Acute myocardium infarction: difficulties and interventions perceived by Italian nurses and physicians.

BACKGROUND: Among cardiovascular diseases, acute coronary syndrome is the main cause of mortality and morbidity in the Western industrialized countries. Evidence suggested how continuous updating in cardiovascular area both for nurses and physicians was essential to improve patient outcomes in clinical process, welfare and rehabilitation, since physicians and nurses could play a key role in empowering the care of patients affected by the acute myocardium infarction (AMI). Although the correlation between continuous training and improvement of nursing care was therefore clear, the difficulties that nurses encountered in AMI patients' management remained unexplored. The present study aimed to identify any difficulties that both nurses and physicians in emergency/urgent departments encountered in the AMI patient care. METHODS: An observational, cross sectional, multicenter online study was conducted, in online mode. An ad hoc questionnaire was created and publicized through social networks, collecting only nurses and physicians. RESULTS: A total of 401 nurses and physicians were recruited. Significant association was assessed between the importance of the re-training participation and the item regarding: "To implement strategies to avoid excessive patient stress," since healthcare workers who constantly re-trained their competences encountered less difficulties than the others (P=0.002). By considering associations between the re-training condition and any interventions implemented by the interviewer to prevent or reduce the psycho-physical stress in AMI patients, a significant association (P=0.017) was assessed between the re-training condition and the improvement of the sleep-rest model (item no. 20), since healthcare professionals who re-trained their competences in the AMI care promoted regular rest condition in the AMI patients. CONCLUSIONS: The study highlighted the importance of basic and advanced training both for physicians and nurses in the AMI patient care, by demonstrating how health promotion and therapeutic education and information could be important to the AMI patient care.

A new prognostic pelvic injury outcome score.

Aim To propose a new prognostic classification system for pelvic injuries based on a new detailed and all-encompassing evaluation of the injury pelvic outcome score and to check the prognostic value of this classification and evaluate its reliability and reproducibility. Methods From January 2017 to June 2020 from 156 pelvic fractures treated at our hospitals, 98 patients with pelvic fractures were recruited according to inclusion and exclusion criteria. All patients compiled three scores (New Score System, Majeed Score, SF-12) sessions two times during the hospital stay to evaluate the endpoint before the trauma and two years after the trauma. All patients carried out three tests independently. The evaluation of three scores included a pelvic and general complication after the surgery, the times needed to compile three score system. For reliability of the new score systems we evaluated the inter-observer or intraobserver agreement, the prediction strength of each score, and a prognostic value. Results A total of 98 patients were enrolled (74 were males and 24 females) with mean age of 43.6 (±18.6) (range 16-75) years. Tau B Kendall value was 0.827 for the new score system, 0.673 for the Majeed score, 0.746 for SF-12, there was p<0.05 for the new score system. Conclusion The new score system is prognostic, reliable, reproducible and can become a useful instrument to adequately correlate the long-term outcomes of pelvic injury fractures. Also, it provides a better evaluation of pain, work, sexual possibilities and satisfaction, balance-sitting-walking and psychological status.