Background and aims:The COVID-19 pandemic represents a source of stress and potential burnout for many physicians. This single-site survey aimed at assessing perceived stress and risk to develop burnout syndrome among physicians operating in COVID wards.Methods: This longitudinal survey evaluated stress and burnout in 51 physicians operating in the COVID team of Gemelli Hospital, Italy.Participants were asked to complete the Maslach Burnout Inventory (MBI) and the Perceived Stress Questionnaire on a short run (PSQs) (referring to the past 7 days) at baseline (T0) and then for four weeks (T1-T4). Perceived Stress Questionnaire on a long run (PSQl) (referring to the past 2 years) was completed only at T0. Results:Compared with physicians board-certified in internal medicine, those boardcertified in other disciplines showed higher scores for the Emotional Exhaustion (EE) score of the MBI scale (P < .001). Depersonalisation (DP) score showed a reduction over time (P = .002). Attending physicians scored lower than the resident physicians on the DP scale (P = .048) and higher than resident physicians on the Personal Accomplishment (PA) scale (P = .04). PSQl predicted higher scores on the EE scale (P = .003), DP scale (P = .003) and lower scores on the PA scale (P < .001). PSQs showed a reduction over time (P = .03). Attending physicians had a lower PSQs score compared with the resident physicians (P = .04).

In several hospitals worldwide, healthcare workers are currently at the forefront against coronavirus disease 2019 (COVID-19). Since Fondazione Policlinico Universitario A. Gemelli (FPG) IRCCS has been enlisted as a COVID hospital, healthcare workers deployed to COVID wards were separated from those with limited or no exposure, whereas administrative staff was destined to work-from-home. Between June 4 and July 3 2020, an investigation was carried out to evaluate seroprevalence of SARS-CoV-2 IgG antibodies among employees of the FPG using point-of-care (POC) and venous blood tests. Sensitivity, specificity and predictive values were determined with reverse-transcription polymerase chain reaction (RT-PCR) on nasal/oropharyngeal swabs as gold standard.Four thousand, seven hundred seventy-seven participants were enrolled. Seroprevalence was 3.66% using the POC test and 1.19% using venous blood test, with a significant difference between the two (p < 0.05).POC sensitivity and specificity were, respectively, 63.64% (95% confidence interval (CI): 62.20% to 65.04%) and 96.64% (95% CI: 96.05% to 97.13%), while those of the venous blood test were, respectively, 78.79% (95% CI: 77.58% to 79.94%) and 99.36% (95% CI: 99.07% to 99.55%). Among low-risk population, point-of-care’s predictive values were 58.33% (positive) and 98.23% (negative) whereas venous blood test’s were 92.86% (positive) and 98.53% (negative). In conclusion, point-of-care tests have low diagnostic accuracy, while venous blood tests seem to show an overall poor reliability.

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Healthcare-Associated Infections (HAIs) are among the most serious public health problems in Europe representing the most frequent adverse event during care delivery. Despite their limitations, point prevalence surveys of HAIs are often preferred to prospective surveillance, since they provide a feasible estimate when resources are limited. The aim of this study was to analyze the results of a six-years point prevalence survey of HAIs in a teaching acute care hospital in Italy and to investigate the main risk factors of HAIs in the acute-care hospital. A point prevalence survey to detect HAIs was carried out in Gemelli Hospital during the last 6 years, from 2013 to 2018. Inpatients of any age in Gemelli Hospital were eligible for inclusion. Patients in outpatient areas were excluded. HAIs were identified according to diagnosis guideline from ECDC in 2011. Statistically significant differences were tested through t-test and Chi-square test. Multi-variate analysis was performed to evaluate the impact of regressor factors for predict HAI’s prevalence. The statistical significance level was set at p &lt; 0.05. The point prevalence ranged from 3,16% in 2017 to 6,64% in 2013. Pneumonia and surgical site infections (SSI) were the most frequent HAIs during the 6 years, with a rate of 27,31% and 26,20% respectively of all HAIs. The multiple logistic regression showed that length of stay at the moment of detection, urinary catheter, CVC and antibiotic therapy are useful to meaningfully predict HAI prevalence, with a regression coefficient (adjusted R2) of 0.2780. Thanks to proper hospital policies, the point prevalence of HAIs does not seem to increase through the years, even though it is still too early to draw any conclusions. Pneumonia and SSI represented each one more than a quarter of all the HAIs, as reported also in literature. There is a strong association between length of stay at the moment of detection and HAIs but it is hard to understand which one is the cause of the other. Key messages Point prevalence from 2013 to 2018 seems to be stable. An accurate incidence survey is needed in order to identify the main risk factors of HAI and to realize more specific hospital programmes. Length of stay at the moment of detection is useful to meaningfully predict HAIs prevalence although the cause-and-effect relationship is still not clear.

Annual flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission especially to frail patients. In our teaching hospital, flu vaccination rate among HCWs has been growing during last 3 years. The aim of this study was therefore to describe the flu vaccination coverage across the past 3 years and to analyze which factors lead to such increase. We performed a cross-sectional study on all HCWs of Fondazione Policlinico Universitario “A. Gemelli” (FPG) hospital of Rome (Italy) to determine the flu vaccination coverage. Socio-demographic and occupational data were collected from hospital personnel records and included age, gender, previous flu vaccination, profession and workplace unit. On site vaccination plus academic detailing involving leaders have been the main strategies adopted in this last 3 years that have already proved to be effective in increasing vaccination coverage among HCWs. During the 2018-2019 season, we analyzed how the flu vaccination coverage among leaders (nurse coordinators and head physicians) could affect all HCWs coverage rate. Flu vaccination rate increased from 9.57% in the 2016-17 to 14.24% in the 2017-18 and to 22.38% in 2018-2019. A total of 4035 HCWs employed in the FPG were included in 2018-19. Concerning the role played by vaccination of leaders in increasing general vaccination coverage during the 2018-2019, the group of HCWs with a vaccinated leader showed a higher coverage rate (28.65%) than the group with a non-vaccinated leader (16.22%) (p &lt; 0.0001). The results are preliminary. Flu vaccination coverage of HCWs in our hospital during the last 3 years has been increasingly higher. Vaccination of the leaders, in addition to previously implemented effective strategies, resulted to be a key factor in increasing flu vaccination coverage among all HCWs. Socio-demographic and occupational variables can significantly influence the coverage rate as well. Key messages Annual flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission especially to frail patients. This study shows the growing flu vaccination coverage rate in our teaching hospital and the effectiveness of the example given by the vaccinated leaders in increasing the coverage among all HCWs.