Influenza vaccination coverage among medical residents: an Italian multicenter survey.

Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011-2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the 2 previous seasons (P<0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011-2012 season (P<0.001). "To avoid spreading influenza among patients" was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination and they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future.

[Residency in hygiene and preventive medicine: present and future]. / Specializzazione in igiene e medicina preventiva: situazione e novità.

INTRODUCTION: The changing needs and expectations of the population and the current financial distress lead the Italian health care system to face a profound challenge that requires also a new evaluation of professionals' training. Specialists in Hygiene and Preventive Medicine (HPM) are called for to develop new knowledge and skills in hygiene, public health, and management, as they fulfill leadership roles within the hospitals. OBJECTIVE: To investigate the current status of Hospital Health Management Boards (HHMB) and the specific know-how they require, in order to develop an adequate post-graduate residency training in HPM. MATERIALS AND METHODS: We conducted a literature review on the main and «gray literature¼ databases; then, we conducted three semi-structured interviews with the Chiefs of the HHMB operating in the major hospitals of Bologna (Northern Italy); lastly, we organised a workshop with residents in HPM and health workers of Emilia-Romagna hospitals. RESULTS: Interviews with Hospital Health Managers have highlighted the main issues faced by a modern HHMB. The main questions discussed were: the changing role of the hospital and its relationship with primary care; the increasing competition among professionals with different specialisations within the HHMB; the need to develop multi-professional teams; the necessity to enlarge HPM residency training programmes in order to meet the HHMB needs. CONCLUSION: The evolution of the HHMB reflects the evolution of the Italian health care system. HHMBs should better fit the organization to the context, and the post-graduate schools in HPM should follow this process. In the framework of the current rules and laws it is possible to focus for implementing training programmes that include management, coordination and negotiation skills, and help build an adequate leadership profile.