A large cross-sectional survey of COVID-19 vaccination willingness amongst healthcare students and professionals: Reveals generational patterns.

AIMS: To determine coronavirus disease 2019 (COVID-19) vaccination hesitancy in healthcare professionals and healthcare students in Italy across four generations (baby boomers, generations X, Y and Z). DESIGN: A cross-sectional descriptive study was performed through an online survey conducted from May to June 2021. The STROBE guidelines were adopted for reporting. METHODS: Data were collected by initially sending a survey link to a convenience sample of healthcare professionals and students, which was followed by snowball sampling. The VAX scale was validated and adopted. An ANOVA was performed to detect differences in vaccine-hesitancy beliefs between the four generational groups. RESULTS: The survey was completed by 1226 healthcare professionals and students. Worries about unforeseen future effects accounted for the higher vaccination hesitancy factor across generations. More positive attitudes towards COVID-19 vaccination were expressed by members of generation Z than by members of generation Y and baby boomers. Members of generation X had the highest vaccination hesitancy scores in the overall scale. CONCLUSION: The results suggest that public health campaigns should take into account the generational differences in COVID-19 vaccination hesitancy to achieve higher levels of vaccine acceptance, including amongst healthcare professionals and students. IMPACT: Vaccination is the most effective strategy to tackle the COVID-19 pandemic. The advice of health professionals strongly influences vaccination willingness in the general population. A consideration of the generational patterns in the COVID-19 vaccination hesitancy of healthcare workers and students may increase vaccination uptake in these populations, which in turn may lead to greater public acceptance of the vaccine.

Effectiveness of a family nurse-led programme on accuracy of blood pressure self-measurement: A randomised controlled trial.

AIMS AND OBJECTIVES: To evaluate the effectiveness of a Family Nurse Practitioner (FNP)-led programme on the degree of adherence of current recommendations on home blood pressure self-measurement (HBPM) as compared to routine care and management. BACKGROUND: HBPM plays an important role for monitoring hypertensive patients; however, patients' adherence to current guidelines is unsatisfactory. A nurse-led training programme in the community setting could be an effective strategy to achieve high level of patients' adherence to recommendations. DESIGN: A multicentre randomised controlled trial was carried out from September 2016 to September 2017. METHODS: In total, 170 patients were randomly allocated into the intervention group (n = 83) and the usual care (n = 87). All participants received usual care (written and verbal information on HBPM recommendations); subjects in the intervention group also received 1-hour training session on how to correctly self-measure BP. Clinical trial registration was done (ClinicalTrials.gov.: NCT04681703). The CONSORT checklist for randomised controlled trials was used in this study. RESULTS: At baseline, the level of adherence to the recommendation was similar in the two groups (p < .05). After 1 month, the adherence significantly increased in the intervention group, where patients were more likely to measure BP at the same hour and from the same arm, in a quiet environment, with the back and uncovered arm supported and the legs uncrossed; recording BP more than once in each measurement session; keeping a diary of blood pressure measurements; use of the appropriate cuff and proper placement of the cuff; and resting for >5 min before performing the measurement (all p < .05). CONCLUSIONS: The FNP-led programme is effective in improving patients' adherence to guidelines on the correct technique to self-measure BP at home. RELEVANCE TO CLINICAL PRACTICE: This programme may be added to the existing interventions in the community setting or considered into specifically nurse-led hypertension management models.

Trust in Nurses Scale: validation of the core elements.

BACKGROUND: The Trust in Nurses Scale (TNS) was developed and psychometrically assessed so that patients' trust could be accurately and reliably measured. The TNS has been translated, assessed and administered to patients in Europe, Asia and North America. AIM: This descriptive, cross-sectional, correlational study aimed to assess the psychometric characteristics of the Italian version of the Trust in Nurses Scale. METHODS: An Italian version of the TNS was developed. We used a forward-backward translation methodology to establish semantic and conceptual equivalence within the Italian context. The scale was then administered to a convenience sample of 200 hospitalised patients in medical, surgical or oncology units. Internal consistency and construct validity were assessed performing Cronbach's alpha and confirmatory factor analysis (CFA). Both a 4-item and a 5-item TNS were assessed. RESULTS: The 4-item TNS demonstrated better construct validity than the 5-item version. Similarly, the internal consistency reliability was better with 4 items than 5 (0.83 and 0.79, respectively). CONCLUSION: The Italian version of the scale has acceptable reliability and validity and may be used to assess this aspect of the nurse-patient relationship. Being tested in different settings, it may be used with all patients admitted to hospital. Trust in nurses is critically important to patient outcomes; however, it is rarely measured quantitatively on a wide scale. The use of the Italian validated scale could be useful to increase evidences on this important topic, as it represents a core component of nursing care.

Morality traits for an ideal nurse manager: A multicentre cross-sectional study.

AIMS: To investigate which morality traits are more important for nurses to determine positive opinions of their nurse manager. BACKGROUND: People selected morality more often than sociability and competence when forming a positive opinion towards an ideal or a newcomer manager. METHODS: A multicentre, cross-sectional study was carried out by administering two questionnaires to 775 nurses on the influence of morality, sociability and competence traits on their impression formation processes. RESULTS: Regarding nurses' perceptions about the morality, sociability and competence traits of an ideal nurse manager, the total score for morality was 20.0; for sociability, it was 14.2; and for competence, it was 19.6. For nurses' opinions about a new nurse manager, the total score of the morality section was 16.2, which was very similar to the total score of the competence section (mean = 16.1). CONCLUSION: Morality positively influences nurses' initial impression of an ideal manager, and though it seems to be a necessary condition, it is not sufficient by itself to support the nursing staff's perception towards a new manager. IMPLICATIONS FOR NURSING MANAGEMENT: Our findings could be useful in better understanding the role of morality in social perceptions and behavioural consequences of staff nurses towards their nurse manager.

Nursing Education: challenges and perspectives in a COVID-19 age.

The COVID-19 outbreak deeply changed our lives on different levels. Social restrictions and distancing shaped in a different way our view of social relationships and behaviours. Like many aspects of daily life, also education has undergone radical changes. Nursing care was strongly affected by the outbreak, not only due to the risks in everyday practice, the heavy workload or the impact on nurses' daily lives outside the healthcare settings, but also because nursing is caring profession and it embeds in its roots the close relationship with the patient, the touch, the patients' body proximity as a way to communicate and to deliver an effective nursing care. All these issues, when brought in nursing education are also a learning opportunity for students and a way to develop their professional identity and to focusing on the nursing role. The COVID-19 outbreak heavily hit the clinical learning environments, as they are healthcare settings. The situation affected students' learning opportunities, since clinical placements were suspended, Universities closed and in-person courses moved into online teaching. While lessons and courses rapidly switched into online teaching, in order to safeguard students' education and faculty's activity, it was not possible to manage the pre-clinical activities, such as simulations and labs, in order to support technical and relational competences. Most of all, it was not possible to arrange the clinical placements due to the uncertainty of the healthcare settings and the social and organizational restrictions to limiting unnecessary accesses to the services, as recommended by the American Association of Colleges of Nursing in 2020.Recently, many authors have explored the issues related to the future of nursing education. In detail, an emerging issue is how it will be possible to educating nurses in a society facing isolation and social distance measures, but at the same time, in a society that needs more and more prepared clinical nurses.

Nursing students' knowledge and attitudes of blood donation: A multicentre study.

AIMS AND OBJECTIVES: To investigate factors involved in the blood donation (BD) in a population of Italian nursing students (NSs). BACKGROUND: Young people are still numerically limited among potential blood donors. Recent research on this topic has underlined the need to promote recruitment programmes and focused advertising campaigns to specific targeted population. DESIGN: Cross-sectional study. The STROBE checklist was used to grant adequate and complete reporting of research. METHODS: The study was carried out in five Italian Universities, and a structured, 22-item questionnaire was distributed to 532 NSs (mean age = 24.64, SD = 7.41, min = 19; max = 55; population, female = 80.8% of total) to explore propensity, obstacles, knowledge of BD and to assess associations between variables. Descriptive (frequency, mean and SD) and inferential (χ2 ) statistics were conducted. RESULTS: The overall level of knowledge among NSs donors is high, when compared with non-donors (p < 0.05); the propensity for donation is acceptable (34.8% of the total are donors; mean = 3.17 donation). The obstacles perceived by participants are "practical" (20% and 22.8% think they do not have enough time to donate or are unsuitable because of lifestyle reasons; respectively). A relevant aspect regards the NSs' perceived role as future healthcare professionals to be responsible to educate and influence potential donors (81.5%). CONCLUSIONS: Specifically tailored BD campaigning should be implemented to sensitise University students. NSs could become effective motivators among students of different Universities or faculties. Thanks to their role and capability to put themselves in the peer group. NSs could contribute to the promotion of this selfless practice and to the development of a mature, responsible civic attitude. RELEVANCE TO CLINICAL PRACTICE: Nursing educators should play a pivotal role in developing teaching methods to promote BD among NSs.

Children's Perceptions About the Quality of Pediatric Nursing Care: A Large Multicenter Cross-Sectional Study.

INTRODUCTION: This study explored children's perceptions about the quality of nursing care and the determinants of their evaluations according to different categories of children's ages. DESIGN: Multicenter cross-sectional study carried out on 692 pediatric patients in eight large Italian regional hospitals. METHODS: We used a validated questionnaire, translated and adapted to the Italian context, consisting of 49 items (5-point Likert scale) exploring nurse characteristics, nursing activities, and nursing environment. FINDINGS: The mean score of children's perceptions of their overall experience of hospitalization was 3.96; the nurse characteristics factor obtained the highest score (mean = 3.79), and it was in positive correlation with the satisfaction level across different age categories: 4 to 6 years, ß = .37; 7 to 11 years, ß = .31; and 12 to 14 years, ß = .32. CONCLUSIONS: Nurse characteristics is the only significant factor contributing to children's satisfaction across the three different age categories. CLINICAL RELEVANCE: In pediatric nursing care, it is important to emphasize that nurses' personal characteristics and the ability to connect with children are essential compared to the ability to perform tasks.

Pathological Gambling among Italian Nursing Students.

PURPOSE: To investigate the role of psychiatric dimensions, behavioral or substance addictions and demographical variables as determinants of pathological gambling among nursing students. DESIGN: Multicenter cross-sectional study. METHODS: From June to October 2015 a survey was carried out among Italian Nursing students. Data were collected using a six-section tool. FINDINGS: Nursing students who completed the survey numbered 1083, 902 (83.3%) had some problems with gambling and 29 (2.7%) showed pathological gambling. Percentage of pathological gambling was significantly associate with illicit drug/alcohol use (65.5%; p=0.001) and with male gender (58.6%) comparing to student nurse with non-pathological gambling (20%) and those with some problem (24.2%). Significant main effect was observed for IAT score (Beta=0.119, t=3.28, p=0.001): higher IAT scores were associated with higher SOGS scores. CONCLUSIONS: Italian nursing students have some problems with gambling and pathological gambling problem, and males are those who have more problems. Results might be useful for faculties of health professionals to identify students at risk in an early stage, to direct prevention tailored interventions. CLINICAL RELEVANCE: Nursing faculties should be aware of the prevalence of Gambling among students. Prevention interventions should be planned to minimize the risk of gambling behavior in the future nurses' health care workers.

[Pathological gambling and internet addiction among nursing students: a pilot study]. / Gioco d'azzardo patologico e dipendenza da internet tra gli studenti infermieri: uno studio pilota.

AIM: To assess pathological gambling and Internet addiction among nursing students. METHOD: A monocentric, observational study was carried out from November 2013 to January 2014 at an Italian Nursing Degree Course using the Italian version of the South Oaks Gambling Screen (SOGS) to assess the risk to develop gambling, and the Internet Addiction Test (IAT) to assess the risk to develop Internet addiction. A total of 420 nursing students were enrolled. RESULTS: Two hundred eighty-three students (67.4%) participated; 11.3 % of participants were identified as ''at-risk'' of pathological gambling (SOGS scores of 1 to 4), whereas the 0.7 % of students were identified as probable pathological gamblers (SOGS scores ≥5). The prevalence of Internet addiction in the sample was 8.8% (IAT scores ≥50). Also, findings showed that students with Internet addiction had a higher risk of developing pathological gambling (B = 0,16; p = 0.005). CONCLUSIONS: The prevalence of pathological gambling and Internet addiction in our sample is relatively small. However, the percentage of students who could be at-risk for gambling and Internet addiction related problems is noteworthy. Further multicenter studies are needed to better understand the association between gambling and Internet addiction among nursing students.

Relationship between peripheral insertion site and catheter-related phlebitis in adult hospitalized patients: a systematic review.

AIM: To explore the relationship between the anatomical site of peripheral venous catheterization and risk of catheter-related phlebitis. BACKGROUND: Peripheral venous catheterization is frequently associated with phlebitis. Recent guidelines, recommend the use of an upper-extremity site for catheter insertion but no univocal consensus exists on the anatomical site with lower risk of phlebitis. DESIGN: Systematic review. METHODS: We searched Medline (PubMed) and CINAHL (EBSCOhost) databases until the end of January 2017. We also reviewed the reference lists of retrieved articles and gray literature was excluded. Searches were limited to articles published in English with no restriction imposed to date of publication. The primary outcome was the incidence of phlebitis associated with anatomical site of peripheral catheterization. We included randomized controlled trials and observational studies on adult patients who required a peripheral catheter for the administration of medi- cation, intermittent or continuous fluid infusion. RESULTS: Antecubital fossa veins are associated with lower phlebitis rates, while hands veins are the most risky sites to develop phlebitis. There is no consensus regarding vein in forearm. CONCLUSION: Choosing the right anatomical site to insert a peripheral venous catheter is important to decrease phlebitis rate. Further studies should compare indwelling time in different anatomical sites with phlebitis rate. A more standardized approach in defining and assessing phlebitis among studies is recommended.

Self-reported medication adherence and beliefs among elderly in multi-treatment: a cross-sectional study.

AIM: To evaluate the association between adherence to treatment and beliefs about medications in multi-treated elderly patients. BACKGROUND: A large body of evidence documented the importance of adherence to therapy in predicting clinical outcomes, and the association between adherence and medication beliefs in patients of various ages and with different health conditions. However, so far only a few studies have specifically investigated the associations between medication beliefs and adherence among elderly in polypharmacy. METHODS: In this multicenter cross-sectional study we used the MMAS-8 and BMQ Scales to assess medication adherence and beliefs about medications, respectively. RESULTS: The final sample consisted of 567 patients. Patients reporting higher levels of necessity or concerns about their medicines showed higher adherence (OR: 1.61, and 2.02, respectively; both p<.001). Accepting patients (high necessity and low concerns) were less likely (OR: 0.24; p<.001) to report adherence than ambivalent ones (high necessity and concerns). CONCLUSIONS: Medication adherence is related to high necessity and concern about treatment. In nursing practice it is important to understand the specific barriers to adherence and to engage patients in the implementation of strategies to improve adherence.

Work-engaged nurses for a better clinical learning environment: a ward-level analysis.

AIM: To correlate workgroup engagement in nursing teams and the clinical learning experience of nursing students. BACKGROUND: Work engagement plays a pivotal role in explaining motivational dynamics. Nursing education is workplace-based and, through their clinical placements, nursing students develop both their clinical competences and their professional identity. However, there is currently a lack of evidence on the role of work engagement related to students' learning experiences. METHODS: A total of 519 nurses and 519 nursing students were enrolled in hospital settings. The Utrecht Work Engagement Scale (UWES) was used to assess work engagement, and the Clinical Learning Environment and Supervision plus nurse Teacher (CLES+T) scale was used to assess students' learning experience. A multilevel linear regression analysis was performed. RESULTS: Group-level work engagement of nurses correlated with students' clinical learning experience (ß = 0.11, P < 0.001). Specifically, the 'absorption' and 'dedication' factors mostly contributed to enhancing clinical learning (respectively, ß = 0.37, P < 0.001 and ß = 0.20, P < 0.001). CONCLUSIONS: Nursing teams' work engagement is an important motivational factor to enhance effective nursing education. IMPLICATION FOR NURSING MANAGEMENT: Nursing education institutions and health-care settings need to conjointly work to build effective organisational climates. The results highlighted the importance of considering the group-level analysis to understand the most effective strategies of intervention for both organisations and nursing education.

[Percezione e soddisfazione degli studenti in Ostetricia al primo anno di tirocinio clinico: studio osservazionale multicentrico]. / Midwifery students' satisfaction and perception of their first clinical placement: multicentre observational study.

AIM: To explore the first year midwifery students' clinical learning experience and satisfaction; to analyse the association between students' satisfaction and individual motivation. METHOD: The multicentre cross-sectional study was carried out in four Italian midwifery degree courses. A convenience sample of 61 students filled out the Italian version of the "Clinical Learning Environment and Supervision plus Nurse Teacher (CLES+T) scale" after the conclusion of their first clinical placement. RESULTS: The mean values of the main sub-dimensions of CLES+T varied from 3.53 (peda- gogical atmosphere) to 3.08 (supervisory relationship). Students (68.9%) were mainly sati- sfied with their clinical placement. With regard to individual motivation, 27 students (44.3%) were motivated at the beginning of the clinical placement, and 31 students (50.8%) were highly motivated. Highly motivated students showed higher satisfaction levels (␣2 = 11,712, p = 0.019). CONCLUSIONS: The findings expand knowledge on the first year midwifery students' clinical learning experience Moreover, the results showed an association between initial student moti- vation and satisfaction that should be investigated through further multicenter studies.

[Cyberstalking among Italian nurses: a large multicentric study]. / Cyberstalking tra gli infermieri italiani: studio multicentrico.

SCOPO: Determinare la prevalenza di cyberstalking tra gli infermieri italiani e valutare il livello di ansia e depressione nelle vittime. METODO: Da aprile a settembre 2014 è stato condotto uno studio multicentrico trasversale in un campione di infermieri italiani (n=997) utilizzando il questionario "Cyberstalking" per analizzare il fenomeno del cyberstalking. Ai partecipanti, che si sono autodefinite vittime di cyberstalking, è stato chiesto anche di compilare gli strumenti "Beck Depression Inventory" e "State-Trait Anxiety Inventory" per valutare, rispettivamente, i livelli di depressione ed ansia. RISULTATI: La prevalenza di cyberstalking tra gli infermieri italiani è risultata pari al 23.3%. Il 42.7% ha dovuto cambiare il proprio stile di vita e lavorativo. Il cyberstalker era prevalentemente di sesso maschile (52%) e, nel 49% dei casi, era un paziente. Le vittime hanno riferito moderati livelli di ansia (media=28.4, SD=23.2) e depressione (media=92.7, SD=18.3); i risultati hanno mostrato un aumento dei livelli di depressione negli infermieri esperti nell'utilizzo del computer, gestori di siti web o blog, e una correlazione negativa tra il livello di ansia e gli infermieri esperti (r = -0.264). CONCLUSIONI: Il cyberstalking è un fenomeno che si riscontra frequentemente tra gli infermieri. Il rapporto infermiere - paziente gioca un ruolo centrale nello sviluppo del fenomeno e le vittime hanno riferito disordini correlati allo stress che influenzano la vita lavorativa. Questi risultati preliminari potrebbero sensibilizzare, i dirigenti ospedalieri, la politica e i centri antiviolenza al fine di sviluppare strategie risolutiv.

Cultural Competence Among Italian Nurses: A Multicentric Survey.

PURPOSE: To assess Italian nurses' cultural competence, as they are increasingly called upon to care for people of foreign origins. DESIGN: A cross-sectional, multicentric study. METHODS: From September 2013 to May 2014, a survey was carried out among Italian nurses. Cultural competence was assessed by the Cultural Competence Assessment tool, translated and adapted to the Italian context. FINDINGS: Nurses who completed the survey numbered 1,432; 70.6% were female; 42.6% ranged in age from 41 to 50 years; and 50.0% were bachelor's prepared. More than 50% had participated in some kind of cultural diversity training. Overall, cultural competence was moderate, showing a moderately high level of cultural awareness and sensitivity (mean = 5.41; SD = 0.66) and a moderate level of culturally competent behaviors (mean = 4.33; SD = 1.10). CONCLUSIONS: Although Italian nurses' cultural competence was acceptable, given the growing diversity of the patient population, nurses should be better prepared to face the changing health requests. CLINICAL RELEVANCE: Providing culturally competent care has been associated with improved provider-client communication, higher satisfaction with care, and health status improvement, as full comprehension of health status, adherence to medications and lifestyle recommendations, and appropriate utilization of the health system. Healthcare providers need to be adequately trained to provide culturally competent care. This research provides, for the first time, a report on Italian nurses' levels of cultural competence, and strengthens the current literature underlining the need for continuous education to enhance cultural competence among nurses.

Physical assessment techniques performed by Italian registered nurses: a quantitative survey.

AIMS AND OBJECTIVES: The aims of the study were to describe which of the core techniques of the physical assessment are regularly performed by a sample of Italian nurses, and to investigate the potential predictors of a more complete examination. BACKGROUND: Physical examination is among the essential tasks of nursing professionals, who are requested to perform a correct and complete physical assessment. DESIGN: Cross-sectional survey. METHODS: The study was performed between August 2013 and January 2014 in 17 Italian regions. A total of 1182 questionnaires were collected. RESULTS: Most participants were females (age range 41-50 years), and worked in Internal Medicine, Intensive Care and Surgical hospital units. Of the 30 core techniques that are currently taught and performed according to the Italian Baccalaureate degree requirements, 20 were routinely performed, 6 were seldom used and 4 were learnt but almost never performed (auscultation of lung, heart and bowel sounds and spine inspection). Graduate and postgraduate nurses, working in Intensive Care Units and Nursing Homes, were more prone than the others to carry out a more complete physical assessment. CONCLUSIONS: The skills to perform a physical assessment are suboptimal among this sample of Italian nurses. Health and educational providers should pose more attention and efforts to provide nurses with an acceptable training in physical examination practice. RELEVANCE TO CLINICAL PRACTICE: This study describes the specific physical techniques performed by nurses in real practice and provides information on which skills require more attention in nursing educational programmes.

[Nurses' experiences of stalking: a narrative review]. / Il fenomeno dello stalking in ambito infermieristico: una revisione narrativa della letteratura.

This narrative review aimed to synthetize the results of the main studies analysing nurses' experience of stalking in different clinical settings. We searched the electronic databases MEDLINE (through PubMed), CINAHL (through EBSCOhost) and the search engine "Google Scholar". Searches were limited to articles published in English and Italian, and published between 1999 and 2013. Stalking refers to a behavioural pattern characterized by persistent unwanted communications and contacts imposed to another person, which, consequently suffer from distress, fear, and anxiety. Several studies explored the risk of stalking in healthcare system, especially in doctors and psychiatrists. Some authors analysed nurses' experience of stalking with particular attention to mental health professionals as a group category with an increased risk of stalking by patients. Results of some studies carried out in different clinical settings (medical and surgical areas, and other healthcare settings) also revealed, even if in a minority, the presence of this phenomenon, showing the presence of staking's behaviours by patients and healthcare colleagues too. However, more researches with large sample size are needed to better understand the phenomenon of stalking in nurses working in different clinical areas.

Phlebitis risk varies by peripheral venous catheter site and increases after 96 hours: a large multi-centre prospective study.

AIMS: This multi-centre prospective field study evaluated whether peripheral venous catheter site of insertion influences the risk of catheter-related phlebitis. Potential predictors of phlebitis were also investigated. BACKGROUND: Millions of patients worldwide use peripheral venous catheters, which frequently cause local complications including phlebitis, infection and obstruction. Although phlebitis predictors have been broadly investigated, uncertainties remain on the potential effect of cannulation anatomical site, duration and the appropriate time for catheter removal. DESIGN: A prospective cohort design was carried out from January-June 2012. METHODS: The clinical course of each patient who received a new peripheral venous catheter for any cause in five Italian hospitals was followed by trained nurses until catheter removal. The presence of phlebitis was assessed every 24 hours using the Visual Infusion Phlebitis score. Analyses were based upon multilevel mixed-effects regression. RESULTS: The final sample consisted of 1498 patients. The average time for catheters in situ was 65·6 hours and 23·6% of the catheters were in place beyond 96 hours. Overall phlebitis incidence was 15·4%, 94·4% of which were grade 1. The likelihood of phlebitis independently increased with increasing catheter duration, being highest after 96 hours. Compared with patients with catheter placed in the dorsum of the hand (22·8% of the sample), those with the catheter located in the antecubital fossa (34·1%) or forearm were less likely to have a phlebitis of any grade. CONCLUSIONS: Antecubital fossa and forearm veins may be preferential sites for peripheral venous cannulation. Our results support Centers for Disease Control and Prevention recommendations to replace catheters in adults no later than 96 hours. A relevant proportion of healthcare personnel did not adhere to such guidelines - more attention to this issue is required.

Nurses' knowledge of evidence-based guidelines on the prevention of peripheral venous catheter-related infections: a multicentre survey.

AIMS AND OBJECTIVES: To evaluate nurses' knowledge of guidelines for preventing infections associated with peripheral venous catheters. BACKGROUND: Guidelines for the prevention of intravascular catheter-related infections are an important tool to help healthcare professionals minimise the risk of infection. However, they are not always applied by nurses. The literature on this topic is limited, and no study examined this matter for peripheral venous catheters. DESIGN: This cross-sectional study was carried out from November 2011-June 2012. METHODS: The nurses' knowledge of peripheral venous catheter guidelines and its association with gender, experience, education and the ward membership was assessed using a validated questionnaire. RESULTS: Sixteen hospitals from six regions of Italy participated, and 933 questionnaires were collected. Most participants were female (70·1%), undergraduate (51·8%), worked in medical (35·8%) and surgical departments (28·0%), and had >10 years of experience (55·0%). The median score on 10 questions was 6 of 10. A majority of nurses knew it is recommended to replace peripheral venous catheters routinely (90·0%), to perform an aseptic technique during connecting/disconnecting the infusive lines (55·2%), and to replace the administration set <24 hour when lipid emulsions have been infused (88·4%). Of note, 52·6% of nurses advocated the use of steel needles, a potentially dangerous practice. In multivariate analysis, a higher level of education and the area of work were associated with better test scores. CONCLUSION: The sample of nurses' knowledge to some recommendations is frequently low. This could be a potential risk factor for patient safety. The results should sensitise healthcare managers to improve nursing training and education, according to clinical risk management perspectives. RELEVANCE TO CLINICAL PRACTICE: These data request for more emphasis on international guidelines in infection prevention initiatives.

Workplace empowerment and nurses' job satisfaction: a systematic literature review.

AIMS: This systematic review aimed to synthesize and analyse the studies that examined the relationship between nurse empowerment and job satisfaction in the nursing work environment. BACKGROUND: Job dissatisfaction in the nursing work environment is the primary cause of nursing turnover. Job satisfaction has been linked to a high level of empowerment in nurses. EVALUATION: We reviewed 596 articles, written in English, that examined the relationship between structural empowerment, psychological empowerment and nurses' job satisfaction. Twelve articles were included in the final analysis. KEY ISSUE: A significant positive relation was found between empowerment and nurses' job satisfaction. Structural empowerment and psychological empowerment affect job satisfaction differently. CONCLUSION: A satisfying work environment for nurses is related to structural and psychological empowerment in the workplace. Structural empowerment is an antecedent of psychological empowerment and this relationship culminates in positive retention outcomes such as job satisfaction. IMPLICATION FOR NURSING MANAGEMENT: This review could be useful for guiding leaders' strategies to develop and maintain an empowering work environment that enhances job satisfaction. This could lead to nurse retention and positive organisational and patient outcomes.