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B9413 - Promozione della sicurezza delle cure e Rischio infettivo

Academic Year 2026/2027

                
                        Docente:
                        Renato Congedo
                    
                        Credits:
                        2
                    
                        SSD:
                        MEDS-24/C
                    
                        Language:
                        Italian
                    
                        Teaching Mode:
                        In-person learning (entirely or partially)
                        
                            Campus:
                            Rimini
                        
                            Corso:
                            First cycle degree programme (L) in
                            Nursing (cod. 8475)

                                    Course Timetable
                                
from Oct 08, 2026 to Nov 26, 2026

Learning outcomes

Healthcare-associated infections (HAIs) represent an increasingly significant public health and societal burden.

Upon completion of this course, students will be able to:

Describe the epidemiological characteristics of the main healthcare-associated infections, recognising the importance of evidence-based nursing practices.
Implement prevention strategies and provide appropriate nursing care to patients with infections caused by transmissible microorganisms.
Plan and implement interventions for the prevention, control, and surveillance of healthcare-associated infections (HAIs).

The course will provide an in-depth examination of evidence-based practices and preventive interventions for infection prevention and control, with particular emphasis on the role of the specialist infection prevention and control nurse.

Course contents

1. Introduction to Healthcare-Associated Infections (HAIs)

Definition of healthcare-associated infections.
Distinction between community-acquired and healthcare-associated infections.
Clinical, organisational, social, and economic impact of HAIs.
Key epidemiological data at European, national, and regional levels.
Healthcare-associated infections, patient safety, and professional accountability.
Relevant legislative, regulatory, and policy framework:
- Italian Law No. 24 of 8 March 2017 on patient safety and healthcare professional liability.
- Italian Ministry of Health Circulars No. 52/1985 and No. 8/1988 on the prevention and control of hospital-acquired infections and infection surveillance systems.
- Italian National Action Plan on Antimicrobial Resistance (PNCAR) 2022–2025.
- Council of the European Union Recommendation 2009/C 151/01 on patient safety, including the prevention and control of healthcare-associated infections.
- Council of the European Union Recommendation 2023/C 220/01 on combating antimicrobial resistance through a One Health approach.
- Emilia-Romagna Regional Government Resolution No. 318/2013 establishing guidelines for healthcare organisations on infection risk management.
- Emilia-Romagna Regional Action Plan on Antimicrobial Resistance (PrCAR) 2022–2025, established by Regional Government Resolution No. 540/2023.

2. The Role of the Infection Prevention and Control Specialist Nurse, Link Nurse, and Infection Risk Governance

Role of the Infection Prevention and Control Specialist Nurse (ISRI).
Role of the Infection Control Link Nurse and healthcare organisation facilitators.
Role of the Infection Prevention and Control Committee.
Organisational infection prevention and control teams and ward-based representatives.
Organisational models for infection prevention and control.
Healthcare organisation programmes for infection risk management and antimicrobial stewardship.
Clinical audits, workplace-based training, direct observation, and feedback.
Patient safety culture and interprofessional accountability.

3. Standard and Contact Transmission-Based Precautions

Standard precautions applicable to all patients.
Hand hygiene in accordance with the World Health Organization (WHO) framework.
Appropriate use of personal protective equipment (PPE).
Respiratory hygiene, sharps safety, and safe management of blood and other body fluids.
Transmission-based precautions.
Contact precautions and patient isolation.
Colonisation and infection caused by multidrug-resistant organisms (MDROs).
Nursing management of patients colonised or infected with transmissible microorganisms.
Patient, caregiver, and visitor education.
Non-stigmatising communication and the promotion of a psychologically safe care environment.

4. Infection Surveillance and Risk Monitoring

Active and passive surveillance systems.
Point prevalence surveys and European Centre for Disease Prevention and Control (ECDC) protocols.
Surveillance of infection clusters, outbreaks, and sentinel microorganisms.
Role of the clinical microbiology laboratory.
Information flows and healthcare organisation and regional surveillance systems.
Key epidemiological indicators.
Role of the Infection Prevention and Control Committee.
Clinical audit, feedback, and continuous quality improvement.

5. Appropriate Use of Detergents, Disinfectants, and Antiseptics

Definitions of detergents, disinfectants, and antiseptics.
Distinction between cleaning, disinfection, and antisepsis.
Indications for use across different healthcare settings.
Best practices for skin care and management.
Product contact time, concentration, storage, and compatibility.
Common errors in the use of detergents, disinfectants, and antiseptics.
Environmental cleaning, disinfection, and management of healthcare facilities.
High-touch surfaces and the healthcare environment as potential reservoirs of microorganisms.
Roles of nurses, healthcare support workers, and environmental cleaning personnel.
Patient and visitor education.

6. Medical Device Reprocessing

Categories of medical devices requiring reprocessing.
Spaulding classification.
Operational stages of medical device reprocessing.
Quality management systems.
Process validation.
Traceability and tracking of reprocessed medical devices.
Reprocessing documentation and record-keeping.
Professional and organisational responsibilities.
European and Italian regulatory framework for medical devices:
- Regulation (EU) 2017/745 on medical devices.
- Italian Legislative Decree No. 137/2022.

7. Measures to Prevent the Transmission of Infections

General principles of infection transmission prevention.
Care bundles for the prevention of major healthcare-associated infections.
Management of invasive medical devices.
Central venous catheter management.
Urinary catheter management.
Nursing management of patients colonised or infected with transmissible microorganisms.
Patient education and engagement in infection prevention.
Appropriate microbiological specimen collection techniques.
Blood cultures, urine cultures, surveillance swabs, and other microbiological specimens.
Prevention of specimen contamination.
Diagnostic stewardship and appropriate microbiological testing.

8. Infection Prevention and Nursing Management of Surgical Wounds Healing by Primary Intention

Classification of surgical wounds.
Prevention of surgical site infections (SSIs).
Perioperative infection prevention bundles.
Preoperative skin preparation.
Antibiotic prophylaxis and antimicrobial stewardship.
Surgical wound dressing and management.
Nursing assessment of surgical wounds.
Nursing documentation and clinical record-keeping.
Postoperative monitoring.
Patient education at discharge.
Continuity of care and post-discharge surveillance.

Readings/Bibliography

1. Scientific Articles Recommended by the Lecturer

Dekker, M., Jongerden, I. P., van Mansfeld, R., Ket, J. C. F., van der Werff, S. D., Vandenbroucke-Grauls, C. M. J. E., & de Bruijne, M. C. (2019). Infection control link nurses in acute care hospitals: A scoping review. Antimicrobial Resistance & Infection Control, 8, 20. https://doi.org/10.1186/s13756-019-0476-8

Dekker, M., Jongerden, I. P., Caris, M. G., de Bruijne, M. C., Vandenbroucke-Grauls, C. M. J. E., & van Mansfeld, R. (2023). Evaluation of an infection control link nurse program: An analysis using the RE-AIM framework. BMC Health Services Research, 23, 140. https://doi.org/10.1186/s12913-023-09111-5

Price, L., Gozdzielewska, L., Matuluko, A., Pittet, D., Allegranzi, B., & Reilly, J. (2022). Comparing the effectiveness of hand hygiene techniques in reducing the microbial load and covering hand surfaces in healthcare workers: Updated systematic review. American Journal of Infection Control, 50(10), 1079–1090. https://doi.org/10.1016/j.ajic.2022.02.003

Price, L., Gozdzielewska, L., Hendry, K., McFarland, A., & Reilly, J. (2023). Effectiveness of national and subnational interventions for prevention and control of health-care-associated infections in acute hospitals in high-income and upper-middle-income countries: A systematic review update. The Lancet Infectious Diseases, 23(9), e347–e360. https://doi.org/10.1016/S1473-3099(23)00049-X

Rice, S., Carr, K., Sobiesuo, P., Shabaninejad, H., Orozco-Leal, G., Kontogiannis, V., Marshall, C., Pearson, F., Moradi, N., O’Connor, N., Stoniute, A., Richmond, C., Craig, D., Allegranzi, B., & Cassini, A. (2023). Economic evaluations of interventions to prevent and control health-care-associated infections: A systematic review. The Lancet Infectious Diseases, 23(7), e228–e239. https://doi.org/10.1016/S1473-3099(22)00877-5

Rutala, W. A., Boyce, J. M., & Weber, D. J. (2023). Disinfection, sterilization and antisepsis: An overview. American Journal of Infection Control, 51(11S), A3–A12. https://doi.org/10.1016/j.ajic.2023.01.001

Rutala, W. A., & Weber, D. J. (2023). Reprocessing semicritical items: An overview and an update on the shift from high-level disinfection to sterilization for endoscopes. American Journal of Infection Control, 51(11S), A96–A106. https://doi.org/10.1016/j.ajic.2023.01.002

Sautter, R. L., Parrott, J. S., Nachamkin, I., Diel, C., Tom, R. J., Bobenchik, A. M., Bradford, J. Y., Gilligan, P., Halstead, D. C., LaSala, P. R., Mochon, A. B., Mortensen, J. E., Boyce, L., & Baselski, V. (2024). American Society for Microbiology evidence-based laboratory medicine practice guidelines to reduce blood culture contamination rates: A systematic review and meta-analysis. Clinical Microbiology Reviews, 37(4), e0008724. https://doi.org/10.1128/cmr.00087-24

Seidelman, J. L., Mantyh, C. R., & Anderson, D. J. (2023). Surgical site infection prevention: A review. JAMA, 329(3), 244–252. https://doi.org/10.1001/jama.2022.24075

2. Legislation, Regulations, and Institutional Reference Documents

- Italian Republic. Law No. 24 of 8 March 2017. Provisions on the safety of healthcare and patients, and on the professional liability of healthcare professionals.

- Italian Ministry of Health. Circular No. 52/1985. Prevention and control of hospital-acquired infections.

- Italian Ministry of Health. Circular No. 8/1988. Prevention and control of hospital-acquired infections: Surveillance.

- Italian Ministry of Health. National Action Plan on Antimicrobial Resistance (PNCAR) 2022–2025.

- Italian Republic. Legislative Decree No. 81 of 9 April 2008. Implementation of Article 1 of Law No. 123 of 3 August 2007 concerning the protection of health and safety in the workplace, with particular reference to occupational exposure to biological hazards.

- Italian Republic. Legislative Decree No. 137 of 5 August 2022. Provisions for the alignment of national legislation with Regulation (EU) 2017/745 on medical devices.

- Emilia-Romagna Region. Regional Government Resolution No. 318/2013. Guidelines for healthcare organisations on infection risk management: Healthcare-associated infections and responsible antibiotic use.

- Emilia-Romagna Region. Regional Government Resolution No. 540/2023. Adoption of the National Action Plan on Antimicrobial Resistance (PNCAR) 2022–2025 and establishment of the Regional Action Plan on Antimicrobial Resistance (PrCAR) 2022–2025.

- Emilia-Romagna Regional Agency for Health and Social Care. Memo 5. Sterilization in healthcare and social care settings.

- Emilia-Romagna Regional Agency for Health and Social Care. Memo 6. Antisepsis and disinfection in healthcare and social care settings.

- Emilia-Romagna Regional Agency for Health and Social Care. Dossier 123. Outbreaks of healthcare-associated infections.

- Emilia-Romagna Regional Agency for Health and Social Care. Dossier 190. Urinary tract infections in adults.

- Emilia-Romagna Regional Agency for Health and Social Care. Dossier 261. Prevention of surgical site infections.

- Emilia-Romagna Regional Agency for Health and Social Care. Surveillance of surgical site infections in Emilia-Romagna: SIChER 2024 Report.

- Emilia-Romagna Regional Agency for Health and Social Care. Surveillance of antimicrobial resistance and systemic antibiotic use in Emilia-Romagna: 2024 Report.

- Emilia-Romagna Region. Regional Prevention Plan 2021–2025.

- Council of the European Union. Recommendation 2009/C 151/01 on patient safety, including the prevention and control of healthcare-associated infections.

- Council of the European Union. Recommendation 2023/C 220/01 on stepping up EU actions to combat antimicrobial resistance through a One Health approach.

- European Parliament and Council of the European Union. Regulation (EU) 2017/745 on medical devices.

- European Centre for Disease Prevention and Control. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals, 2022–2023.

- European Centre for Disease Prevention and Control. Definitions and diagnostic criteria for healthcare-associated infections.

- World Health Organization. WHO guidelines on hand hygiene in health care.

- World Health Organization. A guide to the implementation of the WHO multimodal hand hygiene improvement strategy.

- World Health Organization. Global guidelines for the prevention of surgical site infection.

- World Health Organization. Global report on infection prevention and control 2024.

- World Health Organization. Decontamination and reprocessing of medical devices for health-care facilities.

- Centers for Disease Control and Prevention. Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings.

- Centers for Disease Control and Prevention. Guideline for disinfection and sterilization in healthcare facilities.

Teaching methods

Interactive lectures.

Guided discussion of clinical nursing cases.

Analysis of scenarios drawn from clinical placements.

Practical exercises on epidemiological indicators, infection prevention bundles, and clinical documentation.

Critical discussion of scientific articles and legislative and regulatory documents.

Use of thought-provoking questions, interactive polling, small-group activities, and plenary feedback sessions.

Application of the “scenario–debriefing–take-home message” approach to facilitate the integration of theoretical knowledge and clinical nursing practice.

Assessment methods

The assessment will consist of a written examination including:

Multiple-choice questions;
Short-answer questions;
Analysis of a clinical nursing case;
Interpretation of infection surveillance, prevention, and risk management documentation.

The assessment will evaluate students’ ability to:

Use appropriate technical and scientific terminology;
Integrate legislative and regulatory requirements, scientific evidence, and clinical nursing practice;
Identify potential risks to patient safety;
Propose appropriate infection prevention and control interventions;
Provide evidence-based rationales for nursing decisions;
Accurately document and communicate relevant clinical information.