Search

Data regarding the observance of infection control practices in ambulatory healthcare settings is scarce. This type of data is important since the health care system has evolved in such a way that hospital stays are now briefer and there is an increased provision of healthcare in outpatient settings, such as day surgery, day hospital and ambulatory care services. Studies have shown that transmission of infectious diseases in outpatient health care settings is often associated with lack of, or insufficient adherence to, evidence-based preventive measures. Outpatients have less risk factors for nosocomial infections than inpatients, nevertheless, some high risk settings include physicians' waiting rooms (airborne and droplet transmission) and outpatient settings in which invasive procedures are performed. Preventive strategies consist in verifying the adherence to infection control guidelines (this should be done by specifically trained personnel), developing disinfection and sterilization protocols for medical devices (that are comparable to those used in hospitals), training of healthcare personnel, and development of efficacy-based infection control protocols for outpatient settings.

The authors have analyzed some epidemiological events caused by the exposure to biological material amongst health workers at the Mazzoni Hospital in Ascoli Piceno (the Marches Region). According to a tailor-made questionnaire, 704 accidents occurred in the years 1995-2001. Data showed that nurses are the most frequently exposed (67%). As regards the premises, operating rooms account for 16.5 % of the accidents, ERs 9.2 % and Nephrology/Haemodialysis Units 8.8%. The highest rate of accidents occurred during injections procedures (67%) and precautions were observed only by 65% of the health care workers. The source patient was known in 86% of the cases and all workers were submitted to HBC, HCV and HIV tests. 95 subjects (16%) showed not less than one marker and 80% of them were HCV-positive. No anti-HIV/HCV/HBV seroconversions were registered.