San Giovanni Battista Hospital in Rome: Best Care, Quality, Innovation and Continual Improvements to Care for Vegetative And Minimally Conscious State Patients

Project location: Italy, Rome
Project start date: September 2017 - Project end date: December 2018
Project number: 2017-039
Beneficiary: Associazione Onlus Mons. Azelio Manzetti

The Association "Onlus" Mons. Azelio Manzetti is a No Profit Organization born in May 2013. The Association was strongly desired by Mgr. Azelio Giuseppe Manzetti to assist poor people and help the patients’ needs of the Hospital San Giovanni Battista in Rome - Italy. A group of people animated by Christian Intentions decided to set up this association in order to continue Mgr Azelio’s tireless work and to support the Hospital, a prestigious symbol of excellence in the healthcare field of the Association of Italian Knights of the Sovereign Military Order of Malta (ACISMOM).

The primary Association mission is to provide moral and material help to hospitalized and former patients of "San Giovanni Battista”. The ”Onlus" gives its contribution through fundraising projects, in order to support its mission and help to make it more effective in the services offered to patients.

A great part of the various Association projects are pursued in close cooperation with the Hospital administration that suggests actions to make up for the eventual problems and needs of the structure. ln addition, the Onlus aims to accompany patients with difficulties, in particular at the moment of reintegration at home to improve their quality of life.

From its start, the Association has already fulfilled charity projects. Only few examples among many others: 1) donation of a bed elevator to the “San Giovanni Battista" Hospital; 2) contribution to the delivery fees of medical instruments for a hospital in Congo (Bosobe); 3) fundraising campaign to buy walkers for patients of "San Giovanni Battista” Hospital.

The San Giovanni Battista Hospital in Rome - Italy is a vital component of the ltalian National Health Service and is indisputably a deliverer and distributer of meaningful social and health resources.
The Hospital follows a strict policy based on maintaining and improving the quality in care delivery and assistance. Therefore the Hospital pursues a strong safety culture based on critical components to create a safe healthcare system.

To continue along the quality improvement pathway the Hospital needs support in terms of purchase of safe beds. The Patients treated have problems with memory, sleeping, incontinence, pain, uncontrolled bodily movements and sometimes are able to get out of bed with great risk for themselves.

The Unità di Risveglio deals with patients who survived to a severe brain injury and presents a profound disturbance of consciousness, an high level of clinical instability, with undergoing high risk of complications. These patients are completely dependent from assistance personnel in terms of feeding, turning in bed to prevent pressure sores, assistance with bowel and bladder relief using catheter, management of breathing such as suctioning of secretions (sometimes the care for a tracheostomy tube and not so rarely cardiovascular emergencies. ln order to control and prevent critical situations, which can jeopardize successful recovery of patients, or put their life at risk, the Department
requires 20 Patient bedside Terminals. These are essential to monitor parameters like ECG, Respiration,
NlBP, SpO2, Temperature, lBP, CO2, EtCO2, Multi-Gas/02, ICG, Arrhythmia and ST analysis with recall.

Rehabilitation departments have a serious lack of examination and treatment tables, electro massagers, Kinetec, TENS and EMS Devices, Bicycle Ergometers and Cardioline Electrocardiogram Devices. An increase of them could improve patients treatment by increasing number of sessions.

At present the hospital is equipped with 120 standard hydraulic beds which are not equipped to keep the patients from harm, such as falling. This leads to loss of the occupants’ independence, increased risk of pressure damage and work-related pain for staff. However, electric profiling beds have side-rail design that shields the patient — in order to help prevent patient entrapment and falls; one step head board removal for rapid access to the patient's head; Trendelerburg and reverse Trendelerburg for emergency situations and comfort; Zero-gap that allows safe and easy patient transfers; CPR quick release handle ergonomically located at the headend of the bed and lastly Electrical function lock out controls.

The San Giovanni Battista Hospital provides also care to vegetative and minimally conscious state patients in the Unita di Risveglio Department. The Unità di Risveglio deals with patients who survived to a severe brain injury and presents a profound disturbance of consciousness, an high level of clinical instability, with undergoing high risk of complications. These patients are completely dependent from assistance personnel in terms of feeding, turning in bed to prevent pressure sores, assistance with bowel and bladder relief using catheter, management of breathing such as suctioning of secretions (sometimes the care for a tracheostomy tube and not so rarely cardiovascular emergencies. In order to control and prevent critical situations, which can jeopardize successful recovery of patients, or put their life at risk, the Department requires 20 Patient bedside Terminals. These are essential to monitor parameters like ECG, Respiration, NlBP, SpO2, Temperature, lBP, CO2, EtCO2, Multi-Gas/02, ICG, Arrhythmia and ST analysis with recall. Wired and wireless network capabilities are key.

The Hospital is equipped with 18 patient lifts, 11 of which are definitely used. Patients’ lifts provide many benefits, including reduced risk of injury to patients and to caregivers. Therefore it is necessary the replacement of 6 electrical patient lifts and slings.

The Hospital often needs to transport patients to other medical public hospitals for diagnostic tests. At present, this service is provided by an external service company which provides an ambulance and medical staff at a very high annual fee. The Hospital has professionals who could carry out this service but needs a vehicle.

Rehabilitation departments have a serious lack of examination and treatment tables, electro massagers, Kinetec, TENS and EMS Devices, Bicycle Ergometers and Cardioline Electrocardiogram Devices. Having more of them could improve patients treatment by increasing number of sessions.

This medical equipment wiil be bought thanks to the aid of the Nando and Elsa Peretti Foundation. It not only will maximize the safety and comfort of patients during handling contributing to the rise the hospital standards during patients hospitalization, but also will reduce the risk of injuries of health care workers and to ease their daily work.