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897 / Anti-rotting treatment alternative to formaldehyde

ITALY
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Other
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Topic of the reported practice
Clinical risk management
Aim and the benefit of the Patient Safety Practice
 
The anti-rotting treatment is carried out for transports abroad when is provided by international treaties or when prescripted by the pathologist following case assessment in relation to the requirement of public health protection.
The guidelines for the application of mortuary police rule -updated 2012- also provide anti-rotting treatment alternative to formaldehyde.
Description of the Patient Safety Practice
 
The anti-rotting process is activeted by introducing into body cavities of suitable quantity of special products decelerating the putrefactive process in order to minimize exposure to chemical risk and promote worker safety and the security habitat.
For this purpose the ASS n.5 has eliminated the formaline replacing it with a commercially available product that slows putrefaction, thus reducing the established toxicity of formaldehyde.

It was initially used formalin (35% formaldehyde solution) for the anti-rotting treatment. The treatment was activated by introducing into body cavities 500 ml of formalin through a prefilled syringe, ready for use. Formalin is a category 3 carcinogen and is dangerous for the environment (classified according to EC Directives Carc. Cat 3, risk phrases Xn, R40, as well as R 23/24/25-34-43, CLP classification Carc 2, H 351, as well as Skin Sens 1 H317, H301-311 -314-331-335). Chemical risk exposure resulting from the use of formalin takes place not only at the early stages of use as an anti-rotting material by the healthcare workers, but also for what concerns the environment and, in case of exhumation, it causes a high incidence of undecomposed bodies.
In order to comply with the need to slow down the putrefactive phenomena if required, but reducing the toxicity risk from formalin, this has been replaced with an alternative product available on the market and qualified as "biocidal mixture stabilize d by salts", whose technical sheet does not show carcinogenicity risk. It is classified as irritant Xi, risk phrases R36 R43.
With such a replacement, chemical and carcinogenic risk exposure is then reduced, by acting on the choice of the product to be used, according to national and international regulations concerning health and safety on workplace according to which the employer adopts general protective measures, including "replacement what is dangerous with what is not or is less dangerous" (art 15 letter f Legislative Decree 81/2008).
Attachment of relevant written information and/or photos, as appropriate
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Not relevant
A baseline measurement before implementation of the reported practice was obtained
Not relevant
A measurement after full implementation of the reported practice was obtained
Not relevant
Evaluation of a "positive" effect of the reported practice on Patient Safety
Not relevant
Type of before-and after evaluation
There is no specified text here
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Other or not relevant
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
Nursing facility
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Technical support / technician
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
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Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Other
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
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Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
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Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
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Contact information
 
Name: Michela Codarini
Country: ITALY
Organisation: ASS 5 Bassa Friulana
E-mail: michela.codarini@ass5.sanita.fvg.it
Phone: 0432/921850
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