Plenary 1: The Hospital – A Staff Empowering ... - HPH-Conference

Parallel Sessions
Parallel Session 3: Friday, April 13, 2007, 11.00-12.30
Results
In the last few years each unit specified in their DVR the major
activities performed and their perception of hazards and risks
at the worksite. Through many trials and errors individual DVRs
have been reviewed by the staff unit SPA (ISO 9001:2000
certified) which is in charge of safety (team of engineers,
doctors specialized in occupational medicine and technicians).
Reults were then discussed with staff both as part of the
annual plan of activities (so called budget) and during field
visits at the worksite (twice a year). So far we have one master
plan of safety for the entire hospital describing major risks, and
35 DVRs, one for each unit. All staff participated in educational
courses on safety and prevention of major risks (i.e. fire,
biological risk, chemical risk …) and received detailed information
on specific risks at their worksite. New employees as well
as outsourcing contractors are trained and informed on safety.
Corrective actions include: wide distribution of technical aids,
hoists for patient transfer to prevent back overload, use of
needle preventing devices, individual protection devices, avoiding
the use of anaesthetic gas in the Operating Room. The total
amount of money invested in safety related interventions was
EUR 3.260.000 in 2005 (interventions on buildings ~ EUR
1.500.000; technical aids ~ EUR 1.760.000). Outcome results
on staff health will be seen only in the long period, but the
availability of DVR and related procedures, wide education on
preventive measures, and the use of individual protection
devices have overall reduced occupational incidents in the
hospital workers (i.e. parenteral exposure to blood from 153
cases notified in 2002 to 96 in 2005).
Conclusions
Safety deals both with facility related issues and staff behaviour
at the work site. Patient safety is the other side of the
coin, because the environment for workers and patients is the
same, as well as safety. The strong points of S. Chiara Hospital’s
experience are, in our view, the systemic approach to
safety and the involvement of staff (bottom up) both during
individual unit field visits to assess risks and during work flow
charts engineering and document review discussions. Critical
points are related to change management (behaviours, old
habits, …), strict law requirements sometimes “bureaucratic”,
and high cost investments.
Connex to HPH
Improving staff safety is the other side of the coin to improve
patient safety.
Contact
Enrico BALDANTONI, MD
Medical Director
Ospedale Santa Chiara - APSS
Crosina Sartori 6
38100 Trento
ITALY
+39 046 190 30 15
enrico.baldantoni@apss.tn.it
Session 3-3:
Supporting patients to stop
smoking
Pregnancy and smoking: 13 330
measurements in smoking and nonsmoking
pregnant women at delivery
Conchita Gomez, Michel Delcroix
This was a multicenter study, carried out between January and
December 2005, in 31 maternity wards who are members of
the French Network of smoke-free maternity wards. 13.330
pregnant women (smoking and non-smoking) were included.
They all had singleton pregnancies without complications,
either with spontaneous labour and vaginal delivery, or with
programmed Caesarean section. Pregnancies were at normal
term (37 to 41 weeks amenorrhea). Women were not included
if they had any twin pregnancies, reported alcohol abuse or
other addictions; if they had any chronic medical disease
condition or any other acute illness at the time of delivery; if
the data were not complete and if no maternal expired air CO
was available at delivery. All smoking women received a standard
brief counselling at delivery. Smoking is easy to measure
with a single expiration of the pregnant woman at delivery, and
is aided by an auto-zero function at turn on, combined with a
breath hold countdown timer. The measurement is obtained
the same for the spouse at the delivery.
Conclusion
Both maternal and husbands’ EACO measures during delivery
were dose-dependently and inversely associated with fetal
growth. Even low maternal (6 to 10 ppm) or husbands’ (11 to