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1.
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.

2.
Nurs Ethics ; : 969733019834976, 2019 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-30966867

RESUMEN

BACKGROUND: Moral distress is an increasingly documented problem in nursing and might foster nurses' intention to leave their workplace. It has been studied in different settings, but no specific research has been conducted in Italian correctional facilities. A recent Italian study produced a preliminary validation of the Moral Distress Scale for Correctional Nurses, which needs to be completed. OBJECTIVES: To investigate the level of moral distress of nurses working in the Italian correctional setting, by completing the validation process of the Moral Distress Scale for Correctional Nurses. METHODOLOGY: Multicenter questionnaire survey. All correctional nurses (461) affiliated with the Italian Society of Medicine and Penitentiary Health (also called "Simspe-onlus") were invited to participate and 238 responded. The survey was conducted between April and November 2017 through SurveyMonkey®. Analysis of covariance was conducted to investigate the relationship between moral distress and the other variables under study. Exploratory factor analysis was conducted on the scale to confirm its dimensions. ETHICAL CONSIDERATIONS: The study was approved by the Italian Society of Medicine and Penitentiary Health (Simspe-onlus). The questionnaire included informed consent, pursuant to the law in force. The software could not accept questionnaires without explicit consent. Data were analyzed anonymously. FINDINGS: The median score was 46.5, indicating moderate moral distress. The only variable affecting moral distress was work experience in correctional facilities. Longer experience was correlated to higher levels of moral distress and intention to leave. Incompetent colleagues and short staffing were related to higher levels of moral distress. The scale confirmed the one-dimensional structure suggested by the original authors. DISCUSSION: This is the first study investigating moral distress among Correctional Nurses. The prison context is a high-risk environment for nurses, increasing the intention to leave the workplace. CONCLUSION: Corrective and protective measures, such as specific education, are needed to prevent moral distress development and to reduce nurses' shortage in this area.

3.
Minerva Anestesiol ; 85(8): 886-898, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30947484

RESUMEN

INTRODUCTION: The underlying clinical condition and the Intensive Care Unit (ICU) environment make critical illness a stressful event. Although the usual management consists of sedation, non-pharmacological interventions such as music therapy have been suggested for their drug-sparing effect. Aim of the present review is to assess the current evidence on the effectiveness of music therapy in reducing stress and anxiety in critically ill, adult patients. EVIDENCE ACQUISITION: A systematic review of publications was undertaken using MEDLINE, CINAHL, Cochrane Library, Scopus, Web of Science, Indice Italiano di Letteratura di Scienze Infermieristiche. We included studies of critically ill patients that assessed any effect of music therapy on stress and anxiety, which were variably assessed according to each study's definition. EVIDENCE SYNTHESIS: Eleven studies were included (10 RCTs and one quasi-experimental design), for a total of 959 patients (range 17-373). The overall quality of the studies was satisfactory; several potential sources for bias were identified. Music therapy was generally provided as a single, 30'-intervention, ranging from 15 to 60'. Only in two studies was the intervention repeated more than once daily. The control groups were standard care, relaxation, headphones with no music or noise-cancelling headphones. Music therapy determined a significant reduction in the levels of anxiety and stress, as assessed by self-reported scales and physiologic parameters. Pooled analysis was not performed due to the heterogeneity of the interventions. CONCLUSIONS: Despite significant heterogeneity in trial designs, timing and features of the intervention, music therapy is consistently associated with a reduction in anxiety and stress of critically ill patients.

4.
Nurse Educ Today ; 78: 19-24, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31029954

RESUMEN

BACKGROUND: Malnutrition is a debilitating and highly prevalent condition in acute hospital settings especially in older person; however international literature revealed negative attitudes in providing nutritional care among nurses and health professionals. Few studies have investigated attitudes towards nutritional care among nursing students, there are no data regarding the Italian context. OBJECTIVES: The aim of this study was to explore nursing students' attitudes towards nutritional care in older people. DESIGN: A multicentre cross-sectional survey incorporating a pre post design. SETTING AND PARTICIPANTS: A convenience sample of nursing students of the bachelor's degree in Nursing in the three hospitals were recruited. METHODS: Nursing students completed "The Staff Attitudes to Nutritional Nursing Care Geriatric Scale (Italian version) (SANN_GITA scale)"; first year students completed the scale before (T0) and after (T1) lectures about nutrition and nutritional care. RESULTS: 245 students were enrolled (response rate 88.4%). The overall score of sample attitudes was Median(Me) = 66 (IQR = [60; 72]); at the variation of the year the neutral attitudes are prevalent with a significant tendency to increase the positive attitudes (p < .003) and there is a statistically significant difference (p < .05) in all dimensions except the "habits" dimension "(P = .1126). After two months from the end of the lessons regarding nutritional care there is an increase in subjects with neutral attitudes and a decrease in those with negative attitudes (P = .05). CONCLUSIONS: This study revealed a progressive improvement of the attitudes during the three-year course, underling the importance of nutritional contents provided; understanding the most critical aspects about nutritional care can be helpful in understanding in which areas university education should be improved, in order to train nurses able to assess and face with each patients' assistance need.


Asunto(s)
Actitud del Personal de Salud , Apoyo Nutricional/métodos , Estudiantes de Enfermería/psicología , Adulto , Estudios Transversales , Femenino , Enfermería Geriátrica/métodos , Enfermería Geriátrica/normas , Humanos , Italia , Masculino , Apoyo Nutricional/normas , Encuestas y Cuestionarios
5.
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.

6.
Riv Psichiatr ; 54(1): 31-36, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30760935

RESUMEN

AIM: People with mental disorders have higher risk of suicide compared to the general population. Assessment of risk factors can help nurses reducing suicidal risk. The Nurses' Global Assessment of Suicide Risk scale (NGASR) has proven valid and reliable in supporting the nursing evaluation of suicidal risk in different studies. The aim of the study was to examine the psychometric properties of the NGASR in the Italian population. METHODS: We translated the scale and administered it to a sample of 121 patients admitted to acute psychiatric wards. RESULTS: The Content Validity Index-Scale (CVI-S) was 96.7%, the correlation with the Scale for Suicide Ideation (SSI) score was high (r=.98, p<.001). Inter-rater reliability (rho=.97, p<.001), and test-retest stability (p=.96) were satisfactory. Factor analysis pointed out 5 factors and the 15 items of the NGASR-ita explained 61.29% of total variance. Of the 121 subjects assessed upon admission, 25.62% had average or higher suicidal risk. DISCUSSION AND CONCLUSIONS: The use of valid screening tools in support of Suicide risk assessment is recommended. The NGASR-ita is a valid and reliable tool, suitable for nursing assessment of suicidal risk in the acute psychiatric setting.


Asunto(s)
Trastornos Mentales/enfermería , Evaluación en Enfermería , Escalas de Valoración Psiquiátrica , Ideación Suicida , Suicidio/psicología , Encuestas y Cuestionarios , Adulto , Urgencias Médicas , Femenino , Humanos , Pacientes Internos/psicología , Italia , Masculino , Trastornos Mentales/psicología , Variaciones Dependientes del Observador , Servicio de Psiquiatría en Hospital , Psicometría , Reproducibilidad de los Resultados , Medición de Riesgo , Factores de Riesgo , Traducciones
7.
Br J Nurs ; 28(3): 193-197, 2019 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-30746967

RESUMEN

BACKGROUND:: the need for health care to be safe is increasingly guiding the development of policies to improve clinical practice and education; risk management and patient safety are essential competencies for health professionals. OBJECTIVE:: to examine how students working towards different degrees in Italy perceived their competence in clinical risk management and patient safety when learning in the classroom and the clinical setting. METHODS:: the Italian version of the H-PEPSS questionnaire was given to 154 students; 78 were studying for a nursing degree and 76 were on the cardio-circulatory pathophysiology and cardiovascular perfusion techniques (CPCPT) degree course. RESULTS:: nearly half of the students (46.10%) did not feel confident about their competence in patient safety and risk management during clinical training. CONCLUSION:: significant differences in confidence between the two types of students were found in many areas, including in critical aspects of clinical risk management. However, both types of students had similar levels of confidence in some essential areas.


Asunto(s)
Actitud del Personal de Salud , Competencia Clínica , Seguridad del Paciente , Estudiantes del Área de la Salud/psicología , Estudiantes de Enfermería/psicología , Humanos , Italia , Aprendizaje , Investigación en Educación de Enfermería , Encuestas y Cuestionarios
9.
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
10.
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.

11.
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.

12.
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.

13.
Med Lav ; 109(2): 97-109, 2018 02 06.
Artículo en Inglés | MEDLINE | ID: mdl-29701626

RESUMEN

INTRODUCTION: Moral Distress (MD) is a common experience among nurses and if it is not recognised and treated, it may lead to serious consequences on nurses' health and quality of care. MD has been studied in several healthcare contexts. However, there are only few studies on MD in psychiatry and in Italy there are no data in this field.  Objective: To assess the presence of MD among mental health nurses in Italy and verify whether there is a relationship between MD and burnout. METHODS: We conducted a multicentre survey among nurses of Mental Health services of four hospitals in Milan. The MD Scale for Psychiatric NursesItalianrevised (MDS-PItarev) and the Maslach Burnout Inventory (MBI) were used for data collection. Factor analysis and calculation of content validity index (CVI) and Cronbach's alpha were performed on the Italian version of the MDS-PIta. Three items of the old version of the scale were removed, because judged not relevant in the Italian context. The revised scale maintained excellent CVI (0.89) and Cronbach's alpha (0.93). RESULTS: Of 285 questionnaires distributed, 228 (80%) were returned. The median of MD was 2 (scale range 0-6); MD is correlated with two burnout dimensions: emotional exhaustion (rho(ρ)=0.28, p<0,001) and depersonalization (ρ=0.20, p<0,001). CONCLUSIONS: This is the first study about MD among psychiatric nurses in Italy. We found a medium-low level of MD among nurses who participated in the survey. We also found a modest but significant correlation between MD and two dimensions of MBI. Further studies are needed to confirm these results.


Asunto(s)
Agotamiento Profesional/enfermería , Despersonalización/enfermería , Salud Mental , Principios Morales , Enfermería Psiquiátrica , Adulto , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Estudios Transversales , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Inventario de Personalidad , Enfermería Psiquiátrica/estadística & datos numéricos , Psicometría , Encuestas y Cuestionarios , Recursos Humanos
14.
Minerva Anestesiol ; 84(10): 1150-1159, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29589416

RESUMEN

BACKGROUND: In ICU, the stay is frequently a stressful experience. Caregivers may help to understand patients' perceptions; however, their reliability is uncertain. Despite the recent recommendations of lighter sedation targets, little is known about the impact of "conscious sedation" on ICU patients memories. Purpose of this prospective, observational study is to analyze the stress perception in consciously-sedated ICU-patients, comparing it to caregivers and staff members. METHODS: Twenty-nine high-risk ICU-patients treated with awake/cooperative sedation were enrolled. Before discharge, patients received a validated questionnaire for ICU stressors evaluation, also administered to their main caregiver (N.=29), to caregivers of other ICU patients not enrolled in the study (N.=33) and to staff members (ICU nurses, attending physicians, residents, medical students, N.=56). RESULTS: Total stress score was: patients 141±41, patient relatives 210±63, other relatives: 202±73, ICU staff: 232±44, P<0.001. Among patients, older age (P=0.031), longer ICU-stay (P=0.018) and awake-sedation (P=0.022) were associated with lower stress; sex and illness severity had no effect; mechanical ventilation length (P=0.021) and agitation (P=0.029) were associated with higher stress. Nurses tended to overestimate stressors more than attending physicians and trainees. Within staff members, age (P=0.021) and years of experience (P=0.069) were positively associated with overestimation. CONCLUSIONS: Conscious sedation is associated with stress perception lower than stress assessed by caregivers: relatives and staff members tend to overestimate ICU patient stress, more so with increasing age or expertise. A number of stressors underestimated by staff and families could be target of specific interventions to ameliorate quality of life during ICU stay.

15.
Recenti Prog Med ; 109(2): 137-138, 2018 Feb.
Artículo en Italiano | MEDLINE | ID: mdl-29493641

RESUMEN

AIM: To investigate the prevalence of metabolic syndrome (MS) among nurses, as well as the organizational impact of work-related stress as a consequence of MS among nurses in Italy. To study the organizational models, turnover rates, and job satisfaction among nurses, in a sample of Italian healthcare facilities. BACKGROUND: MS is considered an important metabolic disorder in the modern world, responsible for diseases with economic effects on hospitals. Shift work (SW) seems to be a risk factor for MS, while the Mediterranean diet appears to be protective. Work-related stress causes loss of working days, and generates high costs for hospitals. DESIGN: Prospective observational study. METHODS: The first step will be to create and validate a questionnaire to investigate the prevalence of MS among Italian nurses. The second step will be to estimate the risk of work-related stress. Data regarding absenteeism and turnover will be collected, as indicators of impact on organization. DISCUSSION: This study is the first to investigate the previously describe SW's factors and their impact on organizing nursing work. This study is relevant for the organizations because it helps to define organizational strategies that permit nurses to remain healthy, to be work efficient and therefore to be able to provide high level care.

16.
Community Ment Health J ; 54(1): 66-72, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-28647819

RESUMEN

Prejudices on psychiatric disorders frequently turn into stigmatizating attitudes, also among health care providers. The Opening Minds Stigma Scale for Health Care Providers (OMS-HC) was introduced in 2012 to measure stigma. No Italian versions of this tool exist so far. We wanted to investigate stigma among healthcare students in Italy, and to prepare an Italian version of the scale. A multicentric, cross-sectional study was conducted on a sample of Nursing, Physiotherapy, Occupational therapy, and Dietistics students. The Italian version of the scale was obtained through back-translation.561 students were enrolled, median age 21 years, IQR [20;23], 62.22% females (n = 349). 262 students declared having met subjetcs affected by psychiatric disorders during their training; 50 had one or more psychiatric disorders in their lives. The Italian version proved valid and reliable. Older students had lower stigma scores. No differences existed between stigma scores according to gender and personal experience of mental illness.

17.
Open Nurs J ; 11: 84-90, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28839512

RESUMEN

BACKGROUND: Capillary refill time has been studied in literature as a perfusion indicator. Two pilot studies have proposed possible reference values in healthy adults. No data exist regarding capillary refill time as an indicator of abnormal clinical conditions in adults, which might be of help for triage nurses. OBJECTIVE: We wanted to assess if any relationships existed, between altered capillary refill time and abnormal clinical conditions in the emergency department. We investigated relations between capillary refill time and vital signs recorded in triage and blood tests, by analyzing the clinical records. Mortality at 24 hours, 7 days and over 14 days was investigated by calling the patients after discharge. METHOD: Observational, single-center study on a sample of consecutive patients aged ≥ 18 years in the Emergency Department of a major Milan hospital, from June to October 2014. Multivariate logistic regression was used to investigate the impact of clinical variables on capillary refill time. RESULTS: 1001 patients were enrolled, aged 59 ± 21 (473 aged 65 or more). Longer refill times were found in patients admitted to hospital units after medical consultations in the emergency department compared to those discharged or sent to outpatients. In elderly patients, statistically significant association was found between increased capillary refill time and sepsis (sensitivity 100%, specificity 83.33%, area under the receiver operating characteristics curve 65.95% CI 47-83), oxygen saturation, mean blood pressure, and lactates. In persons aged 45 to 64, altered refill times were associated with abnormal values of glicemia, platelets, and urea. CONCLUSION: Capillary refill time can be used by nurses at triage as a complementary parameter to normal vital signs. This is one of the few studies investigating refill time in adult patients.

18.
J Clin Nurs ; 26(23-24): 5082-5092, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28833723

RESUMEN

AIMS AND OBJECTIVES: To determine and compare the prevalence of malnutrition in medical and surgical hospital units; to assess quality of nutritional care and patients' perception about quality of food and nutritional care. BACKGROUND: Hospital malnutrition in older people leads to increased mortality, length of stay, risk of infections and pressure ulcers. Several studies show that malnutrition is often caused by hospitalisation and related to poor nutritional care. Few studies report data on surgical older patients. DESIGN: A cross-sectional, multicenter study was conducted in 12 hospitals in northern Italy. METHODS: Malnutrition prevalence was determined according to the Mini Nutritional Assessment full-version. Head nurses were interviewed in 80 units, through a validated questionnaire regarding quality of nutritional care. Semi-structured interviews were administered to a sample of patients, to investigate their perception about quality of food and nutritional care. RESULTS: Two hundred twenty-eight patients of 1,066 were malnourished (21.4%). Medical patients were at higher risk, so were women, patients aged 85 or more, with impaired autonomy, pressure ulcers or taking more than three drugs. The lack of personnel impacts on quality of care: in 55% of the units, no nutritional screening is performed; nutritional history is investigated in 48% only. No protocols for nutritional problems exist in 70% of the wards; hardly ever the intake is measured. Patients are mostly satisfied, even though they report that food has no taste and is not well presented. They remark the need for more personnel. CONCLUSION: Prevalence was high, as found in other studies. Medical patients were at higher risk. Nutritional care was inadequate, and often no measures were adopted to prevent malnutrition. Staffing should be increased during meals. RELEVANCE TO CLINICAL PRACTICE: These findings will provide indications on the strategies needed to overcome such barriers.


Asunto(s)
Hospitalización/estadística & datos numéricos , Desnutrición/epidemiología , Evaluación Nutricional , Apoyo Nutricional/normas , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Italia/epidemiología , Masculino , Desnutrición/diagnóstico , Desnutrición/enfermería , Persona de Mediana Edad , Prevalencia , Encuestas y Cuestionarios
19.
Br J Nurs ; 26(15): 882-888, 2017 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-28792842

RESUMEN

AIM: Handover, in particular between two shifts, is a crucial aspect of nursing for patient safety, aimed at ensuring continuity of care. During this process, several factors can affect quality of care and cause errors. This study aimed to assess quality of handovers, by validating the Handoff CEX-Italian scale. METHOD: The scale was translated from English into Italian and the content validity index was calculated and internal consistency assessed. The scale was used in several units of the San Paolo Teaching Hospital in Milan, Italy. RESULTS: A total of 48 reports were assessed (192 evaluations). The median score was 6, interquartile range (IQR) [5;7] and was not influenced by specific (p=0.21) or overall working experience (p=0.13). The domains showing the lowest median values (median=6, IQR [4;8]) were context, communication, and organisation. Night to morning handovers obtained the lowest scores. CVI-S was 0.96, Cronbach's alpha was 0.79. DISCUSSION: The Handoff CEX-Italian scale is valid and reliable and it can be used to assess the quality of nurse handovers.


Asunto(s)
Personal de Enfermería en Hospital/normas , Pase de Guardia/normas , Calidad de la Atención de Salud , Humanos , Italia , Seguridad del Paciente/normas
20.
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
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