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1.
J Transcult Nurs ; : 1043659619889118, 2019 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-31752617

RESUMEN

Introduction: In recent decades, Italy has been exposed to significant migrant flows resulting from political and economic instability in neighbouring countries. As a result, there has been an increased amount of cultural and linguistic diversity (CALD) among nursing students. The aim of this study was to explore the experience of CALD nursing students as lived in the Italian nursing programmes. Method: A descriptive phenomenological method was used in 2017 with the involvement of a purposeful sample of 21 CALD nursing students in five Italian Bachelor of Nursing Science campuses. Data were collected using semistructured interviews; the subsequent content analysis was conducted by two independent researchers. Results: CALD nursing students reported having lived a transformative experience based on seven themes, from "living in the middle, between belonging and detachment" to "acquiring cultural awareness and cultural sensitivity." Discussion: Dealing with linguistic and cultural differences can affected CALD students' academic success, but also encourages them to develop awareness and cultural sensitivity by influencing their peers and the environment of the nursing programme. Therefore, having CALD students is a great value for nursing programmes. Nursing programmes should embody the values of cultural sensitivity and acceptance, including them as a nursing care value and as a concrete strategy to support CALD students. They should also develop strategies to promote the knowledge and responsibilities of nurses among CALD students and increase cultural sensitivity among faculty members at different levels.

2.
Int J Older People Nurs ; 14(3): e12245, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31148416

RESUMEN

BACKGROUND: Nursing students report care of the older people as an undesirable career pathway. Positive clinical placement experiences influence students' attitudes and career intentions with respect to nursing home (NH) setting. The clinical environment's quality depends on meaningful learning opportunities, the relationship with the preceptors, and the pedagogical atmosphere as influenced by the staff-student interactions. AIM: The aim of this study was to explore nursing students' perceptions on their clinical learning experience and competence learned in the NH setting as compared to other clinical areas. METHODS: A secondary analysis was performed of an Italian national cross-sectional study involving 9,607 nursing students attending 95 different three-year bachelor laureate nursing programmes in 27 universities. A questionnaire exploring individual and nursing programme variables was devised. Moreover, students self-reported the perceived quality of the clinical learning experience using the Clinical Learning Quality Evaluation Index tool and the degree of competence learned using a four-point Likert-type scale. RESULTS: Students in the NH setting scored the overall quality of the learning environment significantly higher (p = 0.046) compared to those experiencing other clinical settings, and they scored higher learning occasions (p = 0.002) and self-directed learning opportunities (p = 0.018). No difference emerged in the perceived mean degree of competences learned at the end of the clinical rotation (p = 0.271). CONCLUSION: Nursing students perceive the NH setting to be a good quality learning environment with valuable learning opportunities and self-directed learning opportunities compared to other settings. The nursing home setting provides opportunities to acquire clinical competences comparable to the ones in other clinical settings such as hospital units. IMPLICATIONS FOR PRACTICE: Nursing home settings should be considered by all nursing programmes as a learning environment particularly worthy for students at different levels of their education.

3.
BMJ Open ; 9(3): e025575, 2019 03 20.
Artículo en Inglés | MEDLINE | ID: mdl-30898820

RESUMEN

OBJECTIVE: To explore nursing students' interprofessional educational (IPE) experiences during their most recent clinical rotation and to explore the factors supporting IPE experiences. DESIGN: National cross-sectional study on data collected in 2016. SETTING: 95 Bachelor of Nursing Sciences programmes; 27 Italian Universities. PARTICIPANTS: Students who (a) were attending or just completed their clinical rotations lasting at least 2 weeks in the same unit, and (b) willing to participate in the study. PRIMARY AND SECONDARY OUTCOMES: First to measure the occurrence of IPE experiences in the most recent clinical rotation; the secondary outcome was to discover factors associated with IPE occurrence. MEASURES: The primary outcome was measured using questions based on a 4-point Likert scale (from 0='never' to 3='always'). Explanatory variables were collected at both individual and regional levels with items included in the same questionnaire. RESULTS: 9607 out of 10 480 students took part in the study. Overall, 666 (6.9%) perceived not having had any IPE experience, while 3248 (33.8%), 3653 (38%) and 2040 (21.3%) reported having experienced IPE opportunities 'only a little', to 'some extent' or 'always', respectively. From the multilevel analysis performed using the generalised linear mixed model, factors promoting the occurrence of IPE experiences were mainly set at (a) the clinical learning environment level (high: learning environment quality, self-directed learning encouragement, learning opportunities, quality of safety and nursing care and quality of tutorial strategies); and (b) the regional level, where significant differences emerged across regions. In contrast, male gender was negatively associated with the perception of having had IPE experiences. CONCLUSIONS: A large number of nursing students experienced either 'never' or 'only a little' IPE opportunities, thus suggesting that nursing education tends to remain within the nursing profession. Limiting students' interprofessional exposure during education can prevent future collaborative approaches that have been shown to be essential in providing best patient care. In order to increase IPE exposure, it is necessary to develop strategies designed both at the singular unit and regional levels.

4.
Nurse Educ Today ; 75: 13-21, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30669021

RESUMEN

BACKGROUND: Effective performance of clinical handovers should be one of the priorities of nursing education to promote efficient communication skills and ensure patient safety. However, to date, no studies have explored to what extent nursing students are involved in handovers. OBJECTIVE: To explore nursing students' handover involvement during their clinical rotations and associated factors. METHOD: This was a secondary analysis of a large national cross-sectional study that involved 9607 undergraduate nursing students in 27 universities across 95 three-year Italian baccalaureate nursing programs. The involvement in the clinical handovers was the end point (from 0, never, to 3, always). A path analysis was performed to identify variables directly and indirectly affecting students' handover involvement. RESULTS: Handover involvement was reported as 'only a little', 'to some extent', and 'always' by 1739 (18.1%), 2939 (30.6%), and 4180 (43.5%) students, respectively; only 749 (7.8%) of students reported never being involved. At the path analysis explaining the 19.1% of variance of nursing students' involvement, some variables emerged that directly increased the likelihood of being involved in handovers. These were being female (ß = 0.115, p < 0.001); having children (ß = 0.107, p = 0.011); being a 3rd-year student (ß = 0.142, p < 0.001) and being a 2nd-year student as compared to a 1st-year student (ß = 0.050, p = 0.036); and having a longer clinical rotation (ß = 0.015, p < 0.001) in units with high 'quality of the learning environment' (ß = 0.279, p < 0.001). Moreover, students who were supervised by the nurse teacher (ß = -0.279, p < 0.001), or by a nurse on a daily basis (ß = -0.253, p = 0.004), or by the staff (ß = -0.190, p < 0.001) reported being less involved in handovers as compared to those students supervised by a clinical nurse. Variables with indirect effects also emerged (model of student's supervision adopted at the unit level, and number of previous clinical rotations attended by students). Moreover, handover involvement explained 11.5% of students self-reported degree of competences learned during the clinical experience. CONCLUSIONS: Limiting students' opportunity to be involved in handover can prevent the development of communication skills and the professional socialization processes. Strategies at different levels are needed to promote handover among undergraduate nursing students.


Asunto(s)
Pase de Guardia/estadística & datos numéricos , Preceptoría/métodos , Estudiantes de Enfermería/estadística & datos numéricos , Estudios Transversales , Bachillerato en Enfermería/métodos , Bachillerato en Enfermería/estadística & datos numéricos , Femenino , Humanos , Masculino , Preceptoría/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven
5.
Worldviews Evid Based Nurs ; 15(6): 480-490, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30328676

RESUMEN

BACKGROUND: Easy-to-access tools have been demonstrated to improve evidence-based practice (EBP) competences among nursing students. However, students' perception of access to EBP tools (e.g., clinical practice guidelines [CPGs], protocols) is unknown. AIMS: To explore: (1) nursing students' opportunity to access EBP tools during their education, and (2) associated factors. METHODS: A national cross-sectional study including all Italian nursing programs. Nursing students were deemed eligible according to the following inclusion criteria: Those who (1) were attending or just ended their practical rotation lasting at least 2 weeks at the time of the survey, and (2) expressed through written informed consent their willingness to take part in the study. Participants were asked about their perceived opportunity to access EBP tools during their most recent clinical learning experience (from 0 - not at all to 3 - always). A set of explanatory variables was collected at the individual, nursing program, and regional levels by using a questionnaire. RESULTS: Nine thousand six hundred and seven (91.6%) out of 10,480 nursing students took part in the study. Overall, 4,376 (45.6%) students perceived not at all or only a small opportunity to access EBP tools during their most recent clinical rotation. In the multilevel analysis, factors promoting access were mainly set at the clinical learning environment level (high safety and nursing care quality, high self-directed learning opportunities, high quality of the learning environment, and being supervised by a clinical nurse). In contrast, male gender and lower academic class were associated with a lower perception of accessibility to EBP tools. A consistent variability in the perceived opportunity to access EBP tools emerged across regions. LINKING EVIDENCE TO ACTION: Evidence-based decision-making is increasingly expected from nurses. Therefore, nursing faculties should safeguard and continuously improve students' competence regarding EBP, by implementing strategies mainly at the nursing program and regional levels.

6.
Med Educ ; 52(11): 1156-1166, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30345687

RESUMEN

CONTEXT: Error reporting is considered one of the most important mediating factors for patient safety (PS). However, reporting errors can be challenging for health care students. OBJECTIVES: The aims of the study were: (i) to describe nursing students' opportunity to report errors, near misses or PS issues that emerged during their clinical learning experience; and (ii) to explore associated factors of the process of reporting itself. METHODS: A national survey was conducted on 9607 (91.7%) undergraduate nursing students. The endpoint was to have reported PS issues in the last clinical learning experience (from 0 'never' to 3 'always'). Explanatory variables were set individual, nursing programme and regional levels. RESULTS: A total of 4004 (41.7%) nursing students reported PS issues from 'never/rarely' to 'sometimes'. In the multi-level analysis, factors increasing the likelihood of reporting events affecting PS have been mainly at the nursing programme level: specifically, higher learning opportunities (odds ratio [OR] = 3.040; 95% confidence interval [CI], 2.667-3.466), self-directed learning opportunities (OR = 1.491; 95% CI, 1.364-1.630), safety and nursing care quality (OR = 1.411; 95% CI, 1.250-1.594) and quality of tutorial strategies OR = 1.251; 95% CI, 1.113-1.406). By contrast, being supervised by a nurse teacher (OR = 0.523; 95% CI, 0.359-0.761) prevented the disclosure of PS issues compared with being supervised by a clinical nurse. Students attending their nursing programmes in some Italian regions showed a higher likelihood (OR from 1.346 to 2.938) of reporting PS issues compared with those undertaking their education in other regions. CONCLUSIONS: Nursing students continue to be reticent to report PS issues. Given that they represent the largest generation of future health care workers, their education regarding PS should be continuously monitored and improved; moreover, strategies aimed at developing a non-blaming culture should be designed and implemented both at the clinical learning setting and regional levels.

7.
Nurs Ethics ; : 969733018774617, 2018 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-29783904

RESUMEN

BACKGROUND: Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered. Research aims: This study was aimed at exploring nursing students' perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors. RESEARCH DESIGN: An Italian national cross-sectional study design was performed in 2015-2016. Participants were invited to answer a questionnaire composed of four sections regarding: (1) socio-demographic data, (2) previous clinical learning experiences, (3) current clinical learning experience quality and outcomes, and (4) the opportunity to discuss ethical issues with nurses in the last clinical learning experience (from 0 - 'never' to 3 - 'very much'). Participants and research context: Participants were 9607 undergraduate nursing students who were attending 95 different three-year Italian baccalaureate nursing programmes, located at 27 universities in 15 Italian regions. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after the research protocol was approved by an ethics committee. FINDINGS: Overall, 4707 (49%) perceived to have discussed ethical issues 'much' or 'very much'; among the remaining, 3683 (38.3%) and 1217 (12.7%) students reported the perception of having discussed, respectively, 'enough' or 'never' ethical issues emerged in the clinical practice. At the multivariate logistic regression analysis explaining 38.1% of the overall variance, the factors promoting ethical discussion were mainly set at the clinical learning environment levels (i.e. increased learning opportunities, self-directed learning, safety and nursing care quality, quality of the tutorial strategies, competences learned and supervision by a clinical nurse). In contrast, being male was associated with a perception of less opportunity to discuss ethical issues. CONCLUSION: Nursing faculties should assess the clinical environment prerequisites of the settings as a context of student experience before deciding on their accreditation. Moreover, the nursing faculty and nurse managers should also enhance competence with regard to discussing ethical issues with students among clinical nurses by identifying factors that hinder this learning opportunity in daily practice.

8.
Assist Inferm Ric ; 36(1): 14-23, 2017 Jan-Mar.
Artículo en Italiano | MEDLINE | ID: mdl-28398388

RESUMEN

. Teaching Methods for clinical settings: a review. INTRODUCTION: The teaching process during internship requires several methods to promote the acquisition of more complex technical skills such as relational, decisional and planning abilities. OBJECTIVE: To describe effective teaching methods to promote the learning of relational, decisional and planning skills. METHODS: A literature review of the teaching methods that have proven most effective, most appreciated by students, and most frequently used in Italian nursing schools. RESULTS: Clinical teaching is a central element to transform clinical experiences during internship in professional competences. The students are gradually brought to become more independent, because they are offered opportunities to practice in real contexts, to receive feedback, to have positive role models, to become more autonomous: all elements that facilitate and potentiate learning. CONCLUSIONS: Clinical teaching should be based on a variety of methods. The students value a gradual progression both in clinical experiences and teaching strategies from more supervised methods to methods more oriented towards reflecting on clinical practice and self-directed learning.


Asunto(s)
Competencia Clínica , Educación en Enfermería , Conocimientos, Actitudes y Práctica en Salud , Enseñanza , Humanos , Aprendizaje , Investigación Cualitativa
9.
Assist Inferm Ric ; 36(1): 41-50, 2017 Jan-Mar.
Artículo en Italiano | MEDLINE | ID: mdl-28398391

RESUMEN

. The Clinical Learning Quality Evaluation Index for nursing students. INTRODUCTION: The Italian nursing programs, the need to introduce tools evaluating the quality of the clinical learning as perceived by nursing students. Several tools already exist, however, several limitations suggesting the need to develop a new tool. AIM: A national project aimed at developing and validating a new instrument capable of measuring the clinical learning quality as experience by nursing students. METHODS: A validation study design was undertaken from 2015 to 2016. All nursing national programs (n=43) were invited to participate by including all nursing students attending regularly their clinical learning. The tool developed based upon a) literature, b) validated tools already established among other healthcare professionals, and c) consensus expressed by experts and nursing students, was administered to the eligible students. RESULTS: 9606 nursing in 27 universities (62.8%) participated. The psychometric properties of the new instrument ranged from good to excellent. According to the findings, the tool consists in 22 items and five factors: a) quality of the tutorial strategies, b) learning opportunities; c) safety and nursing care quality; d) self-direct learning; e) quality of the learning environment. CONCLUSIONS: The tool is already used. Its systematic adoption may support comparison among settings and across different programs; moreover, the tool may also support in accrediting new settings as well as in measuring the effects of strategies aimed at improving the quality of the clinical learning.


Asunto(s)
Competencia Clínica/normas , Educación en Enfermería/normas , Aprendizaje , Estudiantes de Enfermería , Encuestas y Cuestionarios/normas , Adulto , Femenino , Humanos , Italia , Masculino , Psicometría/normas , Reproducibilidad de los Resultados , Estudios Retrospectivos
10.
Clin Ther ; 39(2): 311-321, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-28126247

RESUMEN

PURPOSE: Intravenous (IV) fluid therapy is widely used in hospitalized patients. It has been internationally studied in surgical patients, but little attention to date has been dedicated to medical patients within the Italian context. The aims of the present study were to describe the prevalence of fluid therapy and associated factors among Italian patients admitted to medical and surgical units, describe the methods used to manage fluid therapy, and analyze the monitoring of patients by clinical staff. METHODS: In this cross-sectional study of 7 hospitals in northern Italy, data on individual and monitoring variables were collected, and their associations with in-hospital fluid therapy were analyzed by using logistic regression analysis. Patients aged ≥18 years who were admitted to medical and surgical units were included. Patients who received at least 500 mL of continuous fluids were included in the fluid therapy group. FINDINGS: In total, 785 (median age, 72 years; women, 52%) patients were included in the study, and 293 (37.3%) received fluid therapy. Maintenance was the most frequent reason for prescribing IV fluid therapy (59%). The mean (SD) volume delivered was 1177 (624) mL/d, and the highest volume was infused for replacement therapy (1660 [931] mL/d). The mean volume infused was 19.55 (13) mL/kg/d. The most commonly used fluid solutions were 0.9% sodium chloride (65.7%) and balanced crystalloid without glucose (32.9%). The proportion of patients assessed for urine output (52.6% vs 36.8%; P < 0.001), serum electrolyte concentrations (74.4% vs 65.0%; P = 0.005), and renal function (70.0% vs 58.7%; P = 0.002) was significantly higher in patients who did receive fluid therapy versus those who did not. In contrast, the use of weight and fluid assessments was not significantly different between the 2 groups (P = 0.216 and 0.256, respectively). Patients admitted for gastrointestinal disorders (odds ratio [OR], 3.5 [95% CI, 1.8-7.05) and for fluid/electrolyte imbalances (OR, 3.35 [95% CI, 1.06-10.52) were more likely to receive fluids. However, the likelihood of receiving fluids was lower for patients admitted to a surgical unit (OR, 0.36 [95% CI, 0.22-0.59]) and with cardiovascular diseases (OR, 0.37 [95% CI, 0.17-0.79). IMPLICATIONS: Only one third of the study patients received fluid therapy. Crystalloid fluids, are the fluids of choice for maintaining plasma volume. During fluid therapy, measurement of the serum electrolyte concentrations, renal function, and urine output was largely used while weight and fluid balance were rarely assessed.


Asunto(s)
Fluidoterapia/métodos , Soluciones Isotónicas/administración & dosificación , Anciano , Anciano de 80 o más Años , Peso Corporal , Estudios Transversales , Soluciones Cristaloides , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad
12.
Assist Inferm Ric ; 35(1): 29-35, 2016 Jan-Mar.
Artículo en Italiano | MEDLINE | ID: mdl-27183424

RESUMEN

UNLABELLED: . Validation of the Italian Clinical Learning Environment Instrument (SVIAT): study protocol. INTRODUCTION: Nursing students obtain most of their university credits in internship environments whose quality can affect their clinical learning. Several tools are available to measure the quality of the clinical learning environment (CLE) as perceived by students: these instruments developed in other countries, were validated in Italian but do not discriminate those CLEs capable (or not) to promote significant clinical learning. AIM: To validate an instrument to measure the capability of the CLE to generate clinical learning; the secondary aim is to describe the learning environments as perceived by nursing students according to individual course site and tutorial models adopted. METHODS: The study will be developed in three phases: a) instrument development and pilot phase, b) validation of the psychometric properties of the instrument and c) description of the CLEs as perceived by the students including factors/item confirmed in the validation process. Expected outcomes. A large validation, with more than 8,000 participating students is expected; the construct under lying will be confirmed through exploratory and confirmatory factor analysis and will report high internal consistency; the instrument will report also a high test-retest and inter-rater reliability; in addition, the instrument will demonstrate predictive ability by discriminating those units able (or not) to activate effective learning processes.


Asunto(s)
Educación en Enfermería/normas , Estudios de Evaluación como Asunto , Italia , Aprendizaje , Psicometría , Autoinforme
13.
J Pathog ; 2016: 1590952, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27127655

RESUMEN

We evaluated, in a preliminary study, the efficacy of umbelliferone, arbutin, and N-acetylcysteine to inhibit biofilm formation on urinary catheter. We used 20 urinary catheters: 5 catheters were incubated with Enterococcus faecalis (control group); 5 catheters were incubated with E. faecalis in presence of umbelliferone (150 mg), arbutin (60 mg), and N-acetylcysteine (150 mg) (group 1); 5 catheters were incubated with E. faecalis in presence of umbelliferone (150 mg), arbutin (60 mg), and N-acetylcysteine (400 mg) (group 2); and 5 catheters were incubated with E. faecalis in presence of umbelliferone (300 mg), arbutin (60 mg), and N-acetylcysteine (150 mg) (group 3). After 72 hours, planktonic microbial growth and microorganisms on catheter surface were assessed. In the control group, we found a planktonic load of ≥10(5) CFU/mL in the inoculation medium and retrieved 3.69 × 10(6) CFU/cm from the sessile cells adherent to the catheter surface. A significantly lower amount in planktonic (p < 0.001) and sessile (p = 0.004) bacterial load was found in group 3, showing <100 CFU/mL and 0.12 × 10(6) CFU/cm in the incubation medium and on the catheter surface, respectively. In groups 1 and 2, 1.67 × 10(6) CFU/cm and 1.77 × 10(6) CFU/cm were found on catheter surface. Our results document that umbelliferone, arbutin, and N-acetylcysteine are able to reduce E. faecalis biofilm development on the surface of urinary catheters.

14.
Eur Urol ; 69(2): 276-83, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26001610

RESUMEN

BACKGROUND: The evolution of resistant pathogens is a worldwide health crisis and adherence to European Association of Urology (EAU) guidelines on antibiotic prophylaxis may be an important way to improve antibiotic stewardship and reduce patient harm and costs. OBJECTIVE: To evaluate the prevalence of antibiotic-resistant bacterial strains and health care costs during a period of adherence to EAU guidelines in a tertiary referral urologic institution. DESIGN, SETTING, AND PARTICIPANTS: A protocol for adherence to EAU guidelines for antibiotic prophylaxis for all urologic procedures was introduced in January 2011. Data for 3529 urologic procedures performed between January 2011 and December 2013 after protocol introduction were compared with data for 2619 procedures performed between January 2008 and December 2010 before protocol implementation. The prevalence of bacterial resistance and health care costs were compared between the two periods. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The outcome measures were the proportion of resistant uropathogens and costs related to antibiotic consumption and symptomatic postoperative infection. We used χ2 and Fisher's exact tests to test the significance of differences. RESULTS AND LIMITATIONS: The proportion of patients with symptomatic postoperative infection did not differ (180/3529 [5.1%] vs. 117/2619 [4.5%]; p=0.27). A total of 342 isolates from all patients with symptomatic postoperative infections were analysed. The rate of resistance of Escherichia coli to piperacillin/tazobactam (9.1% vs. 5.4%; p=0.03), gentamicin (18.3% vs. 11.2%; p=0.02), and ciprofloxacin (32.3% vs. 19.1%; p=0.03) decreased significantly after protocol introduction. The defined daily dose (DDD) use of ciprofloxacin fell from 4.2 to 0.2 DDD per 100 patient-days after implementation (p<0.001). Antibiotic drug costs (€76,980 vs. €36,700) and costs related to postoperative infections (€45,870 vs. €29,560) decreased following introduction of the protocol (p<0.001). CONCLUSIONS: Adherence to EAU guidelines on antibiotic prophylaxis reduced antibiotic usage without increasing post-operative infection rate and lowered the prevalence of resistant uropathogens. PATIENT SUMMARY: We analysed the impact of adherence to European Association of Urology guidelines on antibiotic prophylaxis for all surgical urologic procedures on the prevalence of infections and resistant bacterial strains and on costs. We found that adherence to the guidelines reduced the rate of bacterial resistance, in particular against piperacillin/tazobactam, gentamicin, and ciprofloxacin, and reduced costs without increasing the risk of postoperative infection after urologic procedures. We recommend adherence to the guidelines as an important part of antibiotic stewardship programmes.


Asunto(s)
Antibacterianos/uso terapéutico , Profilaxis Antibiótica/normas , Farmacorresistencia Bacteriana , Adhesión a Directriz , Urología/normas , Anciano , Anciano de 80 o más Años , Antibacterianos/economía , Ciprofloxacino/uso terapéutico , Escherichia coli/efectos de los fármacos , Europa (Continente) , Femenino , Gentamicinas/uso terapéutico , Humanos , Klebsiella/efectos de los fármacos , Masculino , Persona de Mediana Edad , Ácido Penicilánico/análogos & derivados , Ácido Penicilánico/uso terapéutico , Piperacilina/uso terapéutico , Combinación Piperacilina y Tazobactam , Guías de Práctica Clínica como Asunto , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Procedimientos Quirúrgicos Urológicos/efectos adversos , Procedimientos Quirúrgicos Urológicos/normas
15.
Assist Inferm Ric ; 33(4): 183-8, 2014 Oct-Dec.
Artículo en Italiano | MEDLINE | ID: mdl-25532922

RESUMEN

INTRODUCTION: Updating clinical practice guidelines (CPGs) is a crucial process for maintaining the validity of recommendations. However, the updating process should be explicit and changes made highlighted in the updated text. AIM: To confront and compare two CPGs on hand hygiene (World Health Organization, WHO, 2009 and Centres for Disease Control, CDC 2002), to identify discrepancies and changes made. RESULTS: Although mostly comparable, CDC and WHO guidelines use a different terminology on hand hygiene which could be onfounding: in the former handwashing includes the use of plain soap in the latter also the use of an antimicrobial soap. The lack of a glossary may render tricky the interpretation. Some problems in retrieving the evidence base of a recommendation are highlighted. CONCLUSIONS: Great attention should be paid before implementing an updated guideline. The need of essential and easy to consult guidelines, where in the updated version the news and modifications are highlighted are stressed.


Asunto(s)
Infección Hospitalaria/enfermería , Toma de Decisiones , Adhesión a Directriz , Higiene de las Manos , Control de Infecciones , Rol de la Enfermera , Infección Hospitalaria/prevención & control , Guías como Asunto , Higiene de las Manos/normas , Humanos , Control de Infecciones/normas , Italia , Reproducibilidad de los Resultados , Organización Mundial de la Salud
16.
Assist Inferm Ric ; 33(4): 219-26, 2014 Oct-Dec.
Artículo en Italiano | MEDLINE | ID: mdl-25532928

RESUMEN

The Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE Working Group) has developed a system for grading the quality of evidence. Over 20 organizations including the World Health Organization (WHO) have adopted it. The quality of a body of evidence involves consideration of within-study risk of bias (methodological quality), directness of evidence, heterogeneity, precision of effect estimates and risk of publication bias, and the system considers the assessment of the quality of a body of evidence for each individual outcome. The GRADE approach specifies four levels of quality. Randomized trials, usually the highest grade of evidence, can be downgraded depending on the presence of the methodological problems. A brief overview of the grade system is presented.


Asunto(s)
Enfermería Basada en la Evidencia , Necesidades y Demandas de Servicios de Salud , Atención de Enfermería , Medicina de Precisión/enfermería , Calidad de la Atención de Salud , Enfermería Basada en la Evidencia/normas , Guías como Asunto , Humanos , Italia , Atención de Enfermería/normas , Calidad de la Atención de Salud/normas , Ensayos Clínicos Controlados Aleatorios como Asunto , Sociedades Médicas , Organización Mundial de la Salud
18.
Assist Inferm Ric ; 32(4): 172-4, 2013 Oct-Dec.
Artículo en Italiano | MEDLINE | ID: mdl-24441459

RESUMEN

Why a dossier on qualitative research. The main reasons for a dossier on qualitative research are presented, together with strengths and weaknesses of qualitative research compared to quantitative. The different perspectives offered by the two methods on the exploration and interpretation of phenomena are briefly described.


Asunto(s)
Documentación , Investigación en Enfermería/métodos , Investigación Cualitativa , Humanos , Italia , Investigación en Enfermería/normas , Publicaciones Periódicas como Asunto/normas , Proyectos de Investigación
19.
Assist Inferm Ric ; 32(4): 188-96, 2013 Oct-Dec.
Artículo en Italiano | MEDLINE | ID: mdl-24441462

RESUMEN

Good and bad examples of qualitative research. Not all the research papers are of good quality and contribute to the development of the knowledge. Good and less good examples of qualitative research are presented and commented on, exploring their contribution to the knowledge of a subject, and motivating why the research can be considered a good or less good example.


Asunto(s)
Neoplasias/enfermería , Investigación Metodológica en Enfermería , Cuidados Paliativos , Investigación Cualitativa , Proyectos de Investigación , Suicidio Asistido , Humanos , Italia , Investigación Metodológica en Enfermería/métodos , Investigación Metodológica en Enfermería/normas , Proyectos de Investigación/normas , Encuestas y Cuestionarios
20.
Assist Inferm Ric ; 31(3): 145-50, 2012 Jul-Sep.
Artículo en Italiano | MEDLINE | ID: mdl-23164967

RESUMEN

Hydration with hypodermoclysis in elderly patients. Hypodermoclysis is a technique which consists in the administration of fluids into the subcutaneous tissue for the treatment of mild to moderate dehydration. The article starts from the case of a 74 year old man that, after a stroke, was unable to eat or drink, and was then hydrated with continuous hypodermoclysis for 45 days, obtaining a recovery of the clinical and psychological conditions. An update of the available knowledge on hypodermoclisis, together with some comments on the clinical case are presented.


Asunto(s)
Deshidratación/enfermería , Electrólitos/administración & dosificación , Hipodermoclisis/enfermería , Anciano , Deshidratación/terapia , Humanos , Hipodermoclisis/métodos , Masculino , Resultado del Tratamiento
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