Many bundles have proven effective at preventing surgical site infections (SSIs), but little is known about factors influencing compliance to such bundles. This cohort study includes 41,400 surgeries performed in 47 hospitals throughout a decade. The outcome of interest was binary compliance with a 4-element bundle for SSI prevention. A multivariable logistic regression model was computed with 12 predictor variables: patient sex, age, American Society of Anesthesiologists score, surgical specialty, length of preoperative stay, procedure year, procedure duration, surgical technique, presence of a prosthetic implant, elective versus emergent procedure, hospital type, and hospital size. Bundle compliance has increased significantly since its implementation, reaching 67.1% in the latest year. Lower odds of bundle compliance are correlated with emergent procedures (OR 0.3697), procedure duration above the first tertile (0.8597), age above the first quartile (0.7365), absence of a prosthetic implant, open surgical technique, and preoperative stay above 1 day (0.7920). Older age, longer procedure duration, longer preoperative stay, and an open surgical technique all correlate negatively with bundle compliance and are also known risk factors for SSIs. Certain patient subgroups are at higher risk for bundle noncompliance, and thus show greater margins for improvement.

Medical residents constitute a vulnerable population susceptible to mental health disorders. In Italy, this was evident during the COVID-19 pandemic, when medical residents served on the front line and provided significant support to healthcare services. Therefore, the working group on “Public Mental Health” of the Medical Residents’ Council of the Italian Society of Hygiene, Preventive Medicine, and Public Health (S.It.I.) designed the “Residents’ mental health investigation, a dynamic longitudinal study in Italy” (ReMInDIt). This longitudinal study aims to assess the mental status of medical residents and to explore potential cause–effect relationships between risk/protective factors (identified among sociodemographic, residency program, and lifestyle characteristics) and mental health outcomes (anxiety and depressive symptoms). Data will be collected from a study population of 3615 residents enrolled in Italian residency programs in public health, occupational medicine, and forensic medicine through an online questionnaire that includes validated tools, requires 10 min for completion, and is disseminated by the residents’ Councils. It will be followed by a follow-up administration after 12 months. The ReMInDIt study will play a significant role in generating evidence crucial for enhancing mental health services and promoting protective factors for the mental well-being of this important segment of healthcare professionals.

Background: The coronavirus 2019 (COVID-19) pandemic led to major disruptions in surgical activity, particularly in the first year (2020). The objective of this study was to assess the impact of surgical reorganization on surgical outcomes in Northern Italy in 2020 and 2021. Methods: A retrospective cohort study was conducted among 30 hospitals participating in the surveillance system for surgical site infections (SSIs). Abdominal surgery procedures performed between 2018 and 2021 were considered. Predicted SSI rates for 2020 and 2021 were estimated based on 2018-2019 data and compared with observed rates. Independent predictors for SSI were investigated using logistic regression, including procedure year. Results: 7605 procedures were included. Significant differences in case -mix were found comparing the three time periods. Observed SSI rates among all patients in 2020 were significantly lower than expected based on 2018-2019 SSI rates (p 0.0465). Patients undergoing procedures other than cancer surgery in 2020 had significantly lower odds for SSI (odds ratio, OR 0.52, 95 % confidence interval, CI 0.3-0.89, p 0.018) and patients undergoing surgery in 2021 had significantly higher odds for SSI (OR 1.49, 95 % CI 1.07-2.09, p 0.019) compared to 2018-2019. Conclusions: Enhanced infection prevention and control (IPC) measures could explain the reduced SSI risk during the first pandemic year. IPC practices should continue to be reinforced beyond the pandemic context.

Background and Objective: Surgical site infections (SSIs) are monitored in Piedmont, a Northern Italian region, through a surveillance system based on a European Centre for Disease Prevention and Control protocol. A benchmarking and feedback intervention was implemented in 2019: each...