Sepsis and Nosocomial Infections: The Role of Medico-Legal Experts in Italy

Tattoli, Lucia; Dell’Erba, Alessandro; Ferorelli, Davide; Gasbarro, Annarita; Solarino, Biagio

doi:10.3390/antibiotics8040199

Cited by 9 publications

(7 citation statements)

References 61 publications

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“…In this emergency scenario, a perception of unfair health care policy and non-ethical allocation of resources can contribute to creating tension among the practitioners and expose health workers and hospital administrators to malpractice claims [ 39 , 40 ]. In Italy, over the last two decades, medical professional liability has become a major concern for health care economics and workers, therefore, since 2007, with the aim of decreasing the risk of harm associated with health care, the Italian government has promoted a program to develop activities related to patient and clinical risk management [ 41 ].…”

Section: Risk Of Malpractice Suitsmentioning

confidence: 99%

Ethical Challenges in Health Care Policy during COVID-19 Pandemic in Italy

2020

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Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, Italy has proven to be one of the countries with the highest coronavirus-linked death rate. To reduce the impact of SARS-CoV-2 coronavirus, the Italian Government decision-makers issued a series of law decrees that imposed measures limiting social contacts, stopped non-essential production activities, and restructured public health care in order to privilege assistance to patients infected with SARS-CoV-2. Health care services were substantially limited including planned hospitalization and elective surgeries. These substantial measures were criticized due to their impact on individual rights including freedom and autonomy, but were justified by the awareness that hospitals would have been unable to cope with the surge of infected people who needed treatment for COVID-19. The imbalance between the need to guarantee ordinary care and to deal with the pandemic, in a context of limited health resources, raises ethical concerns as well as clinical management issues. The emergency scenario caused by the COVID-19 pandemic, especially in the lockdown phase, led the Government and health care decision-makers to prioritize community safety above the individuals’ rights. This new community-centered approach to clinical care has created tension among the practitioners and exposed health workers to malpractice claims. Reducing the morbidity and mortality rates of the COVID-19 pandemic is the priority of every government, but the legitimate question remains whether the policy that supports this measure could be less harmful for the health care system.

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Section: Risk Of Malpractice Suitsmentioning

confidence: 99%

Ethical Challenges in Health Care Policy during COVID-19 Pandemic in Italy

2020

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“…It is important to know if healthcare professionals had implemented all the necessary measures to prevent the risk of contagion and if the infection could have been “inevitable” (not due to errors by healthcare personnel) or “avoidable” (related to healthcare responsibility). Specifically, HAIs require an investigation of how an infection occurred and whether it could have been avoided through measures to prevent infectious risk [ 48 ]. Compliance with all protective procedures is fundamental when it comes to professional liability claims.…”

Section: Discussionmentioning

confidence: 99%

“…Compliance with all protective procedures is fundamental when it comes to professional liability claims. On the contrary, failure to comply with these measures is often viewed as negligence and medical fault [ 48 ]. In order to determine the absence of professional healthcare responsibility, it is necessary to demonstrate the complete application of all the measures of prevention indicated in the scientific literature as well as current regulatory provisions [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Hospital-Acquired SARS-Cov-2 Infections in Patients: Inevitable Conditions or Medical Malpractice?

Barranco

Tremoul

Ventura

2021

IJERPH

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Despite numerous measures to contain the infection and limit its spread, cases of SARS-CoV-2 infections acquired in hospitals have been reported consistently. In this paper, we will address issues of hospital-acquired COVID-19 in hospitalized patients as well as medico-legal implications. After having conducted a literature search, we will report on papers on hospital-acquired SARS-CoV-2 infections. Ten scientific papers were selected and considered suitable for further analysis. According to several reports, the SARS-CoV-2 hospital-acquired infection rate is 12–15%. Hospital-acquired COVID-19 represents a serious public health issue, which is a problem that could create reluctance of patients to seek hospital treatment for fear of becoming infected. Healthcare personnel should do all that is necessary to address the problem and prevent further spreading, such as rigorous compliance with all procedures for containing the spread. From a medical-legal point of view, multiple aspects must be considered in order to understand whether the infection is a result of “malpractice” or an inevitable condition.

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“…Two studies remarked the necessity of identifying sepsis as a fundamental factor to improve survival rates [ 53 , 54 ]. Furthermore, one of the studies highlighted an additional cost item derived by sepsis, that is, the litigation costs related to medico-legal and insurance issues [ 53 ]. However, none of the studies in our review included this type of cost.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Testing for Sepsis: A Systematic Review of Economic Evaluations

et al. 2021

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Introduction: Sepsis is a serious and expensive healthcare problem, when caused by a multidrug-resistant (MDR) bacteria mortality and costs increase. A reduction in the time until the start of treatment improves clinical results. The objective is to perform a systematic review of economic evaluations to analyze the cost-effectiveness of diagnostic methods in sepsis and to draw lessons on the methods used to incorporate antimicrobial resistance (AMR) in these studies. Material and Methods: the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the Consolidated Health Economic Evaluation Reporting standards (CHEERS) checklist was used to extract the information from the texts. Results: A total of 16 articles were found. A decision model was performed in 14. We found two ways to handle resistance while modelling: the test could identify infections caused by a resistant pathogen or resistance-related inputs, or outcomes were included (the incidence of AMR in sepsis patients, antibiotic use, and infection caused by resistant bacterial pathogens). Conclusion: Using a diagnostic technique to detect sepsis early on is more cost-effective than standard care. Setting a direct relationship between the implementation of a testing strategy and the reduction of AMR cases, we made several assumptions about the efficacy of antibiotics and the length-of-stay of patients.

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Sepsis and Nosocomial Infections: The Role of Medico-Legal Experts in Italy

Cited by 9 publications

References 61 publications

Ethical Challenges in Health Care Policy during COVID-19 Pandemic in Italy

Ethical Challenges in Health Care Policy during COVID-19 Pandemic in Italy

Hospital-Acquired SARS-Cov-2 Infections in Patients: Inevitable Conditions or Medical Malpractice?

Diagnostic Testing for Sepsis: A Systematic Review of Economic Evaluations

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