Administrative Petition from Consumers Union Safe Patient Project and Activist Network Calling on the California Department of Public Health to Require Hospitals to Take Actions to Reduce Hospital-Associated Infections through More Rigorous Oversight.

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Definition of Hospital Infection: scientific and legal sources 2. Antibiotic-Resistance Phenomenon: causes, effects and numbers 3. Medical liability and release proof: Jurisprudence on I.O. 4. Conclusions

Definition of Hospital Infection: scientific and legal sources

Scientific studies carried out all over the world document how hospital or nosocomial infections are today one of the major causes of morbidity and mortality; the frequency of such infections represents an important indicator of the quality of the health service provided in terms of efficiency and additional public costs, which are often considerable and avoidable.

The factors that can contribute to affect the frequency of nosocomial infections are many:

  • the fact that hospitalized patients are often immunosuppressed and subjected to constant tests and invasive treatments;
  • the care procedures and the hospital environment; the extensive use of antibiotics which facilitates the onset of resistance;
  • the constant change in current medical practice that involves new risks and vehicles for the development of infections.

The first problematic profile that emerges is that inherent in their definition, which assumes specific relevance on a medical and legal level: in general, hospital infections (henceforth I.O.) are those acquired during the stay in the hospital and which were not present in the patient, or in the incubation phase, at the time of entry or hospitalization, which must have occurred for a reason other than infection, which arose during hospitalization or after discharge.

More appropriately with respect to the evolution of the overall health care system, today we speak, in scientific and also legal language, of Infections Related to Assistance (from now I.C.A.), a terminology that takes into account the need to expand the concept of hospital infection to that of infections related to health care and social and health care.

In fact, in recent years, healthcare has undergone profound changes, while previously hospitals were the place where most of the assistance interventions took place; later, starting from the 1990s, both patients admitted to hospital in hospital have increased. serious conditions, therefore at greater risk of hospital infections, both in out-of-hospital care facilities such as assisted healthcare residences for the elderly.

Home and outpatient care

The use of the term I.O. and its inclusion in the “macro-area” of the ICA, must take into account the specific case and the genesis of the infection, although it can be traced back to a single general phenomenon, which on the definitional level has been affected by scientific and jurisprudential evolution.

Home and outpatient careTo define, identify and classify I.O.

Reference was made to the international (in particular that of the Centers for Disease Control and Prevention of Atlanta) and national scientific literature on the subject, to the circulars of the Ministry of Health (52/85 and 8/88), to the legislation (most recently the Law Gelli-Bianco 24/2017), to the jurisprudence of legitimacy and merit on the matter which, in this regard, recalls the most authoritative and recognized scientific literature on this point.