Community Health Assessment Tools Adoptable in Nursing Practice: A Scoping Review.

The WHO European Region defined the role of a new central professional for primary care, the Family and Community Nurse (FCN). The introduction of an FCN in the framework of health policies highlights a key role of nurses in addressing the needs of families and communities. A scoping review was conducted in order to identify and describe the available tools which have been adopted for the assessment of community health needs by FCNs. A comprehensive literature review on the Embase, Cochrane Library, PubMed, CINAHL, Scopus and PsycInfo databases was conducted including all studies up to May 2021. A total of 1563 studies were identified and 36 of them were included. The literature review made it possible to identify studies employing twelve different community assessment tools or modalities. Referring to the WHO framework proposed in 2001, some common themes have been identified with an uneven distribution, such as profiling the population, deciding on priorities for action and public healthcare programs, implementing the planned activities, an evaluation of the health outcomes, multidisciplinary activity, flexibility and involving the community. To the best of our knowledge, this work is the first attempt to provide an overview of community assessment tools, keeping the guidance provided by the WHO as a reference.

Electronic nursing care plans through the use of NANDA, NOC, and NIC taxonomies in community setting: A descriptive study in northern Italy.

PURPOSE: To carry on a descriptive analysis of nursing standardized language through the use of a software within outpatient facilities in northern Italy, organized according to the Chronic Care Model (CCM) and called Community Health Centers (CHC). METHODS: A descriptive design was adopted for the study. NANDA-I, NOC, and NIC taxonomies have been used to analyze care plans pulled from the software. Both qualitative and quantitative data were analyzed. FINDINGS: The average of nursing diagnosis correctly identified with respect to the nursing assessment is 83.7% (SD 29.9%). Class 4 diagnoses from Domains 4 have been identified as the most prevalent (22.4%), followed by risk for unstable blood glucose level 00179 (16.4%) and risk for overweight 00234 (13%). The main nursing outcomes were vital signs 0802 (22.5%), blood glucose level 2300 (16%), and weight loss behavior 1627 (11%). The most prevalent nursing interventions are wound care 3660 (27%), medication administration: intramuscular 2313 (19%), and health education 5510 (14%). The analysis shows ability in identifying nursing diagnoses, but a larger variability with outcomes and interventions. The study highlights the nursing role within CHC and identifies the main areas of expertise in chronic disease management: prevention and health education. CONCLUSIONS: Nurses' role is fundamental for chronic disease management within CHC; NANDA-I taxonomy helps to analyze care plans. IMPLICATIONS FOR NURSING PRACTICE: - A taxonomy such as NANDA-I represents a valid opportunity to make more visible how much nursing skills affect the achievement of a higher level of health in chronic patients. - This study is useful in the further training of outpatient nurses who works in CHC. - The study represents the starting point for future research to deepen the development of a standardized nursing language in outpatient facilities.

SCOPO: Effettuare un'analisi descrittiva del linguaggio infermieristico standardizzato attraverso l'utilizzo di un software all'interno di strutture ambulatoriali del nord Italia, organizzate secondo il Chronic Care Model (CCM) e denominate Case della Salute (CdS). METODI: Per lo studio è stato adottato un disegno descrittivo. Le tassonomie NANDA-I, NOC e NIC sono state utilizzate per analizzare i piani di assistenza estratti dal software. Sono stati analizzati dati sia qualitativi che quantitativi. RISULTATI: La media delle diagnosi infermieristiche correttamente identificate rispetto all'accertamento infermieristico è dell'83,7% (DS 29,9%). Le diagnosi di classe 4 dominio 4 sono state identificate come le più prevalenti (22,4%), seguite da 00179 (16,4%) e 00234 (13%). I principali esiti infermieristici sono stati 0802 (22,5%), 2300 (16%) e 1627 (11%). Gli interventi infermieristici più diffusi sono 3660 (27%), 2313 (19%) e 5510 (14%). L'analisi di adeguatezza mostra la capacità di identificare le diagnosi infermieristiche, ma una maggiore variabilità con i risultati e gli interventi. Lo studio evidenzia il ruolo infermieristico all'interno delle CdS e identifica le principali aree di competenza nella gestione delle malattie croniche: prevenzione ed educazione sanitaria. CONCLUSIONI: Il ruolo degli infermieri è fondamentale per la gestione delle malattie croniche all'interno delle CdS; La tassonomia NANDA-I aiuta ad analizzare i piani di cura. IMPLICAZIONI PER LA PRATICA INFERMIERISTICA: - L'utilizzo di una tassonomia condivisa e standardizzata come NANDA-I nella creazione dei piani di assistenza rappresenta una valida opportunità per rendere più visibile quanto le competenze infermieristiche influenzino il raggiungimento di un livello più alto di salute e benessere nei pazienti cronici trattati nelle CdS. - Questo studio è utile per la formazione degli infermieri ambulatoriali e per quelli che lavoreranno lì. - Lo studio rappresenta il punto di partenza per future ricerche per approfondire ulteriormente, magari a livello multicentrico, lo sviluppo di un linguaggio infermieristico standardizzato attraverso la creazione di piani di assistenza infermieristica basati sulla tassonomia NANDA-I.

The Family and Community Nurse Core Competencies: integrating European standards into the Italian context.

The SARS-Cov-2 pandemic has restored the attention of policy-makers on the essentiality of Primary Care and the need of the Family and Community Nurses (FCNs), in order to ensure the proactive interception of individuals, families and community needs. In Italy, the Decree-Law no.34 of 19 May 2020 was issued, officially introducing the FCN. Therafter, it has been elaborated the "Address lines of the FCN proposal", starting from the "Position Statement on Family and Community Nurses" of the Italian National Federation of Nursing Professions Orders. In Europe, the ENhANCE (EuropeaN-curriculum-for-fAmily-aNd-Community-nursE) project has defined a standardized professional profile of the FCNs, based on specific Core Competencies. The aim of this work was to investigate and integrate the differences between the two profiles. In order to carry out this comparison, these competencies were compared and integrated with those identified by the Tuning model (TM), which identifies the knowledge, the skills and the attitudes that all newly graduated nurses must have acquired at the end of their education programme. Nine of the eleven italian competencies are included among the twenty-eight competencies of ENhANCE. The same applies to two of three competencies identified in the TM. As a result, this benchmark has resulted in a list of 30 competencies. This benchmark integrates the european profile with the national one, also oriented to their effective applicability in educational setting thanks to the TM. Through this comparison it is possible to develop professional educational projects, in order to standardize the grounding process on the national context.

[Identification of Nursing Diagnosis "Non compliance (00079)" and "Ineffective Self-Health Management (00078)": Pilot study]. / L'identificazione delle Diagnosi Infermieristiche "Non Adesione (00079)" e "Inefficace Autogestione della Salute (00078)": Studio pilota.

OBJECTIVES: Survey on a sample of second and third years nursing students, data concerning skills in identifying nursing diagnosis "Ineffective Self-Health management (00078)" and "Non compliance (00079)". The main objectives were to determine differences and similarities between the two diagnosis detected by students, to recognize which elements taken into account to identify them and to determine possible causes of misidentification. METHODS: Semi structured interview with analisys of a clinical case. RESULTS: Lacking knowledge was found regarding both diagnosis. Students stated to have some difficulties to understand and identify diagnosis; most of the them interviewed tend to confuse these two diagnosis precisely because they do not discern the differences. Despite that, most of them succeded in identifying the correct diagnosis in reference to the proposed clinical case, and were able to justify properly the choices made. CONCLUSIONS: The study highlights the need to develop students' skills for the identification of the two diagnoses. There is a overall confusion in describing patient's health conditions, this leads to an innapropriate identification of nursing goals and interventions and to an not efficient delivery of care. Improving actions should be addressed to the causes of a difficult differential identification. Educator therefore should be focus on learning development in order to change knowledge, attitudes and beliefs, perception of self-efficacy, but also in clinical practice in order to improve cognitive skills on nursing diagnosis.

[Clinical practice quality in BNC (Bachelor of Nursing Course). Evaluation of students' satisfaction in the Italian Red Cross School of Nursing, University of Bologna]. / La qualità del tirocinio nel Corso di Laurea in Infermieristica. Indagine sulla soddisfazione degli studenti della Sezione Formativa Bologna 1-Croce Rossa Italiana, Università degli Studi di Bologna.

This study is linked to the previous our "UNI EN ISO 9001:2000 quality system. Project and application at BNC (Bachelor of nursing Course), University of Bologna: degree of satisfaction of third year's students". The aim of this study, carried on in 2006, were to find out how satisfied second (n=61) and third years (n=95) nursing bachelor course students, University of Bologna, were with their clinical practice, about each essential element in this kind of learning. The data were collected using a questionnaire purposely made, with 48 items in 9 fields. 279 questionnaires returned ,79 by second year students and 190 by third year students. Results suggest a general satisfaction of students about their clinical practice experiences. Also in this study, the intermediate evaluation, very important in nursing clinical learning, is a critical variable.

[Planning and application of a valutation methodology in UNI EN ISO 9001:2000 quality system, for the analysis satisfaction level of third-year student University of Bologna, Bachelor of Nursing Course, CRI School of Nursing formative section]. / Progettazione e applicazione di una metodologia di valutazione,all'interno del sistema qualità UNI EN ISO 9001:2000, per l'analisi del livello di soddisfazione dello studente del terzo anno, Università di Bologna Laurea in Infermieristica, Sezione formativa CRI Scuola Infermieri.

The quality of nursing assistance is closely related to the quality of training. In the certification UNI EN ISO 9001:2000 in 2004 of the Bologna nursing school regarding Planning and performance of theoretical-practical nursing training a continual improvement of the product/service is implicit. A method was therefore devised to evaluate the degree of satisfaction in third-year nursing students in Bologna which demonstrated a medium/high level of satisfaction regarding all teaching-related procedures. By monitoring satisfaction levels , it is possible to identify any critical areas and to implement improvement where needed.