Health coaching for undergraduate nursing students: a pilot study for an action research.

BACKGROUND AND AIM: The Nursing undergraduate degree educational program represents an intensive and complex course, and includes a number of professionalizing practical internships, and for these reasons it requires an action to support and improve. Coaching is based on the premise that people have personal strengths and abilities which, through a interview, can be directed to solving their problems. Several studies demonstrate the efficacy of Health Coaching in different University, but never have been measured benefits regard skills improving. The objective of the study is to assess the impact of a health coaching program on the nursing students. METHOD: A pre-post quasi-experimental study was conducted, involving the activation of a Health Coaching Program for 25 nursing students selected through convenience sampling, based on their fulfillment of the inclusion criteria. The Health Coaching Program was administered by the Health Coaching Academy. RESULT: This study also evaluated parameters such as: level of concentration in study, motivation, problem solving and reorganization skills, study organization skills, psycho-physical-emotional state comprehension, decision-making skills and self-esteem, noting a statistically significant increase post-HC program. A statistically significant improvement was also found in the students' perception of their own stress management skills after the course. CONCLUSION: This study strengthens the hypothesis that HC programs contribute to improving performance of nursing students. Those conclusions need to be corroborated by future studies on the topic to further support the hypothesis that programs of HC within the learning nursing contexts can lead to a tangible benefit for students of the health professions.

Education nursing students' in Palliative Care and Pain Therapy: an observational study.

BACKGROUND AND AIM: University education plays an important role in the preparation of future nurses, especially in the care of dying patients, which is one of the most emotionally engaging aspects. The objectives of the study were to describe the attitudes of students in end-of-life care and to analyze the possible relationship with some socio-demographic variables, through an observational study. METHODS: Preliminarily, an analysis of the educational context of the Nursing Course  of the University of Parma was started, through a comparison of the university course with the recommendations of the MIUR concerning the teaching and learning of Palliative Care and Pain Therapy. Subsequently, a questionnaire containing the Frommelt Attitude Toward Care of the Dying Scale Form B and some socio-demographic context variables was administered to a sample of 109 students belonging to the CoS of Nursing in Parma. RESULTS: From the data collected, it emerged that university planning partly reflects the recommendations of the MIUR and how, on average, nursing students have described positive attitudes in all the dimensions investigated. Interesting is the presence of a positive relationship between the personal experiences of bereavement and the attitudes of the students. CONCLUSIONS: Nurses are essential in ensuring the quality of care provided to patients at the end of life; Nursing training in Palliative Care and Pain Therapy should include a complete and varied program (frontal activity, simulation, internship paths...) in order to develop positive student attitudes associated with high levels of satisfaction and improvement of the quality of care provided.

Medication administration and anxiety: an observational study with nursing students.

BACKGROUND AND AIM: Medication administration errors represent a topic of great scientific interest. Medication administration is considered by nursing students a complex process during which it is easy to make mistakes; therefore, institutional measures have been adopted in order to reduce medication errors. However, it remains a critical issue in nursing practice for which several causes have been identified, including environmental factors and individual knowledge. Mistakes can be made by nurses and especially by students who must cope with additional causal factors including anxiety management. The aim was to investigate state anxiety levels among nursing students when it comes to medication administration. RESEARCH DESIGN AND METHODS: An observational study involving a convenience sample of 150 nursing students from a Northern Italy University has been conducted; they were asked to complete a questionnaire to measure the levels of state anxiety in relation to medication administration.   Results. There were no particularly high levels of state anxiety among students associated with medication administration; however, state anxiety levels were slightly higher in third-year students than in second-year students, and this is most likely due to the growing complexity of the medication administration process compared to the lack of experience.   Conclusions. Although the results don't show statistically significant data, the effectiveness of nursing education plays a crucial role in reducing medication errors, which is why it is essential to provide suitable tools for the professionals of the future and invest in clinical simulations.

"Growing through relationship" - the Engagement of the Health Professional Students in the Internship Experience: a Grounded Theory Research.

BACKGROUND AND AIM: Little is known about the students' engagement in the training experience and how it is lived by the health professional students. We aim at building a theoretical model of the engagement process starting from their lived experiences with Grounded Theory approach. METHODS: In-depth qualitative interviews are conducted with 12 students from the Master Degree Courses in Nursing, Physiotherapy and Prevention Techniques in the environment and in the workplace, who had carried out and/or were doing internships in the same territory (2nd and 3rd year). Results The health professions' student engagement in the training program is developed in three main phases: initial phase, central phase and final phase, where emotions, behaviours, awareness contribute to the development of the entire engagement process with different relevance. The intertwining of these different components that develop along the stages of the experience gives life to the core category: growing through relationship, which expressed the crucial role of the relational network built during the internship experience in shaping students' engagement. CONCLUSIONS: The results of this study underline the crucial role of students' engagement in the internship experience in favouring both better learning outcomes and perspective professional success and wellbeing. (www.actabiomedica.it).

The safety of care focused on patient identity: an observational study.

BACKGROUND AND AIM: Healthcare organizations, in order to reduce errors and extend the number of safe practices, are looking for possible solutions to enhance the clients' health quality care and trying to spread the culture of safety healthcare. Although in the literature the field of research "patient safety" is very debated, there are few empirical studies that investigate about the strategies undertaken by nursing students for the patients identification process during their care pathway. The aim of this study is to investigate the knowledge of the Ministerial Recommendation No. 3/2008 among nursing students, a specific Italian directive that aims to guarantee the safety of cares. METHODS: A four-weeks single-center observational study was conducted, involving a convenient sample of 112 students of the 2nd and 3rd  year of the Nursing Course Degree of the University of Parma. The survey was conducted using an ad-hoc questionnaire. RESULTS: The use of the identification wristband is considered one of the most important strategy to make sure the patient identification; unfortunately it is in practice used just in few occasions and only when performed specific procedures; it is furthermore noted that patients are not enough informed about the use and finalities of the identification wristband. CONCLUSIONS: Considering the importance of the patient identification process to guarantee the  safety of cares, the results produced, suggest that this investigation field deserves further insights in order to collect more substantial data and expand knowledge on the specific subject, so as to fill  knowledge gaps and sensitize nursing students to the correct use of the identification wristband.

Competence assessment of the clinical tutor: a multicentric observational study.

BACKGROUND AND AIM OF THE STUDY: In the international literature there are no validated tools which investigate clinical tutors' skills. The main objective of the study has been to describe the clinical nurse tutor's skills, required to properly train nursing students during their educational path. METHODS: In this observational study a non-probability sampling has been used. The study was led in two centers: the AOUPR of Parma and the AUSL of Parma, after obtaining the favorable opinion from the Ethics Committee of the Northern Emilia Large Section. The data have been collected by using a structured and self-given survey that investigated three areas. Each item has a 4-point Likert scale, in which 1 indicates "for nothing" and 4 "very much". The data have been analyzed with the statistical software IBM SPSS v.26 ® and with the open-source statistical software Jamovi v.1.6.9 (https://www.jamovi.org.). The number of factors in the original model was reduced using several established research steps and then evaluated for data quality and construct validity using principal component analysis and confimatory factor analysis. RESULTS: Among 397 administered questionnaires, only 300, which were considered valid, have been filled. The psychometric properties of the investigation tool turned out to be good in all the areas analyzed with a Cronbach alpha higher than 0.70. The extensive process resulted in a version with 4 factors. CONCLUSIONS: Nurses' answers have allowed to draw the required profile of the clinical tutors in the different organizational contexts. The results can target possible training proposals to create opportunities for the clinical tutors.

The Nursing Management of Tourniquet: the infective risk related to its use.

BACKGROUND AND AIM OF THE WORK: Reusable tourniquets should be considered and used in clinical practice as semi-critical devices, as they are colonized by potentially pathogenic agents, a possible cause of care-related infections. The aim of the study was to analyse the management of tourniquets in the clinical reality of wards, investigating the aspects related to their use in venepuncture procedures, the cleaning process after their use and storage. METHODS: It has been conducted an observational study with a questionnaire on a sample of nurses (N = 73) and nursing students (N = 60) recruited in a hospital and in an University of northern Italy. RESULTS: Data revealed a very positive attitude regarding the high standards of hand hygiene among nurses and nursing students sampled; the critical issues concern the lack of shared protocols or guidelines for the management of tourniquets that lead to discussion both on their use in clinical practice and on the disinfection process after use as well as tourniquets disposal. CONCLUSIONS: Tourniquets can represent a serious potential danger in terms of infections transmission, especially in the pandemic period we are experiencing; their use is practically transversal in all healthcare settings and it is therefore necessary to implement the use of shared management and disposal guidelines / protocols. From this research it appears that in the setting explored, although much attention is paid to hand hygiene, this aspect still seems to be a critical point of nursing care.

A third mission at the Nursing Study course University of Parma. Intervention report.

BACKGROUND: The term Third Mission refers to the activities with which universities interact directly with the communities and the territory of reference, combining the objectives of the third mission with the two traditional missions: teaching and research.  These were the premises that guided the Nursing Studies Course of the University of Parma, with the goal of implementing a structured path of "Intercultural Nursing" on a demo-ethno-anthropological basis. METHODS: The path taken was divided into several phases: arrangement of moments of interaction with students; teaching activity aimed at students based on the relationship between ethno-anthropological knowledge, aspects of migration medicine and social legislation; direct meetings with representatives of some communities present in the Parma area. RESULTS: The interaction with students was achieved through meetings called "Cultural Coffee". The first meetings, in the measure of 4-5, took place in the period October-December 2013, subsequently, the same number of meetings was repeated in the following years. In 2019, two important results were achieved: the creation of an ADE (teaching chosen by the student) dedicated to multiculturality. Another activity of the "Intercultural Nursing" course involve the students with some communities in the Parma area. CONCLUSION: The results of this experience and the underlying idea that these aspects, if addressed in the basic training, can be for the professionals most expendable in the workplace, provide reasons to continue the path started. The international comparison on the intercultural skills of nurses, indicates collaboration and partnership with communities, as fundamental elements for a complete and effective assistance.

The nurses' uniform in pediatrics, the opinion of children and nurses.

BACKGROUND AND AIM: The nursing uniform represents a non-verbal mean of communication which in the case of children can arouse positive or negative emotions. The first study conducted on a sample of 107 children, aimed to define their preferences on different models of decorated nursing uniforms; the second one conducted on 101 nurses to understand the preferences, the meanings attributed to the uniform and their availability to adapt it according to the preferences expressed by the children. METHODS: We conducted an observational study with a qualitative approach. For the first objective with the children, a visual stimulus was used, showing 6 models of uniform: the traditional plus 5 models of different colors and themes (cartoons characters and videogames). For the second objective with the nurses, in addition to reproducing the same visual stimulus, a semi-structured questionnaire was used. RESULTS: Children and nurses seem to be in perfect accord, because in both groups, color models were the most chosen. Nurses defined their uniform with terms of particular moral, intellectual and professional value and declared themselves available to align with the preferences of the children. CONCLUSIONS: This study leaves little doubt about preferences; it also represents the true originality of the study because almost never in the literature have been compared the point of views of children and professionals, generally favoring the comparison between children and care givers. Our findings could represent a further landmark for guiding the choices of health organizations on currencies to be adopted in the pediatric field. (www.actabiomedica.it).

Nursing students' perception of the quality of clinical learning: a mixed methods inquiry.

BACKGROUND AND AIM: As part of the Nursing Degree Course, the "internship" period represents a strategic lever to systemize the fundamental combination of theoretical study and nursing practice. However, only a few studies have examined in depth students' perception of this experience. The aim of the study was to assess the quality of the places in which the University of Parma's Nursing students did their internships based on their experience. METHODS: Through a quantitative and qualitative study, students who had completed at least one clinical internship (n.200) were asked to fill out a self-report questionnaire on the quality of learning using the CLEQUEI scale (1) and answer a few social and demographical questions. In addition to the questionnaire, 24 narrative interviews (semi-structured) were conducted; these interviews deepened the significance of the assigned internship experience. RESULTS: Throughout all the clinical contexts that were analyzed, the dimension of the perceived quality of the internship averaged a value ≥ 44 (the minimum cut-off indicating the presence of necessary elements to promote the processes of quality clinical learning). The perceived quality dimension particularly stands out in the Pediatric Area, in which it amounted to a mean value of 66 (close to the maximum cut-off value of > 66). This result indicates the opportunity to further develop the processes used in students' quality clinical learning. The latter describe the internship as a moment of both personal and professional growth of fundamental importance in one's own training process. CONCLUSIONS: Overall, the University of Parma's Nursing students have a good perception of the quality of clinical learning. The significance of assigned internship presents some elements which are a relevant part of the new paradigm. However, there are still some aspects which need improvement, such as the necessity to reevaluate certain parts of the teaching organization of the professionalizing activities and of the clinical internships throughout the duration of the three-year course.

ALLiance for sEcondary PREvention after an acute coronary syndrome. The ALLEPRE trial: A multicenter fully nurse-coordinated intensive intervention program.

The main objective of cardiovascular disease prevention is to reduce morbidity and mortality by promoting a healthy lifestyle, reducing risk factors, and improving adherence to medications. Secondary prevention after an acute coronary syndrome has proved to be effective in reducing new cardiovascular events, but its limited use in everyday clinical practice suggests that there is considerable room for improvement. The short-term results of evidence-based studies of nurse-coordinated secondary prevention programs have been positive, but there is a lack of long-term outcome data. The Alliance for the Secondary Prevention of Cardiovascular Disease in the Emilia-Romagna region (ALLEPRE) is a multicenter, randomized, controlled trial designed to compare the effects of a structured nurse-coordinated intensive intervention on long-term outcomes and risk profiles after an acute coronary syndrome with those of the standard of care. All of the patients randomized to the intervention group take part in 9 one-to-one sessions with an experienced nurse from the participating centers with the aim at promoting healthy lifestyles, reducing risk factors, and increasing adherence to medication over a mean period of 5 years. The primary clinical end point is the reduction in the risk of the 5-year occurrence of major adverse events (a composite of cardiovascular mortality, nonfatal reinfarction, and nonfatal stroke). The primary surrogate end point is the achievement of prespecified targets relating to classical risk factors, lifestyle modifications, and adherence to pharmacological therapy after 2 years of follow-up. Coronary heart disease is a chronic degenerative disease, and patients who recover from an acute coronary syndrome (ACS) are at high risk of developing recurrent events.1 Although secondary prevention measures have proved to be effective and are strongly recommended by all of the international guidelines,2., 3. the 4 EUROASPIRE surveys4., 5., 6., 7., 8. showed that there was still a high prevalence of conventional risk factors, that secondary prevention measures were inadequately implemented, and that their main goals were often not reached. In addition, there were considerable discrepancy in secondary prevention practices between centers and countries, and a widespread underuse of cardiac prevention and rehabilitation programs despite their demonstrated effectiveness in reducing cardiovascular risk over time.9., 10. Over the last 10 years, nurses have been increasingly involved in successful cardiovascular risk management,11., 12., 13. but although this has improved levels of cardiovascular risk, no clear reduction in hard end points such as major cardiovascular adverse events and mortality has been demonstrated.10 The aim of the ALLEPRE trial is to evaluate the benefit of a homogeneous, structured, secondary prevention intervention program, fully coordinated by nurses from in- and outpatient clinics, in terms of cardiovascular risk profiles and major clinical events in ACS patients living in the large Emilia-Romagna region of Italy.

Nurse training in self-management of patients with cardiovascular diseases: a multicentre observational study.

BACKGROUND AND AIM: The therapeutic education and self-management carried out by nurses, are winning elements in cardiovascular secondary prevention, but because they are complex matters, they require special training by the professionals. The target of the study has been to assess the effects in clinical practice of a training program for nurses in the management of patients with cardiovascular diseases, leaning towards a self-oriented patient management and therapeutic patient education. METHOD: The research utilized a quali-quantitative study to compare the responses of 53 trained nurses (experimental group) and 101 untrained nurses (control group). The instrument used was a self-report structured in two sections: the first, a qualitative kind, was used to investigate the portrayal of nurses regarding self-management; the second, a quantitative kind, included a Likert scale based on 5 points (1=never, 5=always) that investigated the professional nurse's action in its bio-psycho-socio-relational and clinical activities (La Sala, 2012). RESULTS: The trained nurses' approach is more oriented towards the psycho-socio-relational dimension, compared to the untrained nurses. A difference also emerged regarding activities of a bio clinical nature, which are performed much more by untrained nurses compared to trained professionals. CONCLUSIONS: The health education and self-management skills were used by trained nurses during their care of patients with cardiovascular diseases, stressing the importance for professional nurses to develop an integrated competence, using narrative talks as the main tool in a patient-centred approach.

Narrative Based Medicine as a tool for needs assessment of patients undergoing hematopoietic stem cell transplantation.

BACKGROUND AND AIM: In the last years we have seen an ever increasing number of patients with haematologic disorders who need hematopoietic stem cell transplantation (HSCT). The whole sector of HSCT results, infact to be in a continous scientific and technological clinical progress, offering a very advanced care. Despite this, some aspects are underconsidered, some of which could be fundamental to determine the success of the care pathway, such as the experience of the illness by the patient. Using a Narrative Based Medicine approach we wanted to investigate clinical, psychosocial and organizational aspects of the patient's journey whilst undergoing HSCT. METHOD: Various narrative interviews were conducted using non-structured approach. Results were analysed by thematic contents. RESULTS: Psycological dimension is the most compromised: above all emerged sentiments of oppression linked to the isolation period in the Low Bacterial Load (LBL) room. To note are also the different dynamics with which the patients perceive the organisation and hospital structures, and how much these factors can influence their care experience. CONCLUSIONS: Results suggest the need in clinical practice of an integration between qualitative and clinical approach, so as to permit the psychosocial and relational necessities to emerge, often unexpressed by patients undergoing HSCT.

The quality of nursing in intensive care: a development of a rating scale.

BACKGROUND AND AIM: The evaluation of nursing care is a topic of great interest and especially crucial in intensive care contexts. However, inside the Italian scientific scenario it is still difficult to measure NSO, or Nursing Sensitive Outcomes, due to the lack of indicators or scales shared by the nursing community. The aim of the present study was therefore to develop a Quality Nursing Care Scale for the Intensive Care (ICU-I-QNCS). METHOD: From the literature review of the Intensive Care Unit (ICU) quality standards, they were generated 63 items. Then 43 experts assessed them through the Content Validity Index (CVI). Items with a CVI score <0.90 were removed from the scale. RESULTS: All the 63 items have achieved an average score CVI equal or greater than 0.90. 5 item reached an optimal average CVI score (=1); 23 showed an average CVI score between 0.90-0.94 and last 35 were between 0.95-0.99. CONCLUSIONS: The ICU-I-QNCS has obtained an acceptable CVI level and it reflects the underlying theoretical model of Doran (2002).

Bio-clinical and psycho-social nursing practice. An experimental research in an Intensive Coronary Care Unit.

BACKGROUND AND AIM: The literature on patients with cardiovascular disease emphasizes the importance of providing a bio-medical and a psycho-social nursing care during the three phases of the nursing process (acceptance, assistance, education). How is his multidimensional nursing approach actually used during nursing practice? The present study aimed to evaluate the effects of a nursing educational training and it was finalized to implement a multidimensional care practice of nurses working in Intensive Coronary Care Unit (I.C.C.U.). METHOD: The entire nursing staff of the I.C.C.U of Parma Hospital (N = 17) took part in the research and it has been randomized in two subgroups. A group of 9 nurses participated as experimental group. They filled up a semi-structured questionnaire investigating the bio-clinical and psycho-social nursing activities, before (pre-test, time 1) and after (post-test, time 2) a professional training. 8 nurses participated as control group. They filled out the same questionnaire (at the time 1 and 2), but they did not participate at the professional training. RESULTS: Results indicated how the nursing practice was more related to the bio-clinical (e.g. blood pressure) than to the psycho-social (e.g. mood) activities at the time 1. After the professional training (time 2), only the experimental group changed its professional practice, by integrating the bio-medical with the psycho-social nursing. CONCLUSIONS: The data showed the importance to promote a multidimensional educational path for nurses that assess the impact of the professional training on the professional practice, in order to improve the quality of care delivered to patients affected by cardiovascular disease.

Multi-dimensional nursing form: a novel means of approaching nurse-led secondary cardiology prevention.

BACKGROUND AND AIM: Secondary prevention after an acute coronary syndrome (ACS) has proved to be effective in patients with coronary heart disease, and is strongly recommended by the international guidelines. However, there is a lack of widespread secondary preventive programmes in real-world clinical practice, even though it has been shown that these can be successfully conducted by nurses. METHOD AND RESULTS: We have designed a multicentre randomised trial involving patients with ACS in which nurses will fully coordinate secondary prevention in the intervention arm using a multidimensional nursing form after attending ad hoc teaching sessions.

A cross selectional survey in a critical care: the job satisfaction and functioning team of the health professionals.

BACKGROUND AND AIM OF THE WORK: Health care workers, especially those who are part of the OS core, are essential in the delivery of services, as they represent the institution at the time of the contact with the user and they represent also the image of the organization. Health administrations, therefore, are called to improve the performance through a better motivation and satisfaction of the staff, in view of two strategic aspects: job satisfaction of professionals and team collaboration. METHOD: Between January and September 2014, a survey at the OU (UUOO) intensive care and sub intensive has been made inside three hospitals in Emilia Romagna. It' s been a multicentre cross-sectional quantitative study by administering a self-report questionnaire designed to investigate the different constructs. On 742 questionnaires were spread 454 professionals gave it back  (response rate = 73%). Of those, 273 (60.1%) were nurses, 119 (26.2%) were physicians and 62 (13.7%) were healthcare operators. 62 (13.7%) Job Satisfaction was measured with the McCloskey Mueller Satisfaction Scale. Team Functioning was measured with the Index of Interprofessional Team Collaboration. RESULTS: Results from MANOVA indicated that physicians were less satisfied of scheduling than both nurses and healthcare operators. For professional opportunities, instead, healthcare operators showed the lower level of satisfaction. The participants seem to perceive a high level of team effectiveness and therefore the professionals involved in the care of critically ill patients than the two dimensions analysed, (reflection between the processes and interdependent roles), also state a greater tendency to respect the roles interdisciplinary, maintaining their professional autonomy and a lower tendency to use critical thinking to act professionally in order to improve the effectiveness of care provided. CONCLUSION: The study results oriented healthcare administrators, to take paths that feed the job satisfaction and the collaboration of professionals by developing the aspects investigated. Considering the shared perception among the professions studied, compared to the constructs under investigation, it seems to be clear how the routes should be designed in a systematic order to involve, in an integrated way the best professionals (nurses, doctors and OSS) involved in taking managing critical patients. No statistically significant difference have been found between these three professions considered, on most dimensions of job satisfaction investigated (relations between colleagues, 'social interactions, work-family balance, time work organization and working professional opportunity). There is a difference between two specific factors: the work time planning organization and wich is seen less by the nurses, while the job opportunities that are perceived less from the OOS.

Therapeutic adherence and health outcomes in acute coronary syndrome (SCA) patient: the role of nursing.

BACKGROUND AND AIM: The literature on cardiovascular disease has highlighted that therapeutic adherence is often inadequate. What are the reasons for this poor adherence to medication? The goal has been to measure the different factors related to therapeutic adherence,  differentiating the SCA patients on three levels of self-referred therapeutic adherence and delving the relations between self-reported therapeutic adherence and socio-demographic, clinical, emotive, cognitive and socio-relational variables. METHOD: A total of 84 Italian patients (66.7% males) with (SCA) took part in the study and completed a semi-structured questionnaire investigating the variables described above. RESULTS: RESULTS indicate the influence of clinical variables, showing that patients suffer more of dyspnea and angina symptoms than those that state to follow prescriptions. But the emotive aspects seem able to interfere more with the adherence: the subjects scarcely adherent have felt more threatened by their illness, and experimented more symptoms of anxiety and sadness than highly adherent patients. At a cognitive level the adherent patients have chosen coping strategies not centred on emotions, but headed to the solution of the problem. At socio-relational level is confirmed the importance of the social support in favouring the adherence. CONCLUSIONS: Among the different factors here considered, are those psychological and relational that tend to be associated to level of adherence for prescriptions. The outcomes have shown that the demo-graphical and clinical variables result are not tightly associated to the adherence, confirning instead the importance of psycho-social factors, as already notable in the literature in heart studies. The implications have been discussed.