[The assessment of nurses satisfaction for an organization that values posts and professional responsibilities]. / Contributi valutazione della soddisfazione per l'organizzazione basata sulla valorizzazione di posizioni funzionali, tra gli infermieri del Policlinico S. Orsola-Malpighi.

UNLABELLED: To assess the effectiveness of a new organizational model for professional development, that assigns and financially rewards 12 positions that encompass specific responsibilities (such as responsible of Evidence based Nursing; expert in pressure ulcers, responsible of the newly employed nurses), nurses' satisfaction was measured. METHOD: From November to December 2003 the MC Closey Muller Satisfaction Questionnaire was administered to all the nurses in service in the wards. Levels of satisfaction of nurses with and without specific responsibilities were compared. The answers for each item are on a five points Likert scale. RESULTS: The questionnaire was administered to 1.167 nurses (58.9% of the nurses of the hospital); 602 were assigned positions with specific responsibilities. Overall, nurses with positions assigned were more satisfied (2.76 vs 2.61, p.0.01) and statistically significant differences were obtained for 14/31 items of the scale, and for 5/8 subscales. CONCLUSIONS: The results obtained, although the level of satisfaction is lower compared to other studies, confirm the strategy of professional development adopted in the Hospital. The analysis of results for each position allowed some reflections and to identify strategies to improve the organizational support to some positions.

Emergency department triage performance timing. A regional multicenter descriptive study in Italy.

OBJECTIVES: We explored the time employed by nurses to perform the ED triage process in the clinical setting. Moreover, we assessed the influences on triage timing performance exerted by variables related to nurses, local EDs' features, and by interruptions. METHODS: This is a multicenter prospective descriptive-explorative study performed in 11 EDs of the Tuscany region (Italy), using a 5 tier triage system. The sample was made up of 1/3 of nurses working in each ED. Sampling was performed by a stratified proportional randomization (length of service classes: <5 years; 5-10 years; >10 years). Triage nurses were observed during their triage work-shift. RESULTS: In 2014, 120 nurses were observed, during 1114 triage processes. The timings of triage phases were: waiting time to triage, median 2.55 min (IQR 1.28-5.03 min; range 0.1-56.25 min); triage duration, median 2.58 min (IQR 1.36-4.35 min; range 0.07-50 min). 400 interruptions were recorded (35.9%). In 9.9% there were 2 interruptions at least. There were significant differences in the medians of triage duration among the years of nurses' triage experience (P < 0.001). The presence of interruption was significantly associated with the increasing of the time intervals in all the triage phases (P < 0.0001). Finally, we recorded significant differences in all the triage time phases between the EDs. CONCLUSION: We found that the nurses triage time performances are similar to other triage systems in the world.