Self-reported knowledge, practice and perceived usefulness of Care Bundles: A Pilot Survey among Italian Healthcare Professionals

Background: Healthcare-associated infections (HAIs) are a global concern, with Italy reporting a 7.5% prevalence, one of the highest rates in Europe. They contribute to longer hospital stays, antimicrobial resistance, and annual costs exceeding EUR 7 billion across Europe. To address HAIs, WHO 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 CHERRIES and CROSS standards, 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.