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.

[Survey on follow-up of new born babies after the discharge from the birth centres of the Ligurian public hospitals]. / Studio descrittivo sul follow-up post-dimissione dei nati sani a termine nei centri nascita degli ospedali pubblici liguri.

INTRODUCTION: Continuity of care in the postpartum period is strongly recommended by international guidelines. Several studies demonstrate how an individualized follow-up program may decrease newborn's mortality and morbidity and prevent or early identify chronic diseases or diseases with long-term effects for mother, newborn and family. In Italy the lastest recommendations on postnatal care of mothers and newborns have been relea- sed in 2000. AIM: To describe the organization of healthy term newborns post-discharge follow-up in the 10 birth centers of Ligurian public hospitals. METHODS: Descriptive study, conducted in 2015 through telephonic interview with head nurses (or their delegates) of the centers. RESULTS: All 10 birth centers participated in the study recommend a follow-up visit, but only half have a formalized procedure for follow-up. Most of them recommend the first follow-up visit within 2-3 days from discharge. Half of centers provide the first follow-up visit at the birth center's clinic, three don't recommend follow-up visits after the first one. None of them links the follow-up visit of the newborn with the mother's one; usually the needs of mother and newborn are identified and met by pediatric nurses, nurses and neonatologist. All the centers provide a telephone number for post-discharge needs. Two centers make calls to mothers considered to be at risk of postpartum depression. DISCUSSION: The study describes different newborn care pathways related to follow-up after discharge in the Ligurian birth centers. At the moment there is no homogeneous implementation of the interventions recommended at national level.

[Survey of secondary school students 18 years old or older about knowledge on risks to the fetus related to alcohol consumption during pregnancy]. / Indagine tra gli studenti maggiorenni sulle conoscenze sui rischi per il feto legati al consumo di sostanze alcoliche in gravidanza.

INTRODUCTION:  Being not perceived as risky for health, alcohol consumption is socially accepted worldwide. Nevertheless, related risks for the fetus are relevant, even for occasional use. In Italy there is a high consumption of alcohol among young people and pregnant women, and an increasing number of children born with alcohol-related disorders. AIM: To investigate the knowledge on fetal alcohol-related disorders among students over 18 years of age in a regional capital in the North of Italy. METHODS: In May, 2015, a survey with an online, validated questionnaire was conducted on N=1321 students. RESULTS:  A total of N=246 valid questionnaires was obtained (18,6%). The 76,4% of students knew that drinking alcohol during pregnancy damages fetus, but only the 23,5% knew that this damages are permanent. Only the 43,5% knew that this damages are preventable; of them, the 77,6% stated that the only way to prevent them is abstention from alcohol consumption, though 30,1% answered that alcohol use is allowed without damage the fetus. Only the 17,5% answered to know Fetal Alcohol Spectrum Disorders. CONCLUSION:  The study showed satisfying knowledge on general aspects, but scarce on specific ones, and a limited awareness that only complete abstinence from alcohol when pregnant can prevent irreversible damages of the fetus. This results could help to program educational interventions for teenagers, carried out by nurses, pediatric nurses and other health professionals to increase their knowledge and prevent in utero exposure. Future studies could be aimed at identifying the most effective educational methods to do so.

Factors influencing self-management in patients with type 2 diabetes: a quantitative systematic review protocol.

AIM: To describe a protocol for a quantitative systematic review, to identify critique and summarize factors that influence self-management education. BACKGROUND: Self-management education enables patients to manage their condition successfully and it is associated with better self-care, good control over lifestyle and leading the best possible quality of life, notwithstanding the presence of a chronic disease. Type II Diabetes is a chronic disease that requires lifestyle adjustments and disease management to keep glycaemia and long-term complications under control. Education has to be customized and based on an assessment that includes factors influencing self-management, such as personal characteristics that can optimize the educational intervention. DESIGN: The protocol for the systematic review was conducted according to the guidelines of the Centre for Reviews and Dissemination, York (UK). METHOD: The review question was defined in terms of population, interventions, comparators, outcomes and study designs. The protocol included decisions about the review question, inclusion criteria, search strategy, study selection, data extraction, quality assessment, data synthesis and plans for dissemination. Funding for the review was confirmed on January 2011 by the Centre of Excellence for Nursing Scholarship in Rome. DISCUSSION: An initial summary will be made by tabulating the data; the review will be reported in a narrative style and be developed according to the PRISMA guidelines. The protocol for the systematic review will allow us to identify, among the factors influencing self-management in people with Type II diabetes, the personal characteristics most relevant to the factors of motivation and empowerment. In addition, the systematic review will also identify an appropriate self-management model.

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.

[Falls of paediatric in- and out-patients in hospital: an Italian survey]. / Le cadute pediatriche in ospedale: una indagine italiana.

Falls can be considered as the most relevant accident for frequency and severity among in-hospital paediatric accidents (0-18 years). There is still a lack of a common framework in defining and categorizing paediatric falls across European and Italian paediatric centres. The aim of this survey was to explore key aspects of paediatric in-hospital falls in a number of Italian paediatric facilities. In 2010, a questionnaire was sent to 15 paediatric centres selected through convenience sampling. Fourteen questionnaires (93.3%) were returned, six centres (42.9%) define clearly the term "fall", while 8 (57.1%) declare to track falls frequency; three (21.4%) trace the consequences of falls. Four centres (28.6%) track the impact of falls on care plans. Usually information on falls and on children are collected (10 centres, 71.4%) and reporting procedures are frequently in place (10, 71.4%); whereas, fall management procedures (5 centres, 35.7%) are rarely in place. Five centres (35.7%) use a paediatric fall risk assessment tool (devised by the centre itself, and not validated); none of the implemented prevention measures for high-risk patients evaluate effectiveness. Data show a lack or no consistency of paediatric fall-related practices in Italian paediatric facilities, this phenomenon its impact on care plans and healthcare costs is therefore difficult to evaluate, as well as making a comparison between facilities. Collaboration among major paediatric centres should be encouraged in order to establish a common framework and share approaches.

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.

Knowledge of gestational alcohol drinking risks: results from a survey among Italian secondary school students.

INTRODUCTION: Ethanol is the most widely used drug worldwide. Its consumption has been increasing, and it is reported even during childbearing. Prenatal exposure to ethanol can lead to irreversible damages of the fetus. Knowledge about this risk could prevent these damages. There is no information about knowledge of the Italian students on this issue. METHODS: Therefore the aim of this study was to describe the awareness of the Italian students attending the last year of secondary school about risk of gestational alcohol drinking for the delivering mother and the fetus. An online multiple-choice anonymous survey for students was used and e-mailed to the all Italian secondary schools. RESULTS: The respondents were 9.921 and the obtained results evidenced that that young females are more informed than males, and students in Northern and Central Italy are better informed than those in the South, especially on general aspects. The most of respondents knows that alcohol consumption during pregnancy can damage the fetus. However, many youngsters failed to translate this belief into the practice. CONCLUSIONS: In conclusion, interventions are needed to enhance knowledge and prevent these damages, and health professionals, with nurses in the first row are entitled to provide education on this topic.

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.