Infections and Smartphone Use in Nursing Practice: A Systematic Review.

AIM: Nurses use their smartphones during the work shift. The objective of this review is to investigate the presence of bacteria on mobile phones and the procedures to disinfect or decontaminate the smartphone and decrease the infection rate. METHOD: This systematic review was carried out through a search on the main scientific databases by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research was conducted by considering articles published in the last ten years. RESULTS: Of 502 initial articles, 489 were excluded and 12 articles were considered relevant. Twelve articles were included in the review. The analysis of the studies showed a high contamination of pathogenic microorganisms on the device's surfaces, most of which appear to be antibiotic resistant. The use of smartphones during clinical practice increases the risk of contracting nosocomial infections. The presence of bacteria on mobile phones and their use favors the cross-transmission of microorganisms. CONCLUSION: Onset prevention is a primary goal for the entire multidisciplinary team. There are no protocols concerning smartphones disinfection during clinical practice, but their implementation would reduce the incidence by improving nursing care.

Fatigue in Kidney Transplantation: A Systematic Review and Meta-Analysis.

Fatigue is still present in up to 40-50% of kidney transplant recipients (KTR), the results of studies comparing the prevalence among patients on hemodialysis (HD) and KTR led to conflicting results. Fatigue correlates include inflammation, symptoms of depression, sleep disorders and obesity. Fatigue in KTR leads to significant functional impairment, it is common among KTR poorly adherent to immunosuppressive therapy and is associated with a serious deterioration of quality of life. The following databases were searched for relevant studies up to November 2020: Medline, PubMed, Web of Science and the Cochrane Library. Several studies have compared the prevalence and severity of fatigue between KTR and hemodialysis or healthy patients. They have shown that fatigue determines a significant functional deterioration with less chance of having a paid job and a significant change in quality of life. The aim of the review is to report methods to assess fatigue and its prevalence in KTR patients, compared to HD subjects and define the effects of fatigue on health status and daily life. There is no evidence of studies on the treatment of this symptom in KTR. Efforts to identify and treat fatigue should be a priority to improve the quality of life of KTR.

The opinions and feelings about their educational needs and role of familial caregivers of Parkinson's Disease patients: a qualitative study.

BACKGROUND AND AIM OF THE WORK: In the advanced stages of Parkinson's Disease, patients need complex care and support, especially at home, where they often receive assistance by familial caregivers. However, caregivers may be or feel unable to cope with their role and, despite the needs of caregivers are often assessed in the literature, their opinions and feelings about these needs are not widely explored yet. This study aimed at exploring the opinions and feelings about their educational needs and role of familial caregivers of Parkinson's Disease patients. METHODS: A qualitative study was conducted from October to December 2017 in a polyclinic of central Italy. Fourteen caregivers voluntarily participated in the study; semi-structured face-to-face interviews were conducted, and audio recorded until data saturation. Two investigators reviewed the transcribed notes, created Meaning Units, Sub-categories and finally the Categories with emerged themes. RESULTS: The analysis of the 14 interviews generated three categories: supportiveness of healthcare educational programs; sense of inability to manage caregiver tasks; need for interaction with other familial caregivers. CONCLUSIONS: The caregivers declared their belief that healthcare educational courses can be useful in helping them live and understand the caregiving tasks and expressed their need to share their experiences with other caregivers. In fact, they often they felt abandoned and poorly trained for the patient's management at the home. The clinical practice should allow healthcare professionals to meet the training and emotional needs of caregivers and create a trust relationship with them to make caregivers skilled in caring for patients.

Effectiveness of implementing link nurses and audits and feedback to improve nurses' compliance with standard precautions: A cluster randomized controlled trial.

BACKGROUND: To prevent health care-associated infections, health organizations recommend that health care workers stringently observe standard precautions (SPs). Nevertheless, compliance with SPs is still suboptimal, emphasizing the need for improvement interventions. METHODS: A cluster randomized controlled trial with a pretest-post-test design was conducted with 121 clinical nurses who worked in different wards of a university hospital. The intervention group (n = 61) had 3 infection control link nurses nominated and attended systematic audits and feedback. The control group (n = 60) received only the standard multimodal approach used in the hospital. Pre- and post-test assessment of SPs compliance was performed via the World Health Organization observational hand hygiene form and Compliance with Standard Precaution Scale Italian version. RESULTS: At the post-test, nurses in the intervention group reported significantly increased compliance with hand hygiene, whereas no significant improvement was found in the control group. Nurses in both groups reported significantly increased Compliance with Standard Precaution Scale Italian version scores; however, a higher increase and practical significance was observed in the intervention group. Participants who improved their scores were also compared between groups, showing a significantly greater increase of individual scores in intervention group compared to the control group. CONCLUSIONS: The findings of this study provide significant practical implications for hospitals seeking to improve compliance with SPs among nurses, showing the effectiveness of using infection control link nurses combined with systematic audits and feedback.

Stress-related vulnerability and usefulness of healthcare education in Parkinson's disease: The perception of a group of family caregivers, a cross-sectional study.

Parkinson's Disease is associated with a high assistive complexity, thus generating in caregivers a burden proportional to the intensity of the care provided. This study aims to evaluate whether the stress-related level of caregivers is related to their perception of the need for healthcare education. A cross-sectional study was conducted on 69 family caregivers that completed the Stress-related Vulnerability Scale (SVS scale) with a tool of proposed interventions stratified according to caregivers' need as "nothing", "somewhat", "moderately" and "extremely". A direct association between the SVS scale and the perception of the usefulness of interventions was detected, and significant differences were observed for "Caregivers tele-support group" and "Peer-led support group" interventions, thus suggesting an important role for caregivers' emotional status in considering of training courses. Caregivers are split between low vulnerability, with minimal perception of training need, and high burden state with the acute necessity of support to manage patients.

Experiences of compliance with standard precautions during emergencies: A qualitative study of nurses working in intensive care units.

Aim To explore factors that influence intensive care nurses' experiences of being compliant with standard precautions (SP) during emergencies. BACKGROUND: Intensive care nurses can be exposed to a greater risk of biohazardous exposure during an emergency. The primary strategy to address the complex variety of biological hazards in clinical practice is represented by the implementation of SP guidelines. Previous research has indicated that nurses' compliance rates with SPs are suboptimal, but no study has focused on the factors influencing compliance during an emergency. DESIGN: A descriptive qualitative study was conducted in an Italian university hospital with 19 intensive care nurses who had at least two years of work experience in critical care. The nurses were interviewed in four focus groups and were asked about their experiences of being compliant with SPs during an emergency. Data were analyzed using conventional content analysis. RESULTS: Three themes emerged: conflict, competencies, and context. Conflict was reported regarding the need to save the patient and the need for self-protection through the use of SPs. In particular, nurses had to manage the pressure of limited time. Competencies were identified by nurses' knowledge, attitude, skills, training, and experience. Context was related to the work and organizational conditions during the emergency, including overcrowding. CONCLUSION: To support intensive care nurses' compliance with SPs during emergencies, conflict, competencies, and context should be audited regularly in clinical practice. The findings of this study could inform infection control programs and training that targets intensive care nurses.

Compliance with Standard Precautions among Clinical Nurses: Validity and Reliability of the Italian Version of the Compliance with Standard Precautions Scale (CSPS-It).

BACKGROUND: The compliance with Standard Precautions (SPs) guidelines, as a primary strategy for the prevention of healthcare associated infections, is still suboptimal among healthcare providers. However, no instrument measuring nurses' compliance with SPs is available in Italian. This study aims to assess the validity and reliability of the Compliance with Standard Precaution Scale⁻Italian version (CSPS-It) among clinical nurses. METHODS: The study consisted of two phases: (1) translation and cross-cultural adaptation of the CSPS; (2) validity and reliability evaluation of the CSPS-It. Confirmatory factor analysis (CFA) and hypothesis testing were performed to evaluate the construct validity. Cronbach's alpha, intra-class correlation coefficient of test-retest scores, and item-total correlations were computed to establish reliability. RESULTS: The CSPS-It showed a sound validity and reliability. The unidimensional model tested at CFA yielded acceptable fit indices. The hypothesis testing supported better nurses' compliance based on participation in at least one training course on SPs. CONCLUSIONS: The CSPS-It is a valid and reliable instrument for measuring the compliance with SPs among clinical nurses. This version will allow for the conduction of further studies in favor of progress in this specific field of research. Managers should pay greater attention in monitoring compliance with SPs among clinical nurses.

A Mobile App for the Remote Monitoring and Assistance of Patients with Parkinson's Disease and their Caregivers.

The remote monitoring of patients is based on digital systems that enable the remote collection, usually at home, of health data and its transmission to health centers. The telemedicine paradigm is of particular interest in chronic diseases, fragile population and elderly monitoring. Parkinson's disease (PD) is a neurodegenerative disorder having high impact on the lives of patients and their families. Such a disease impacts on the physical and psychological abilities of the patient and may have an effect on the relationship among family members. The strict monitoring of PD patients and their caregivers is of paramount importance in the implementation of prompt actions counteracting the worsening of the disease or that of the caring process. In this paper we present a mobile App developed for PD patients and their caregiver. The App aims at improving the communication among the patient/caregiver and the specialists, covering aspects related to both the disease symptoms and the caring process. In the paper we describe the App along with results collected during a one year experimentation on a cohort of 10 patients and 7 caregivers. The results show that the approach is accepted by patients and caregivers. Furthermore, obtained results demonstrate that the monitoring system is effective in the identification of dangerous conditions for the patient and useful in the implementation of reactive health management strategies.

The effects of a multidisciplinary education course on the burden, health literacy and needs of family caregivers.

Chronic diseases are mostly managed by family caregivers that often face the "caregiver burden". This study aimed to understand whether a multidisciplinary theoretical-practical training course could influence the burden, health literacy and needs of caregivers. Seventy-six familial caregivers were asked to complete the Caregiver Burden Inventory-CBI, Caregiver Needs Assessment-CNA, and Health Literacy Questionnaire-HLQ, before and after the course. A significant decrease in CBI and an increase of CNA were observed. However, a significantly higher rate of CBI decrease and a lower increase of CNA were detected in the neurological compared to the oncological group (p = 0.001). Moreover, the ability of the participants to look for and find health information significantly improved. The course contrasted caregivers' burden, increased their search for health information, and revealed their requiring of training and emotional and social support. Caregiver education plays a pivotal role in the management of chronic patients, enhancing the quality of life of both patients and caregivers.