to identify a common strategy to promote flu vaccination among HCWs in addition to the ones already implemented. It was decided to launch a FLUChallenge: a platform of monitoring updated bi-weekly and available on the THs' internal websites with the vaccination coverage overall and stratified by job category and macro-areas of activity. Descriptive and inferential analysis were performed. Preliminary Results 6673 HCWs included (4241 Gemelli, 2432 Humanitas). The overall flu vaccination coverage at the end of the 2019-20 campaign was 28.4% (1026 HCWs vaccinated Gemelli, equal to 24.2%; 869 HCWs vaccinated Humanitas, 35.7%). Both THs significantly increased the vaccination coverage compared to the previous year (+10% Gemelli, 22% in 2018-19, p = 0.01; +45.7% Humanitas, 24.5% in 2018-19, p The FLUChallenge intervention was an effective strategy to increase flu vaccination coverage in the two TH. The website platform was useful for the purpose of accountability and able to create a positive challenge between the HCWs working in the two THs involved. Key messages Flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission. It is important to promote new engagement and innovative strategies to increase flu vaccination coverage among HCWs, when it is not mandatory.

Background The quality of medical records is an important factor in the patient diagnostic and therapeutic path, useful to ensure continuity of care and accountability which are essential targets of the health systems. Through the tools of clinical governance, such as audit, hospital management should therefore encourage a better quality in clinical documentation to improve the quality of health services and the standard of clinical practice. Aim of this study was assessing the differences …

Various enzymatic or mechanical methods have been proposed in the past to dissociate cells from different solid tissues. An automated mechanical disaggregation device (Medimachine) has recently been proposed. Unfortunately, most of these techniques are associated with a high cellular damage and a low cell recovery and are difficult to apply to skin biopsies. In this paper, we propose a combined enzymatic and mechanical method based on Medimachine, useful for the isolation of skin infiltrating T-lymphocytes from small cutaneous biopsies. As this method is easy and allows for a more correct qualitative and quantitative cytofluorimetric analysis of the lymphocyte subsets, it may be useful in the immunophenotyping of cutaneous T-cell lymphomas.

Background The European Union frame in public health calls for common and openly known safety standards for crossing-border patients; Clinical Risk Management (CRM) is essential to minimize and control healthcare associated risks and spread the results within the organizations and to external stakeholders. Our objective was to develop a system of indicators able to represent the performance of healthcare organizations on CRM and guide their …

Medical record is an important tool in the patient diagnostic and therapeutic path, but it’s becoming more and more essential for the administrative reporting. In several country, such as Italy, medical records are used by the third payer also for evaluation of the health care facilities appropriateness. Aim of this study was assess the relationship between the medical records quality and the appropriateness of hospital …