[The assessment of the impact of education and support to nursing research on nurses' scientific production in an Emilia Romagna Hospital]. / Valutazione dell'impatto della formazione e del supporto alla ricerca infermieristica sulla produttività scientifica in un ospedale dell'Emilia Romagna.

INTRODUCTION: In Italy research conducted by non medical professions is scarce also for the lack of knowledge on methods. At Rizzoli hospital in Bologna in 2006 a Centre for research to educate and support health professionals was implemented. AIM: To assess the impact of the research centre on number of research articles and protocols produced by nurses. METHODS: Interrupted time series. In the five years before and after the implementation of the centre data on the number of protocols approved by Ethical Committee with a nurse as principal investigator and on the number of articles published on impacted journals with a nurse as first author were collected. The number of nurses authors of the publications was also collected. RESULTS: For all the variables an increasing trend, starting from 2006 was observed, with statistically significant differences from 2008 for the number of research protocols presented (p=0.037), the number of nurses authors of scientific articles (p=0.027). Although the number of publications on impacted journals increased from 2006, differences were not statistically significant after 2008. CONCLUSIONS: An hospital based Centre for education and support to research for health professionals may facilitate the scientific and research production.

[Effectiveness of the transparent sterile dressing vs standard to fix the peripheral venous catheter (PVC) on the incidence of phlebitis. A randomized controlled trial]. / Efficacia della medicazione sterile trasparente rispetto a quella standard per il fissaggio del catetere venoso periferico (CVP) sull'incidenza delle flebiti.Trial randomizzato e controllato.

UNLABELLED: Effectiveness of the transparent sterile dressing vs standard to fix the peripheral venous catheter (PVC), on the incidence of phlebitis. A randomized controlled trial. INTRODUCTION: The type of dressing could contribute to the incidence of phlebitis, infiltration and accidental removals but the results of the studies are contrasting and samples are limited. AIM: To compare the effectiveness of a transparent polyurethane sterile dressing on the rate of phlebitis associated to peripheral venous catheter (PVC) vs a non sterile sticking plaster in use in current practice (standard dressing). DESIGN: Randomized controlled trial. Participants. 1061 PVCs (703 patients, adults and children) at a research orthopedic hospital in the north of Italy; 540 PVCs allocated to receive the sterile and 521 the standard dressing. RESULTS: 96 PVCs were excluded for phlebitis, 48 (9.6%) in the sterile and 48 (10.1%) in the standard dressing group, RR 0.96 (95%CI 0.697 - 1.335). Accidental removal of the PVCs was more frequent with the sterile dressing (9.6% vs 6.3%) but the number of catheters removed without complications was larger in the standard dressing group (48.9% vs 54.9% P=0.0503). Eighty-five PVCs were replaced for detachment of the dressing (50, 9.2% sterile and 35, 6.7% standard dressing). The cheapest transparent sterile dressing costs 32 cents while the standard 9 cents. CONCLUSIONS: A sticking non sterile plasters is not influential on the rate of phlebitis and ensures an good fix of the PVC compared the transparent sterile dressing to of polyurethane film.

Use of polyurethane foam inside plaster casts to prevent the onset of heel sores in the population at risk. A controlled clinical study.

AIM: The aim of this study was to test the effectiveness of polyurethane foam in contact with the heel inside a plaster cast to decrease the rate of pressure sores in the population at most risk. BACKGROUND: The rate of pressure sores caused by the plaster cast is reported to be 14-15% in the paediatric population, 33.3% in patients having undergone chemotherapy for bone tumours and 43% in orthopaedic patients who already have sore skin when the cast is applied (grade 1 lesion) to the heel. DESIGN: Controlled clinical trial. METHODS: From November 2007-January 2009, all consecutive subjects requiring lower limb casts having undergone chemotherapy and/or presenting heel soreness received polyurethane foam in contact with the skin of the heel before applying the cast. The results were compared with those of patients with the same risk factors but were not administered the foam and were enrolled from May 2005-August 2006. RESULTS: In total, 156 patients were enrolled, 85 in the control group and 71 in the experimental group. In the experimental group, 2 of the 56 patients (3.6%) with sore skin developed a pressure sore compared with 21 of 49 (42.9%) in the control group without polyurethane foam (p < 0.0005). In the experimental group, one of the 24 patients (4.2%) patients undergoing chemotherapy developed a pressure sore compared with 18 of 54 (33.3%) in the control group (p = 0.005). CONCLUSIONS: Placing polyurethane foam in contact with the skin of the heel inside a plaster cast prevents the formation of pressure sores. RELEVANCE TO CLINICAL PRACTICE: This study provides evidence that using polyurethane foam to prevent sores even inside plaster casts in populations at most risk is a simple and cost-effective strategy and decreases the discomfort, pain and risks in these patients.

[Cohort study of peripheral catheter related complications and identification of predictive factors in a population of orthopedic patients]. / Studio di coorte sulla popolazione ortopedica delle complicanze correlate all'utilizzo del catetere venoso periferico e identificazione dei fattori predittivi.

INTRODUCTION: Peripheral venous catheters (PVC) may cause complications, specifically local. Their management varies across health care workers and wards, and guidelines recommendations are often weak and based on experts' opinion. AIM: To measure the incidence of PVCs phlebitis, occlusions, accidental removal and infiltrations and their predictive factors in an orthopedic population. METHODS: From may 4 2009 to 30, in an orthopedic hospital, data on patients to whom a PVC was inserted were collected: patient's and PVC characteristics, management and securing strategies, until one of the following outcomes: phlebitis, occlusion, accidental removal, infiltration or end of treatment. RESULTS: Overall, 873 patients were recruited and 139 PVCs. The following complications occurred: phlebitis 10.9%; occlusions 16.8%; accidental removals 5.8%, local infiltrations 14.4%; 648 PVCs (46.5%) were removed without complications. The risk for all complications (multivariate analysis) increased with age and for the other complications also with the administration of blood transfusions thorough PVC, irritant drugs and use >3 times/day for phlebitis; small gauge, not using PVC and surgical site infections for occlusions; positioning the PVC in the hand and fixing the PVC with the Chevron method for accidental removals; and female sex, transfusions and thromboembolic therapy for infiltrations. CONCLUSIONS: The incidence of phlebitis is high compared to the gold standard of 5%. Knowing the incidence of main complications is a requirement for any improvement strategy and may favor the abandonment of useless or dangerous practices.