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1.
J Adv Nurs ; 2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-38967383

RESUMEN

AIM: To describe the activities nurses perceived to be delegable to other staff (delegable activities) in order to estimate the time nurses spend on delegable activities and explore nurses' reasons for not delegating these activities. DESIGN: Mixed-methods explanatory sequential. METHODS: In total, 236 nurses from 27 medical and surgical wards of five hospitals in northern Italy completed a web-based survey during a single shift between June and July 2022. Minutes spent on delegable activities, staff member to whom participants could have delegated and reason(s) for not delegating were reported. Chief nurses provided specific wards' characteristics using a paper-and-pencil questionnaire. Twenty semi-structured interviews were conducted to explore delegable activities and reasons for not delegating. Quantitative and qualitative results were merged using joint displays. RESULTS: Participants spent approximately one-quarter of their time performing delegable activities, mainly delegable to nurse aides or nurse clerks, and performed due to a lack/shortage of staff or their concurrent participation in other activities. Participants recognized that activities requiring clinical assessment and decision-making skills cannot be delegated, whereas technical activities and indirect care should be delegated. Organizational, structural and cultural factors, as well as patient characteristics, available staff and experience affected delegation, leading nurses to perform delegable activities to ensure patient care. CONCLUSION: Nurses spend a considerable part of their time on delegable activities due to a lack of staff or support services and suboptimal organization, which could be addressed by optimal staff management, but also to the complexity of the contexts, including individual and cultural factors that should be addressed through policy interventions. IMPACT: This study estimates the time nurses spend on delegable activities in acute care settings. Our findings highlighted the reasons that sustain the decision not to delegate that policymakers, healthcare managers, and nurse educators should consider to promote nurses' delegation skills. REPORTING METHODS: MMR checklist. PATIENT/PUBLIC CONTRIBUTION: None.

4.
J Clin Epidemiol ; 152: 47-55, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36156301

RESUMEN

OBJECTIVES: To assess whether the use of the revised Cochrane risk of bias tool for randomized trials (RoB2) in systematic reviews (SRs) adheres to RoB2 guidance. METHODS: We searched MEDLINE, Embase, Cochrane Library from 2019 to May 2021 to identify SRs using RoB2. We analyzed methods and results sections to see whether risk of bias was assessed at outcome measure level and applied to primary outcomes of the SR as per RoB2 guidance. The relation between SR characteristics and adequacy of RoB2 use was examined by logistic regression analysis. RESULTS: Two hundred-eight SRs were included. We could assess adherence in 137 SRs as 12 declared using RoB2 but actually used RoB1 and 59 did not report the number of primary outcomes. The tool usage was adherent in 69.3% SRs. Considering SRs with multiple primary outcomes, adherence dropped to 28.8%. We found a positive association between RoB2 guidance adherence and the methodological quality of the reviews assessed by AMSTAR2 (p-for-trend 0.007). Multivariable regression analysis suggested journal impact factor [first quartile vs. other quartiles] was associated with RoB2 adherence (OR 0.34; 95% CI: 0.16-0.72). CONCLUSIONS: Many SRs did not adhere to RoB2 guidance as they applied the tool at the study level rather than at the outcome measure level. Lack of adherence was more likely among low and very low quality reviews.


Asunto(s)
Proyectos de Investigación , Informe de Investigación , Humanos , Revisiones Sistemáticas como Asunto , Sesgo , Estudios Epidemiológicos
5.
Recenti Prog Med ; 113(1): 30-35, 2022 01.
Artículo en Italiano | MEDLINE | ID: mdl-35044373

RESUMEN

This article is about current challenges to evidence-based medicine (EMB) in Italy. The authors, who share a 20-year commitment to the field of clinical research, discuss what they define as a phase of "stagnation" in practicing and teaching methods and research tactics, both in clinical and academic settings. Early success of EBM cultural movement was not persistent. The authors reason about how the teaching of EBM has remained a niche, concerning few professionals compared to the needs of the country. The authors identify some reasons that might have led to inconsistent attention to research methodology and address ways to strengthen the contribution of academic medicine to clinical research.


Asunto(s)
Medicina Basada en la Evidencia , Proyectos de Investigación , Medicina Basada en la Evidencia/métodos , Humanos , Italia
6.
Recenti Prog Med ; 112(5): 392-393, 2021 05.
Artículo en Italiano | MEDLINE | ID: mdl-34003192

RESUMEN

This story is a piece of a nurse's daily life, the encounter with a patient that will remain indelible for everyone during subsequent hospitalizations. His story has taught us, once again, how fundamental and helpful for everyone, not only for the patient, is the care relationship between the carers (doctors, nurses and support staff) and the patient.

7.
Prof Inferm ; 72(3): 181-186, 2019.
Artículo en Italiano | MEDLINE | ID: mdl-31883569

RESUMEN

INTRODUCTION: Coronary interventions and electrophysiology procedures may be painful both during and shortly after the procedure. AIM: To assess the onset of pain and anxiety in patient undergoing coronary interventions and electrophysiology procedures; to describe the administration (frequency, timing, dosage and outcomes) of analgesics and anxiolytics before, during and after the procedure. METHODS: A descriptive multicenter study was carried out. Pain and anxiety were measured with a 10-point visual analogue scale (VAS) before, during, after the procedure and for the following 24 hours. Patient were asked to rate their satisfaction for the information received and pain control. RESULTS: Data on 230 patients were collected. The most performed procedure was the transradial coronary catheterization (68.7%). The pacemaker/defibrillator implantation resulted the most painful procedure (median 4, IQR 3-6) and also the most anxious (median 5, IQR 2-6). 13 Patients received an analgesic during the procedure for a low-to-severe pain; during the following 24 hours 34 patients (5 undergoing transradial coronary catheterization and 29 the implant of pacemaker/cardiac-defibrillator) suffered from severe pain and with the exception of 5, all requested pain relief. Satisfaction for pain control was inadequate for patients who underwent electrophysiology procedures and 55 patients would have needed more information on pain. CONCLUSION: Pain control and patient satisfaction may be improved, pre-procedural anxiety needs more attention and better information on the procedure should be provided.


Asunto(s)
Analgésicos/administración & dosificación , Ansiolíticos/administración & dosificación , Ansiedad/prevención & control , Dolor Asociado a Procedimientos Médicos/prevención & control , Anciano , Ansiedad/etiología , Cateterismo Cardíaco/efectos adversos , Cateterismo Cardíaco/métodos , Técnicas Electrofisiológicas Cardíacas/efectos adversos , Técnicas Electrofisiológicas Cardíacas/métodos , Femenino , Humanos , Masculino , Dimensión del Dolor , Dolor Asociado a Procedimientos Médicos/epidemiología , Dolor Asociado a Procedimientos Médicos/psicología , Satisfacción del Paciente
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