Being a nurse between research and clinic: What challenges and opportunities for a PhD-prepared nurse? Overview from an Italian paediatric hospital.

AIM: To report a reflection on the role, challenges and opportunities for nurses with advanced education in research outside the academic field. DESIGN: A discursive paper. DATA SOURCES: We reported the case of an Italian paediatric research hospital where PhD-prepared nurses started to apply their knowledge and competencies in different fields, both in clinical and organizational settings. From this experience, an overview of the possible barriers and challenges that PhD-prepared nurses may face up within the hospital setting. DISCUSSION: The application of PhD-prepared nurses in hospital settings could be an opportunity to advance high standards of quality of care in managerial and clinical areas and to create networks between highly specialized professional figures and different clinical-care realities. CONCLUSION: More research is needed to explore how to apply the advanced competencies of PhD-prepared nurses within healthcare organizations to provide high-quality and safe care and services. This paper can provide insights for a reflection on applying and developing PhD-prepared nurses' skills and competencies within the hospital setting in clinical, research and managerial areas. This can enhance the effective application of highly competent nursing professional figures. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution, due to study design.

A qualitative study of pediatric nurses' perception of factors affecting negotiation of care in a pediatric stem cell transplant unit.

BACKGROUND: The adoption of a 'family-centered-care' philosophy is essential for the care process and its negotiation. A better understanding of nurses' perception of factors that affect the process of negotiation could allow us to better address future interventions and to improve FCC. The purpose of our study was to investigate pediatric nurses' perception of factors that affect the process of negotiation of care with Stem Cell Transplantation pediatric patients and their parents. METHODS: A qualitative research design with in-depth interviews was chosen. Sixteen interviews (16 nurses) were audio recorded and transcribed verbatim. Two researchers conducted independently a thematic analysis of the verbatim transcripts of the interviews. RESULTS: Four themes emerged from the data as factors that affect the process of negotiation: (a) communication, (b) personal factors (c) specificity, and (d) organization. CONCLUSIONS: These themes represent interesting points for future improvement interventions. Negotiation in the Stem Cell Transplant setting would deserve further research, with special focus on children' and parents' perception of factors affecting this important aspect. Furthermore, in the future, negotiation guidelines could be validated and implemented effectively and an already validated tool could be used to document the negotiation process in the Stem Cell Transplant setting.

Investigating the use of Barrows Cards to improve self-management and reduce healthcare costs in adolescents with blood cancer: a pilot study.

AIM: To test if the Barrows Cards method improves adherence to immunosuppressive therapy self-management following hematopoietic stem-cell transplantation in adolescents affected by blood cancer and reduce costs. BACKGROUND: Chronically ill adolescents need to be helped to improve self-management, make sure they can confidently and safely manage therapy at home and reduce readmissions and costs. We identified the Barrows Cards method, originally used to test decision-making skills and critical thinking in medical students. In this pilot study, we tested the efficacy of the Barrows Cards Method in improving adhesion to immunosuppressive therapy in a group of adolescents following hematopoietic stem-cell transplantation and analysed its cost-effectiveness. DESIGN: A mixed-method study. METHODS: The Barrows Cards method is an educational intervention based on the theory of problem-based learning that uses at least 15 cards specially designed to teach participants how to manage a specific problem. We piloted the Barrows cards method in terms of adherence to immunosuppressive therapy and self-management in a group of 17 adolescents affected by blood cancer before being discharged. Participants were enrolled between 2013-2015. Activity Based Costing was used to analyse the cost-effectiveness. RESULTS: The Barrows Cards method significantly improved adherence to immunosuppressive therapy in blood cancer adolescents and reduced readmissions. We also showed how this method could significantly reduce healthcare costs. CONCLUSIONS: Further research is required, but the Barrows Cards method could be effectively used by nurses to improve self-management in chronic patients and reduce health costs.

Space For Children: improving mastery and reducing negative emotions about COVID-19 in youth via mobile interactive storytelling.

BACKGROUND: The COVID-19 pandemic has been a complex event for children and adolescents, significantly impacting their daily activities. In this scenario, our study aims at verifying if "Space for Children," an ad-hoc developed game based on interactive storytelling about the pandemic, can increase mastery and reduces negative emotions about COVID-19. METHODS: The app Space for Children has been sponsored and spread online by email and social media platforms for a limited time period (from May 2021 to January 2022). Before and after the interactive storytelling, participants answered two questionnaires containing a couple of critical questions regarding their emotional state and their perceived mastery about COVID-19. RESULTS: Two hundred thirty-six participants (M=116; F=120) between 7 and 12 years old completed the Space for Children interactive experience. Our results show a significant effect of the game experience on emotional state and perceived mastery regarding COVID-19. Indeed, before the interactive storytelling unpleasant emotional states prevail (reported by 77% of participants) while after the game a clear prevalence of pleasant emotions emerges (reported by 68% of participants). Regarding perceived mastery, results show that self-reported very expert participants passed from 49% to 88%. All the results hold irrespective of age group and sex. CONCLUSIONS: This study presents preliminary findings that highlight the potential benefits of utilizing new technologies based on Interactive Storytelling for Children to effectively convey age-appropriate information about complex real-life events, such as the COVID-19 pandemic, while also mitigating associated negative emotional responses.

Safety and health immigrant paediatric oncology patients: a qualitative study.

BACKGROUND: A "risky situation" is a situation that potentially can lead to adverse event. Studies describe how language barriers can have an impact on patient safety. Several studies describe a lack in management of language barriers (detecting, reporting and bridging) in the hospital paediatric care. Immigration and cancer care are rarely discussed in the paediatric literature. The present study was inspired by our previous study where it was highlighted that the paediatric nurses in a Department of Paediatric Haematology and Oncology perceived how sometimes the paediatric patient and his family were at risk. We surmise that in the case of paediatric health immigrant patients, the issue of correct understanding deserves more care than in communication among adults only. METHODS: A qualitative approach was used. 56 paediatric nurses were interviewed. Semi-structured-interviews were recorded, transcribed verbatim and analyzed using qualitative techniques for recurrent themes. Nurses were interviewed until data saturation was achieved. Analysis was conducted using the thematic synthesis approach. RESULTS: The results include the three main themes: "language barriers" , "therapeutic education" (sub-themes: hygiene, food beverages, behavioural rules), "resources". These mentioned factors seem influence, in turn, the safety of the paediatric patient . CONCLUSIONS: The results suggest linguistic barriers put at risk the whole relationship of care patient-family-nurse and is likely to jeopardize the patient's safety. Nurses are conscious they have to take under control the nursing process to care the patient and the family. Nurse would like to bridge difficulties to improve the safety for this kind of patient.

An online international learning project in an undergraduate children's nursing programme.

Internationalisation of the curriculum (IoC) is a focus for higher education institutions. IoC aims to equip students with essential enhanced skills in relation to becoming global citizens and ensuring that their practice is culturally competent. Undergraduate courses must furnish children's nursing students with learning opportunities that meet the outcomes of the 2018 Nursing and Midwifery Council standards of proficiency. The standards require that nursing education, supervision and training should provide students with the learning opportunities needed to achieve the desired proficiencies and programme outcomes. This article analyses and evaluates the implementation of an online international learning (OIL) project in an undergraduate children's nursing programme in the UK. The pilot project has been identified as a useful and successful teaching method for promoting intercultural awareness among students and provides guidance for future OIL design. Finally, this article offers recommendations on how to address barriers and challenges related to this teaching method.

Exploring Factors Influencing Transcultural Caring Relationships in the Pediatric Stem Cell Transplant Setting: An Explorative Study.

In the literature, there is evidence about the importance of ensuring a Family-Centered approach for foreign patients to provide culturally competent care. The Italian context shows a lack of studies concerning nurses' perceptions regarding factors that influence foreign patients' daily care. In addition, the number of pediatric patients coming to Italian hospitals to be cured has increased dramatically in the last few years. This study aims to investigate the pediatric nurses' perception of the factors influencing nursing care for foreign pediatric patients who have undergone a stem cell transplant (SCT) and their families. A qualitative approach is used. Semi-structured interviews were recorded, transcribed verbatim, and analyzed using qualitative techniques for recurrent themes. Italian SCT pediatric nurses were interviewed until data saturation was achieved. Four themes emerged from the analysis: "Respect for other cultural traditions," "Different roles," "Communication," "Equal treatment and different opportunities." Communication was seen as a barrier in caring for foreign patients. Nurses perceived a lack in their training and knowledge when caring for foreign patients. The hospital supports nurses when caring for foreign patients. We found that pediatric nurses do not feel they are caring for foreign patients in the same way as they do for Italians, but adopt strategies to improve their relationships with them. Semi-structured interviews proved to be useful in highlighting the nurses' perceptions. These data were confirmed by the results of the audit conducted with the "Children and Young People's Audit Policy Tool," The tool suggests specific interventions when foreign patients are admitted.

Falls among children in an Italian hospital: a prospective study.

AIM: The aim of this study was to assess the number of falls that occurred among children admitted to a children's hospital and explore their characteristics. METHOD: A descriptive, longitudinal, prospective design was chosen. Data were collected from records of a children's hospital over six months and analysed using descriptive statistics. RESULTS: Fifty eight falls were investigated. Most of these involved children, mainly boys, aged between one and three years, and most occurred in the evenings. All but one child was injured and 30 received medical interventions. In most cases an adult was present but was not paying sufficient attention to the child. CONCLUSION: Falls among children admitted to a children's hospital are increasingly recognised as an issue to be addressed by health organisations. Further investigation is required on a larger scale to agree definitions, classifications and preventive measures concerning children falling in hospital.