The epilepsy specialist nurse: A mixed-methods case study on the role and activities.

PURPOSE: To describe the role and activities of epilepsy specialist nurses (ESNs) operating as a team in the setting of a hospital specialising in the diagnosis and management of seizure disorders. METHODS: We conducted a descriptive mixed-methods embedded single case study. We recruited 9 ESNs, 14 of their professional colleagues and 9 'key informants' to analyse their perceptions of the role and activities of ESNs. We collected data through interviews, questionnaires, observations, and documentation. The study was conducted at the Filadelfia Epilepsy Hospital, Denmark. RESULTS: The team of ESNs offers holistic care to patients and their caregivers regarding the clinical, social, and emotional aspects of epilepsy. The ESNs are integrated in a multidisciplinary team and promote collaboration among the team members. ESNs also contribute to organisational aspects and perform research activities. CONCLUSION: A structured group of ESNs can operate effectively and extensively in a specialised hospital setting. Our findings contribute to clarifying the description of the ESN's role, and provide an example of how ESNs can be incorporated into a hospital's organisational structure.

Development of a subset of ICNP Nursing Diagnoses for the promotion of self-care in people with diabetes mellitus: a multi-center observational study.

INTRODUCTION: Self-care is a key for people with diabetes mellitus (DM) to avoid severe complications and to maintain quality of life. Person-centered and accurate nursing care plans can help nurses to deliver effective self-care promotion interventions. Few studies focused on nursing diagnoses that are specific for diabetes self-care education, and none of them used the International Classification for Nursing Practice (ICNP). International Catalogues of ICNP nursing diagnoses are missing in this field. AIMS: To identify the ICNP nursing diagnoses that are useful to promote self-care in people with DM; to describe the prevalence of ICNP nursing diagnoses in self-care of people with DM. METHODS: A subset of 55 ICNP nursing diagnoses was developed based on the Middle Range Theory of Self-care of Chronic Illness, and most recent diabetes clinical guidelines. Then, the subset was tested through a multicenter cross-sectional design involving a consecutive sample of 170 adults with confirmed diagnosis of Type 1 or Type 2 DM. Data were collected by medical records, physical examinations and semi-structured interviews. RESULTS: 1343 nursing diagnoses were identified, with an average of 8 nursing diagnoses per patient. The 100% of the nursing diagnoses were described using the pre-developed subset. Overall, the five prevalent nursing diagnoses were: Body weight problem (56.4%), Non adherence to immunization regime (53.5%), Conflicting attitude toward dietary regime (41.7%), Impaired weight monitoring (39.4%), and Lack of knowledge about blood glucose diagnostic test result (32.3%). Nursing diagnoses by self-care maintenance, monitoring and management were also described. CONCLUSIONS: A huge amount of nursing diagnoses was identified suggesting the need of intensive education. Clinicians and administrators can use this subset to improve the accuracy of the documentation of diabetes care. In Public Health, the subset can be used to assess the cost-effectiveness of diabetes healthcare services. Future research is needed to assess the effectiveness of this subset in settings that are different from the one where it was developed. Finally, this subset could be a starting point to develop and International ICNP Catalogue for diabetes care.

A systematic review and Meta-analysis on the association between Hand-Foot Syndrome (HFS) and Cancer Chemotherapy Efficacy.

Hand-foot syndrome (HFS) is a common skin toxicity of traditional chemotherapies. Some studies showed that HFS has an association with progression-free survival (PFS) and the overall survival (OS). So far, there is not available any systematic literature reviews or meta-analysis aimed to assess the associations between HFS, PFS and OS. For this reason, this study aims to quantitatively summarize, critically review, and interpret the recent literature related to the associations between HFS and efficacy of chemotherapy in terms of PFS and OS. Queries shaped by PICOM framework, a systematic search of three electronic databases (PubMed, Scopus, and Science Direct) was carried out for the period between January 2010 and December 2017. Quantitative data pooling was based on the calculation of Hazard Ratio (HR) with 95% Confidence Interval (95% CI) for the OS and PFS associated to the presence of HFS, through the data of original publications. Five papers were included in this systematic review for the quantitative data pooling. Patients with HFS showed improved PFS (HR = 0.532 [0.431-0.656]; p = 0.000) and improved OS (HR = 0.522 [0.427-0.638]; p = 0.000). HFS causes a reduction of compliance with oncology treatments. Healthcare providers should use this result as a trigger to foster patients' coping and the one of their family caregivers, enhancing their adherence to cancer treatments.

Developing a subset of ICNP nursing diagnoses for medical and surgical hospital settings, informed by an Italian nursing conceptual model: a multicenter cross-sectional study.

BACKGROUND: The International Classification for Nursing Practice (ICNP) is designed to facilitate the expression of nursing diagnoses, interventions and outcomes. The development of the ICNP subsets may support nurses by providing appropriate terms for documenting nursing care. This project aimed to develop a subset of ICNP nursing diagnoses oriented by an Italian Nursing Conceptual Model (MPI) to describe nursing clinical data in medical and surgical acute hospital wards. STUDY DESIGN: A subset of ICNP nursing diagnoses was developed based on a literature review and on an expert consensus. A cross-sectional study was conducted in three Northern Italian hospitals to empirically test the subset in target settings. METHODS: In accordance with the guidelines adopted by the International Council of Nursing, the study followed the process for developing an ICNP subset. Twelve expert nurses from clinical settings and nursing education in surgical and medical care participated in a Delphi method to further validate the subset. A cross-mapping process has been implemented and the prevalence of diagnoses was described. Data were collected from healthcare documentation of admitted patients, including, retrospectively, nursing clinical data from the patients' admission date to the time of data collection. RESULTS: Documentation from 476 admitted patients was analysed: 228 were from surgical and 248 from medical wards. 24,142 nursing diagnoses were detected consulting retrospectively each documentation. A total number of 21,401 nursing diagnoses (88%) were fully mapped by the ICNP subset. CONCLUSION: Results showed a high capability of ICNP terminology to describe nursing care in acute medical and surgical areas in Italian hospitals. The identified subset of ICNP diagnoses could be a valuable way to support a computerized documentation system for hospitals using MPI and ICNP. Results could be used to start revising nursing education programs in order to introduce this nursing standardized terminology combining it with the nursing conceptual model in use.