[Effects of residents' care needs classification (and misclassification) in nursing homes: the example of SOSIA classification]. / Effetti della classificazione (e mis-classificazione) del case- mix nella rappresentazione dei bisogni degli ospiti delle Re- sidenze Socio-Assistenziali per Anziani non Autosufficienti (RSA): l'esempio della Scheda di OSservazione Intermedia dell'Assistenza (SOSIA).

Since 2003, the Lombardy region has introduced a case-mix reimbursement system for nursing homes based on the SOSIA form which classifies residents into eight classes of frailty. In the present study the agreement between SOSIA classification and other well documented instruments, including Barthel Index, Mini Mental State Examination and Clinical Dementia Rating Scale is evaluated in 100 nursing home residents. Only 50% of residents with severe dementia have been recognized as seriously impaired when assessed with SOSIA form; since misclassification errors underestimate residents' care needs, they determine an insufficient reimbursement limiting nursing home possibility to offer care appropriate for the case-mix.

[A sampling study in 6 Lombardy hospitals on the knowledge possessed by nurses on the risks associated with accidental exposure to patient blood]. / Indagine campionaria in sei ospedali lombardi sulle conoscenze possedute dagli infermieri sui rischi associati all'esposizione accidentale al sangue dei pazienti.

In six hospitals of the Lombardy Region 3.000 questionnaires have been circulated to evaluate the degree of awareness and information of the personnel with respect to the behavior to be adopted at the occasion of an accidental exposure to the blood of patients. Up to 63% (1896) of the original questionnaires were available for the analysis. The mean of the responses which can be considered correct for the professional level involved, does not seem to be an area-dependent variable. The number of correct answers declines proportionally as the age increases. A drastic difference in the degree of knowledge is documented to exist between general and professional nurses, who however are exposed to the same risk. The ignorance on the role and choice of disinfectants and on the way of disposing of used needles is particularly striking. The results of the questionnaire, mainly when they are referred to each hospital, are easily utilizable to finalize and support information and training programs.