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Self-reported knowledge, practice, and perceived usefulness of care bundles: a pilot survey among Italian healthcare professionals - 06/12/25

Doi : 10.1016/j.jhin.2025.08.009 
V. De Nicolò a, b, , , A. Sinopoli b, , P. Santalucia b, M.S. Spinelli b, D. Rinaldo b, V. Bruno b, A. Napoletano b, , D. Coclite b,
on behalf of the

Working Group

  Membership of the Working Group is supplied in the Acknowledgements.

a Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy 
b National Centre for Clinical Governance and Excellence of Care – Italian National Institute of Health, Rome, Italy 

Corresponding author. Address: University of Milan, Milan, 20122, Italy. Tel.: +39 3498466827.University of MilanMilan20122Italy

Summary

Background

Healthcare-associated infections (HAIs) are a global concern, with Italy reporting a 7.5% prevalence. The World Health Organization recommends infection prevention strategies, including care bundles (CBs), evidence-based interventions to improve patient safety. Despite their effectiveness, adoption of CBs in Italy remains low (20–25%).

Aim

This pilot survey aimed to test the feasibility of a large-scale study on healthcare workers' knowledge and use of CBs in high-risk wards.

Methods

The study took place from October to November 2024. An anonymous online questionnaire, developed according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) and the Consensus-Based Checklist for Reporting of Survey Studies (CROSS), investigated demographics, knowledge, use, and barriers/facilitators to CB implementation, as well as feedback on the tool. Participants – physicians and nursing/obstetric staff from various specialties – were recruited through Scientific Societies and Professional Associations.

Findings

A total of 753 healthcare professionals completed the questionnaire (73.5% response rate). Most respondents were from northern regions (43.6%). Nearly half of physicians (49%) were unfamiliar with CBs, though 90% of them expressed interest in training. Among those familiar with CBs, only 57% reported applying them. Anaesthetists and surgeons showed greater awareness than orthopaedists. While 64% of nurses noticed CBs, 53% of obstetricians were unaware, and only 23% of the latter group used them in practice.

Conclusion

The survey highlights gaps in the knowledge and application of CBs across professional groups, emphasizing the need for targeted strategies to enhance adoption in clinical practice.

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Keywords : Healthcare-associated infection, Healthcare quality improvement, Infection prevention strategies, Care bundle, Questionnaire


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© 2025  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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