[The resignations among nurses in the Veneto healthcare institutions. A retrospective study]. / Il fenomeno delle dimissioni tra gli infermieri nelle Aziende Sanitarie del Veneto. Uno studio retrospettivo.

. The resignations among nurses in the Veneto healthcare institutions. A retrospective study. INTRODUCTION: The phenomenon of large-scale resignations is complex, heterogeneous and cannot be attributed solely to the pandemic crisis, during which many people reconsidered the role of work in their lives. The health system was particularly exposed to the shocks caused by the pandemic. AIMS: To describe the turnover and analyse the resignations of nurses in the NHS hospitals and districts of the Veneto Region. METHODS: The hospitals were categorised into 4 types: Hub and Spoke of level 1 and 2. The positions of nurses with permanent contracts between 1 January 2016 and 31 December 2022 were analysed, considering active, nurses on duty for at least one day. The data were extracted from the human resource management database of the Region. Unexpected resignations were considered those occurring before the retirement date (59 years for women and 60 for men). Negative and overall turnover rates were calculated. RESULTS: The risk of unexpected resignations was increased for nurses not resident in Veneto, of male gender and employed at a Hub hospital. CONCLUSIONS: The flight from the NHS is in addition to the physiological flow of retirements, due to increase in the coming years. It is necessary to: act on the retention capacity and attractiveness of the profession; implement organisational models based on task sharing and shifting; implement digital tools; favour flexibility and mobility to improve the balance between work and personal life; efficiently integrate professionals quali-fied abroad.

[Measuring nursing sensitive outcomes in publicly funded hospitals in the Veneto Region, Italy: the development of a regional policy]. / Misurare gli esiti dell'assistenza infermieristica nelle Aziende Ospedaliere e Socio Sanitarie Locali della Regione del Veneto: sintesi dell'esperienza di sviluppo di una policy regionale.

INTRODUCTION: The indicators used in the Italian National Outcome Strategy does not include measurement of nursing care outcomes so these have not yet been assessed systematically in our country but only in the context of specific research projects. Positive and negative outcomes of nursing care have been documented in the literature, the latter associated with missed nursing care, a phenomenon that occurs when conditions are such that nurses are unable to deliver planned care to patients. OBJECTIVES: To describe the rationale, methodology and main results achieved to date in the development of a regional policy aimed at establishing a panel of indicators for monitoring nursing care-sensitive outcomes hospitals in publicly funded hospitals in the Veneto Region (northern Italy). METHODS: A plurennial, multi-method project based on [1] identification of selection criteria for a Minimum Data Set of indicators; [2] a rapid review of the literature and of the policies established internationally to measure nursing care-sensitive outcomes; [3] the establishment of an initial panel of indicators and evaluation of any critical issues with the chosen indicators, and [4] identification of the most appropriate tool for measuring missed nursing care. RESULTS: The medical and surgical units were considered to be the most suitable settings for the pilot study. Following the literature review, indicators that were already being monitored in the current regional information system were chosen, with the intent to prevent an additional administrative burden to nurses. By using a progressive consensus process, five outcome indicators (functional status, falls, pressure sores, urinary tract infections, aspiration pneumonia) and one process indicator (missed nursing care) were selected., and the tools for measuring the above-mentioned indicators and their related risks, were identified. A regional policy was then established to measure these indicators in a pilot phase, with the intent of implementing them as stable indicators to be measured in the new computerized hospital information system. CONCLUSIONS: An initial panel of nursing-sensitive outcome indicators has been defined to be used in Internal Medicine and General Surgery units of hospitals in Italy's Veneto Region. Despite its limitations, the project represents the first effort to create a regional policy to measure the contribution of nursing care to the health outcomes of patients and that will also the identification of potential relations with other variables such as personnel staffing and/or skill mix.