Healthcare-associated infections (HAIs) pose a safety risk to patients and healthcare personnel. Although hand hygiene (HH) is a fundamental preventive measure, insufficient availability of the resources required to perform HH properly may limit its effectiveness and create a bioethical conflict in healthcare delivery. A documentary review of national and international scientific literature related to HAIs and HH was conducted to examine the bioethical enforceability of this practice in light of the principles of beneficence, non-maleficence, and justice. In this study, the bioethical enforceability of HH refers to the extent to which its performance may reasonably be required of healthcare personnel under specific circumstances, including those involving institutional resource limitations. The literature search was conducted in PubMed, Google Scholar, Scopus, and Web of Science, as well as in resources from the World Health Organization (WHO) and the Pan American Health Organization (PAHO), national and international regulatory instruments, and textbooks. The information was analyzed from a bioethical perspective. Greater resource availability, by itself, has not been shown to improve health outcomes. Effective HH depends on individual, institutional, and organizational factors. Therefore, when institutional limitations objectively hinder or prevent its effective implementation, they may modify the conditions under which HH is bioethically enforceable and affect the proportional attribution of individual responsibility, without implying that healthcare personnel should refrain from using available resources and adopting reasonable measures to protect patients.
Italy renews its National Prevention Plan (NPP) on a multi-year cycle that binds all Regions to shared, centrally defined public health objectives. In 2026, the Ministry of Health adopted the NPP 2026–2031, which succeeds the 2020–2025 cycle and will guide regional prevention planning until 2031. The objectives of this opinion are to appraise the achievements and principal shortcomings of the outgoing cycle, to analyse the innovations of the new Plan, and to propose priorities for its implementation. The main innovations of the new Plan include seven macro-objectives, fourteen binding thematic areas, a reinforced multilevel governance architecture, an NRRP-funded National Health Prevention Hub for intersectoral data integration, and a national digital platform for planning, monitoring, and evaluating Regional Prevention Plans. Drawing a comparison between the Italian model and comparable approaches adopted elsewhere in Europe, the paper situates the NPP 2026–2031 among Europe’s statutory, cascading prevention frameworks. Converting adopted policy into equitable, sustained population health gains will depend on proportional and durable funding, standardized outcome monitoring, and investments in adequate standard staffing levels for a multiprofessional public health workforce that operationalizes prevention at the local level.
Germicidal UV-C light has been around for 120 years, and while it is widely utilized in the food industry, it is less implemented within the pharmaceutical industry. In this paper, we present an optical-assisted implementation process of UV-C lamps within a Good Manufacturing Practice (GMP) setting. The presented approach consists of six steps: understanding the room; optical simulations; dose, cycle and frequency; safety; maintenance plan; and installation, verification and results. Each of these steps is described by following an actual implementation example inside a class D/C Personal Airlock (PAL). The Environmental Monitoring (EM) effect is compared 12 months prior to and 12 months after the implementation of the UV-C lamps. Here, it is shown that the total number of alerts was reduced from 32 (6.0%) to 12 (2.6%), the three-in-a-row alerts were reduced from 3 to 0, while the action levels were reduced from 4 (0.8%) to 0 (0.0%). The mean Colony-Forming Unit (CFU) count decreased from 3.60 before UV-C implementation to 1.94 after implementation, corresponding to a 46% reduction. Finally, we discuss different approaches of implementation into other types of cleanrooms, and possible mitigation actions should a UV-C system underperform.
A safe and hygienic healthcare facility environment is fundamental to protecting patients and healthcare workers and to sustaining public trust in health systems. Evidence on patient-perceived healthcare facility safety in low- and middle-income countries (LMICs), including Namibia, remains limited. This study assessed participants’ perceptions of healthcare facility safety within a national community-led monitoring (CLM) programme, and identified factors associated with these perceptions. Data were collected using a questionnaire comprising 37 items addressing participants’ sociodemographic characteristics, their experiences with the received services, and their perceptions of safety within healthcare facilities. The questionnaire covered several dimensions, while the outcome was assessed with a single dichotomous question. We analysed routinely collected CLM data from 15,066 individual beneficiaries of care aged ≥18 years accessing healthcare services across Namibia between January 2024 and November 2025. Data were analysed using IBM SPSS version 30. Descriptive statistics were used to summarise participant characteristics and safety perceptions. Associations between perceived facility safety and selected factors were assessed using chi-squared tests and bivariable and multivariable logistic regression models. Among 15,066 participants, 87.9% (95% CI: 87.4–88.4) perceived healthcare facilities as safe, with national rates increasing from 86.8% in 2024 to 88.9% in 2025. Negative experiences such as inadequate healthcare workers, poor attitudes, discrimination, and dissatisfaction with services were statistically significantly associated with lower perceived safety (p < 0.05). Potential policy considerations like structural workforce strengthening and facility-level infrastructure improvements to improve patient experience, safety culture, and quality of care require further research.
Dental public health plays a crucial role in ensuring equitable access to oral healthcare services. In Italy, despite a universal National Health System (Servizio Sanitario Nazionale, SSN), dental services remain largely privatized. This narrative review examines the current status of dental public health in Italy, in opposition to private practice, exploring the structure of services, public provisions, essential levels of care (LEA), services in the penitentiary system, and comparing the Italian model with other European systems. This review identifies three critical dimensions undermining equity in dental care: access disparities, limited public provision, and lack of systemic reform. Through international comparison, the paper outlines actionable strategies to improve service coverage and population oral health.
